The Scientific Debate on Khat Addiction: Evidence Across Humans, Animals, and Policy Domains

Abstract

Khat’s addictive status is highly contested, shaped by conflicting evidence, varied epidemiology, and politically charged regulation. Although its psychoactive alkaloids, cathinone and cathine, are controlled in several jurisdictions, khat itself remains ambiguously regulated, as shown by the UK’s 2014 move to classify it as a Class C drug, a decision driven as much by sociopolitical narratives as pharmacology. WHO assessments describe khat as capable of producing mild to moderate psychological dependence, with harms linked more to patterns of use and structural vulnerabilities than alkaloid exposure alone. Human studies show widely differing dependence rates due to cultural factors and inconsistent diagnostic tools, and recent adolescent research warns against equating prevalence with addiction without validated measures. Limited preclinical work finds khat extract can induce conditioned place preference and relapse-like behavior, though weaker than classic stimulants. Evidence-based treatments remain underdeveloped. Progress requires standardized assessments, expanded neurobehavioral studies, and community-grounded interventions.