Khat consists of the young leaves of the Catha edulis plant; it is usually chewed for its stimulant effect when fresh but may be drunk as an infusion of leaves. In the United Kingdom, it is sold legally (it is illegal in the United States) and is used by Somali populations (72,73). The main component is cathinone, with effects similar to those of amphetamine, resulting in euphoria, increased alertness, and anorexia (74). There may also be mood lability, anxiety, and insomnia (75).

Heavy khat consumption may result in mania-like symptoms, paranoia, and an acute schizophrenia-like psychosis, usually resolving within weeks of cessation of use (76,77). Although there is no specific physical withdrawal syndrome, depression, hypersomnia, and loss of energy may occur when khat use is stopped (75).

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