Contemporary Trends in the Use of Khat for Recreational Purposes and Its Possible Health Implications

Khat is an ancient class C drug substance that is usually consumed for its stimulating effects induced by the intake of psychoactive alkaloids—cathinone and cathine which have been identified as precursors for oral cancer and impotence in men in addition to other health complications. Although khat is legal in Kenya, some countries have outlawed the cultivation, sale and possession of khat as a countermeasure against narcotic and psychotropic substances. The increasing trends in the use of khat among the youth and adults of all races in the world, regardless of its associated dangers, are worrying. This paper seeks to explore the emerging trends on the use of khat and the chemical compounds generated responsible for psychoactive behaviour. Nonetheless, the health implications of repeated khat use and the challenges it poses in the management of the Coronavirus disease-2019 (Covid-19) have been reviewed and reported in this work. Possible toxicological consequences are discussed in detail. A literature search was done by targeting articles published within the period of 2012-2020 in PubMed, Crossref, Google Scholar and Web of Science. The articles were picked if they contained information on khat use, trends in khat use, health effects and Covid-19 management using khat. Various techniques by which khat is consumed including oral chewing, smoking, and sprinkling, bombing and keying were identified and discussed in this work. A range of chemical compounds present in khat and their associated toxicological health impacts linked to khat consumption have been presented from the literature surveyed. Nonetheless, the medicinal aspects of khat use with recommendations from a medical perspective are also discussed. Molecular modelling of selected psychoactive compounds generated from khat smoking is also presented in this study. Results showed that cathinone breaks down to yield benzenyl and 3-aminobuytanyl-2-one radicals that react with hydride and metals to yield carcinogenic benzene molecule and C-centered environmentally persistence free radicals, respectively. Furthermore, the HOMO an LUMO structures for these organic molecules illustrates that they act as nucleophiles that can react with electrophilic unsaturated human bio-molecules such as amino acids and lipids to initiate shifts in pi-electrons and dienophile electrons resulting in gene alterations and mutation. Accordingly, khat chewing can be regarded as a possibly serious practice that may aid in the present spread of SARS-Cov-2-virus and manifestation of other health concerns such as cancer. This study identifies campaigns against khat chewing, cessation and abstinence as strategies against the associated negative health impacts of khat. These findings are important in facilitating policy makers to make informed decisions for control and consummation of khat as a possible narcotic substance.