Abstract
The study examines psychological and social effects on married adult males who consume khat (Catha edulis) throughout Gondar City Ethiopia. The research demonstrates khat serves as a substantial public health concern because it triggers various adverse mental health impacts affecting individuals at all life stages and extended family and community members. Using both snowball sampling and convenience methods researchers gathered ten regular khat users for an investigation on addiction patterns and psychological symptoms and social effects and withdrawal mechanisms. The study implemented Amharic participants who received transcription services as well as thematic structural analysis. Those who use khat understand it serves as an addictive substance while using it to battle their life stress. The research revealed that repetitive unfortunate encounters caused both mental diseases and depression and psychosis and led to household ruptures and financial ruin. Subjects experienced major obstacles in ending their khat consumption since their bodies reacted with physical withdrawal symptoms and their minds remained addicted to its effects. The study demonstrates that health authorities should create personalized intervention programs which inform users about khat dangers and offer retreatment solutions to address addiction symptoms across physical and mental health domains. The study works to develop new public health policies and increase knowledge about khat behavioral effects within affected demographic groups.
Published in
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Innovation (Volume 6, Issue 3)
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DOI
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10.11648/j.innov.20250603.12
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Page(s)
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55-62 |
Creative Commons
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
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Copyright
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Copyright © The Author(s), 2025. Published by Science Publishing Group
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Keywords
Khat (Catha Edulis), Addiction, Mental Health, Psychological Consequences, Social Implications, Motivations for Cessation
1. Introduction
1.1. Background of the Study
The global problem of substance misuse damages both health status of populations and national levels of prosperity and social well-being
[9] | Ismail, N. A., Ibrahim, S., & Mohamed, S. (2022). A systematic review of drug abuse and its health implications globally. International Journal of Health Sciences, 16(4), 75-88. https://doi.org/10.53730/ijhs.v16n4.7167 |
[9]
. Drug and substance use (DSU) exists as a worldwide problem that produces multiple disabling effects on physical wellbeing and mental health from psychoactive substance misuse. DSU generates multiple destructive impacts beyond individual health complications because these behaviors escalate ongoing social concerns including violence and crime possibilities while boosting infection risk for HIV/AIDS and Hepatitis B and C and tuberculosis
[15] | United Nations Office on Drugs and Crime. (2021). World Drug Report 2021. UNODC. |
[15]
. The financial burden of substance addiction affects both healthcare systems and criminal justice institutions and public service infrastructure
[10] | Maghsoudi, A., Rashidian, A., & Yarmohammadian, M. H. (2019). The economic burden of substance use disorder treatment in healthcare systems. Health Policy and Planning, 34(9), 642-653. https://doi.org/10.1093/heapol/czz069 |
[10]
.
Traditionally many societies in the Middle East and East Africa used Khat (Catha edulis) as a drug
[11] | Mihretu, B., Beyene, Y., & Mulugeta, A. (2017). Khat (Catha edulis) leaves use and its impact on mental health in Eastern Ethiopia. Ethiopian Journal of Health Sciences, 27(6), 657-666. https://doi.org/10.4314/ejhs.v27i6.8 |
[11]
. The two main psychoactive compounds in this herbal stimulant called cathine and cathinone produce its stimulant effects according to the United Nations Office on Drugs and Crime
[15] | United Nations Office on Drugs and Crime. (2021). World Drug Report 2021. UNODC. |
[15]
. People who use khat tend to overdose and develop psychological dependence which leads to different adverse effects including manic behavior, paranoia and hallucinations and increased susceptibility to severe mental health problems including depression and anxiety
[7] | Edward, J. D., & Atkins, J. K. (2022). The psychological health impacts of khat use: New findings from recent studies. The Journal of Drug Issues, 52(1), 23-37. https://doi.org/10.1177/00220426211059362 |
[13] | Perkins, M. E., Mendoza, M., & Kinsella, R. (2022). Withdrawal and recovery: Challenges in treating khat addiction. Substance Abuse Policy Research, 14(1), 55-71. https://doi.org/10.1186/s13011-022-00545-5 |
[7, 13]
.
Khat expenditure continues in East Africa and the Arabian Peninsula regions although people face documented health problems from khat use. A study has found that five to ten million people globally use khat particularly within social and cultural communities of Ethiopia and Somalia and Yemen
[6] | Efrem, A., Yitayih, M., & Van, J. M. (2022). Khat consumption in Ethiopia: A mixed-method study. Global Health Research and Policy, 7(1), 10-20. https://doi.org/10.1186/s41256-021-00237-3 |
[17] | Yitayih, M., & Van, J. M. (2021). Cultural perceptions of khat consumption in Ethiopia: A critical review. Journal of Substance Use, 26(4), 396-402. https://doi.org/10.1080/14659891.2020.1778945 |
[6, 17]
. Users of chronic khat consumption develop multiple adverse mental health problems including increased rates of mental disorders, development of post-traumatic stress disorder (PTSD) and heightened psychological distress according to research by
[8] | Hassen, H. A., Khatib, M., & Khalid, M. (2021). Mental health consequences of khat use: Evidence from studies in Ethiopia. International Journal of Mental Health Systems, 15(1), 1-10. https://doi.org/10.1186/s13033-021-00457-7 |
[3] | Bahhawi, T. A., & Al-Ahmadi, Y. S. (2018). Khat consumption and mental health: A review of issues and implications in the Arabian Peninsula. Journal of Substance Abuse Treatment, 95, 38-43. https://doi.org/10.1016/j.jsat.2018.01.014 |
[8, 3]
.
1.2. Statement of the Problem
Khat (Catha edulis) use has considerable negative impacts on public health because of its widespread consumption in East Africa and the Arabian Peninsula where it specifically affects vulnerable groups. Studies about mental health problems caused by khat addiction in married adult males remain inadequate even though consumption levels increase and mental health deteriorates. The research demonstrates khat has naturally established itself throughout different cultures to gain social acceptance
[1] | Ahmed, M. A., Geda, R. A., & Mohamed, A. C. (2020). Normalization of khat use in rural settings: Cultural acceptance and health misconceptions. East African Journal of Public Health, 17(1), 10-17. |
[17] | Yitayih, M., & Van, J. M. (2021). Cultural perceptions of khat consumption in Ethiopia: A critical review. Journal of Substance Use, 26(4), 396-402. https://doi.org/10.1080/14659891.2020.1778945 |
[1, 17]
but this cultural narrative hides the major health risks arising from its use.
The consumption of khat nutrients produces an additional risk factor that leads to increased cases of depression and PTSD according to
[8] | Hassen, H. A., Khatib, M., & Khalid, M. (2021). Mental health consequences of khat use: Evidence from studies in Ethiopia. International Journal of Mental Health Systems, 15(1), 1-10. https://doi.org/10.1186/s13033-021-00457-7 |
[8]
. Research participants indicate that current information lacks enough rich qualitative aspects although there exist known data constraints. The use of the cross-sectional methodology to research khat-related damage fails to provide satisfactory explanations about addiction development
[12] | Olani, A., Getachew, C., & Ersado, T. (2023). The psychosocial consequences of khat use among young adults: A qualitative study from South Wollo, Ethiopia. Substance Abuse Treatment, Prevention, and Policy, 18(1), 18-29. https://doi.org/10.1186/s13011-023-00545-y |
[12]
. The connection between khat consumption and mental health disease development remains challenging to trace since biometric studies must deal with preexisting analytical confounders
. The research investigates khat addiction through three key research questions regarding the addiction development process and its mental and physical consequences and societal effects together with stoppage attempts factors. Khat users experience psychological distress at rates that are practically double compared to individuals without khat exposure revealed
[16] | Wondemagegn, A., Jin, G., & Lichtenberger, J. (2017). Khat use and its socio-economic impact in Ethiopia: Findings from a qualitative study. BMC Public Health, 17(1), 1-10. https://doi.org/10.1186/s12889-017-4900-4 |
[16]
thus making these matters worthy of close investigation.
The social and economic consequences of Khat addiction reach farther than private use to encompass the whole community and the family members of consumers. The financial burden of Khat use becomes severe because instead of buying essential goods users allocate their money to khat which results in family breakdowns and reduced mental capabilities
[5] | Dhaifalah, I. E., & Santavy, J. (2004). The social and economic implications of khat use on family dynamics in Yemen. Journal of Family Issues, 25(8), 1217-1230. https://doi.org/10.1177/0192513X04264493 |
[5]
. Studies need to investigate how social demands affect married adult males who use khat because this same effect calls for immediate scientific evaluation.
Realistic intervention approaches require understanding about what motivates users to stop consuming khat because this creates the base for effective methods. The withdrawal symptoms and craving intensities of khat users create barriers to abstinence that lead them to reutilize the drug regularly
. Studies have shown religious traditions and cultural customs influence when people start taking khat as well as how they stop but academic research lacks insights specifically from khat-using married males.
The comprehension of khat user motivation toward stopping substance use enables successful intervention development. The presence of khat withdrawal symptoms forces users into repeated drug relapses according to
.
Research investigation shows religious and cultural elements contribute to the beginning and conclusion of khat usage but lacks sufficient qualitative data about the experiences of married users.
Seeking to build current scientific knowledge this research examines the psychosocial factors affecting married adult male khat consumption in Gonder city’s Ethiopian population. Research for this study has focused on identifying addiction patterns together with social effects and psychological elements and the quitting process of affected individuals to guide public health strategies about khat impacts.
Research examining khat-related mental health risks has increased substantially while psychosocial outcome investigations have not been well studied within specific communities. Current research covers insufficient qualitative studies examining married adult men who use khat in Ethiopia and their process during both drug use and drug cessation. Addiction to khat requires people to understand their addiction development along with knowledge about psychological and social effects, as well as their challenges during addiction break attempts.
This research intends to fill the gap by answering the following questions:
1) What is the process of building an addiction to khat?
2) What psychological, health, and societal consequences are linked to khat consumption?
3) What experiences and reasons do regular khat users articulate concerning cessation?
2. Literature Review
2.1. Drug Abuse and Global Health
Substance use disorder is an extensive global challenge which influences health and economic strength and the social welfare of any nation
[9] | Ismail, N. A., Ibrahim, S., & Mohamed, S. (2022). A systematic review of drug abuse and its health implications globally. International Journal of Health Sciences, 16(4), 75-88. https://doi.org/10.53730/ijhs.v16n4.7167 |
[9]
. Drug and substance use (DSU) is a global issue, and non-medical use of psychoactive substances is linked to many adverse effects on health in both physical and mental domains. Those who engage in substance use are more at risk of contracting diseases such as HIV/AIDS, Hepatitis B and C, and TB that impose heavy costs on society
[15] | United Nations Office on Drugs and Crime. (2021). World Drug Report 2021. UNODC. |
[15]
. The cost of substance addiction to other people becomes an increased burden on public services and the criminal justice system
[10] | Maghsoudi, A., Rashidian, A., & Yarmohammadian, M. H. (2019). The economic burden of substance use disorder treatment in healthcare systems. Health Policy and Planning, 34(9), 642-653. https://doi.org/10.1093/heapol/czz069 |
[10]
.
2.2. Khat as a Psychostimulant
Khat (Catha edulis) stands as one of the widely recognized psychotropic drugs among experts. Traditional usage of Khat as a psychostimulant herb exists throughout many regions in East Africa and the Middle East which contains its active components cathine and cathinone
[15] | United Nations Office on Drugs and Crime. (2021). World Drug Report 2021. UNODC. |
[15]
. People understand well how khat provides stimulant effects while its danger of overdose and psychological dependence remains a concern. People who consume khat experience multiple negative effects including manic behavior, paranoia and hallucinations and will develop depression and anxiety symptoms after prolonged usage
[7] | Edward, J. D., & Atkins, J. K. (2022). The psychological health impacts of khat use: New findings from recent studies. The Journal of Drug Issues, 52(1), 23-37. https://doi.org/10.1177/00220426211059362 |
[13] | Perkins, M. E., Mendoza, M., & Kinsella, R. (2022). Withdrawal and recovery: Challenges in treating khat addiction. Substance Abuse Policy Research, 14(1), 55-71. https://doi.org/10.1186/s13011-022-00545-5 |
[7, 13]
.
The practice of khat consumption persists despite health dangers because its distribution ranges from East Africa into the Arabian Peninsula. The worldwide khat consumption range estimates at five to ten million users mostly involves residents of Ethiopia, Somalia and Yemen who consider this practice integral to social customs
[6] | Efrem, A., Yitayih, M., & Van, J. M. (2022). Khat consumption in Ethiopia: A mixed-method study. Global Health Research and Policy, 7(1), 10-20. https://doi.org/10.1186/s41256-021-00237-3 |
[17] | Yitayih, M., & Van, J. M. (2021). Cultural perceptions of khat consumption in Ethiopia: A critical review. Journal of Substance Use, 26(4), 396-402. https://doi.org/10.1080/14659891.2020.1778945 |
[6, 17]
. Khat users who maintain long-term use develop multiple damaging mental health issues because khat increases the occurrence of mental disorders and triggers post-traumatic stress disorder (PTSD) and leads to psychological distress
[8] | Hassen, H. A., Khatib, M., & Khalid, M. (2021). Mental health consequences of khat use: Evidence from studies in Ethiopia. International Journal of Mental Health Systems, 15(1), 1-10. https://doi.org/10.1186/s13033-021-00457-7 |
[3] | Bahhawi, T. A., & Al-Ahmadi, Y. S. (2018). Khat consumption and mental health: A review of issues and implications in the Arabian Peninsula. Journal of Substance Abuse Treatment, 95, 38-43. https://doi.org/10.1016/j.jsat.2018.01.014 |
[8, 3]
.
2.3. Socioeconomic Implications of Khat Use
In response to an increase in the usage of khat, the society faces significant socio-economic implications. Daily khat chewing practices may be linked to the household problems, neglect of academic responsibilities, and poor job performance by virtue of poorer quality and quantity of time spent collecting and consuming khat
[5] | Dhaifalah, I. E., & Santavy, J. (2004). The social and economic implications of khat use on family dynamics in Yemen. Journal of Family Issues, 25(8), 1217-1230. https://doi.org/10.1177/0192513X04264493 |
[16] | Wondemagegn, A., Jin, G., & Lichtenberger, J. (2017). Khat use and its socio-economic impact in Ethiopia: Findings from a qualitative study. BMC Public Health, 17(1), 1-10. https://doi.org/10.1186/s12889-017-4900-4 |
[5, 16]
. In addition, the range of symptoms associated with the chewing of khat, such as anxiety, anger, and insomnia, can affect daily living
[1] | Ahmed, M. A., Geda, R. A., & Mohamed, A. C. (2020). Normalization of khat use in rural settings: Cultural acceptance and health misconceptions. East African Journal of Public Health, 17(1), 10-17. |
[1]
, and negatively influence family relations
[12] | Olani, A., Getachew, C., & Ersado, T. (2023). The psychosocial consequences of khat use among young adults: A qualitative study from South Wollo, Ethiopia. Substance Abuse Treatment, Prevention, and Policy, 18(1), 18-29. https://doi.org/10.1186/s13011-023-00545-y |
[12]
.
2.4. Gaps in Current Research on Khat Addiction
Assessing khat consumption within cultural environments also minimizes recognition of its mental health risks as proposed by
[1] | Ahmed, M. A., Geda, R. A., & Mohamed, A. C. (2020). Normalization of khat use in rural settings: Cultural acceptance and health misconceptions. East African Journal of Public Health, 17(1), 10-17. |
[1]
and
yet psychosocial research on khat addiction among married men remains scarce. The current literature provides comprehensive descriptions of khat consumption's negative psychological effects that increase depression rates and PTSD incidence
[8] | Hassen, H. A., Khatib, M., & Khalid, M. (2021). Mental health consequences of khat use: Evidence from studies in Ethiopia. International Journal of Mental Health Systems, 15(1), 1-10. https://doi.org/10.1186/s13033-021-00457-7 |
[8]
; these individual user perspectives are not presented in a holistic way.
The addiction process remains poorly understood because most studies employ cross-sectional designs according to
[12] | Olani, A., Getachew, C., & Ersado, T. (2023). The psychosocial consequences of khat use among young adults: A qualitative study from South Wollo, Ethiopia. Substance Abuse Treatment, Prevention, and Policy, 18(1), 18-29. https://doi.org/10.1186/s13011-023-00545-y |
[12]
.
Understanding how khat use leads to different mental health disorders should be established urgently because different variables might confuse the results
.
Scientific evidence presents a significant finding that khat users experience serious psychological problems at a rate of approximately 25% compared to people who do not use khat
[16] | Wondemagegn, A., Jin, G., & Lichtenberger, J. (2017). Khat use and its socio-economic impact in Ethiopia: Findings from a qualitative study. BMC Public Health, 17(1), 1-10. https://doi.org/10.1186/s12889-017-4900-4 |
[16]
.
Individuals who consume Khat create socio-economic problems that first affect them yet these issues spread throughout their loved ones and the broader community. Consuming Khat results in financial loss of important household requirements which creates more broken families and severe mental health decline
[5] | Dhaifalah, I. E., & Santavy, J. (2004). The social and economic implications of khat use on family dynamics in Yemen. Journal of Family Issues, 25(8), 1217-1230. https://doi.org/10.1177/0192513X04264493 |
[5]
. The effects of khat require complete investigation because studies demonstrate that khat consumption leads to specific economic challenges affecting married adult males with particular stressors
.
2.5. Motivations for Quitting Khat Consumption
The identification of factors that aid users with khat cessation development methods that deliver effective results. Withdrawal symptoms coupled with compulsive cravings lead individuals to face immense obstacles while maintaining abstinence and ultimately cause them to start using khat again
.
Current research lacks investigations about khat's origin and conclusion among specific cultural and religious groups while neglecting fundamental understandings from male married khat users.
The research demonstrates how weak knowledge exists regarding psychosocial effects of khat use on Ethiopian married male adults. The study seeks to reveal gaps in research knowledge about khat use so public health professionals can better create evidence-based intervention and policymaking guidelines to address its consequences.
3. Research Methodology
3.1. Study Setting
Researchers studied Gondar City as the main experimental site within the Amhara region of Ethiopia. Outside of tourist activities Gondar functions as a historical center where numerous cultural events take place. The society faces important issues because of excessive khat use that produces multiple negative outcomes across individual and community settings. Experts link social and health problems to Khat consumption because users prepare this stimulant from Catha edulis plant leaves
[14] | Reda, A. A., & Aderaw, A. (2021). Khat chewing patterns in Ethiopia: A nationwide survey. Addictive Behaviors Reports, 13, 100332. https://doi.org/10.1016/j.abrep.2021.100332 |
[16] | Wondemagegn, A., Jin, G., & Lichtenberger, J. (2017). Khat use and its socio-economic impact in Ethiopia: Findings from a qualitative study. BMC Public Health, 17(1), 1-10. https://doi.org/10.1186/s12889-017-4900-4 |
[14, 16].
3.2. Study Design
The research employed qualitative case studies to provide extensive investigations of khat related psychological effects as well as social effects and health outcomes in people who use khat daily or severely in Gondar City. The method provides thorough access to personal experiences which establish an enhanced comprehension of related challenges
.
3.3. Participants of the Study
The study involved typical khat consumers from Gondar City who use khat at various establishments referred to as “chat bets.” Ten participants who consumed khat regularly in Gondar City were recruited using combination techniques of convenience sampling and snowball sampling. The mixed sampling methods produced diverse khat consumer participation which made possible the collection of substantial and multifaceted data
3.4. Data Collection Tools
The researcher created an interview guide as their primary instrument for collecting original data. Open-ended questions within the guide aimed to trigger extended responses to encourage innovative thinking for new topics and concepts. Essential enquiries comprised:
The research explores what original factors drove users to start khat consumption and eventually become regular consumers.
What dose of khat do people use at present and has their consumption changed since beginning this drug habit? The khat users understand how their substance use affects their personal relationships.
Participants described the various medical, behavioral and social impacts they experience because they consume khat every day. The individuals consider discontinuing khat usage while sharing their future reasons behind such a decision.
The research inquiries followed qualitative study principles to study how khat usage affects individuals and wider society.
3.5. Method of Data Analysis
Thematic analysis was employed to thoroughly assess the information obtained through interviewing participants. All interviews were recorded by audio devices while additional hand notes were taken simultaneously throughout the procedures. The researchers conducted Amharic language interviews at first before translating them through professional interpreters into the English language. The investigators analyzed and combined the data based on the study's objectives through an organized framework which generated three core themes that encapsulated participant perceptions and experiences.
3.6. Data Gathering Procedures
The interviews established an agreeable environment which promoted effective interaction between the interviewer and interviewee. To join the study participants needed to provide their consent through a signed form that demonstrated their willingness to participate voluntarily. All participants received protection for their confidentiality through security measures that prevented disclosure of personal identification and responses. Open interviews with durations between 30 and 45 minutes took place in accommodating spaces which supported free discussion between participants. During the interview process the researcher obtained recording authorization along with written notes to attain comprehensive data collection.
3.7. Disclosure of Interest
The authors confirm that they do not have any financial or personal relationship that may be considered potential conflict of interests that may have taken place in this research, analyzing, and concluding this study. It was independent research without sponsorship of it by organizations that had vested interest on the results. Consent was ensured though all participants gave an informed consent and ethical approval was undertaken to uphold the academic quality and ethics of confidentiality in the execution of the study. The results and conclusions are of the authors alone.
4. Results
4.1. Demographic Characteristics of Participants
Table 1. Demographic characteristics of participants.
Code | 001 | 002 | 003 | 004 | 005 | 006 | 007 | 008 | 009 | 010 |
Age | 46 | 25 | 40 | 37 | 26 | 32 | 61 | 23 | 30 | 36 |
Sex | M | F | M | M | M | M | M | M | M | M |
Religion | Orthodox Christin | Orthodox Christin | Orthodox Christin | Muslim | Orthodox Christin | Orthodox Christian | Orthodox Christin | Orthodox Christian | Orthodox Christian | Orthodox Christian |
Marital status | Divorced | Not married | Married | Married | Not married | Not married | Divorced | Not married | Married | Not married |
Khat chewing experiees | 15 years | 7 years | 10 years | 12 years | 5 years | 11 years | 25 years | 4 years | 8 years | 13 years |
Table 2. Educational and Occupational background of participants.
Job status | Employed | Un-employed | Employed | Private business | Un-employed | Private business | Retire | Un-employed | Employed | Businessman |
Educational status | First degree | First degree | First degree | High school completed | High school comple ted | Elementary school completed | Diploma completed | Element ary school completed | First degree | High school completed |
During the research period different demographic groups among ten participants formed the sample population. The study included subjects between 23 and 61 years old whose average participant was 35.6 years old. Among the population eight identified as male gender while one of the participants self-identified as female. The participants belonged to nine Orthodox Christian faith communities with additional membership from a single Muslim religion. The survey revealed that three participants were married whereas five others were single and two experienced divorced.
The participants displayed diverse experiences with khat chewing which averaged out to 11 years as reflected in the study. The longest reported khat usage period reached 25 years and the shortest reached five years. There were significant differences in study participants' educational attainments because few completed universities but most finished elementary school.
Workers in multiple positions carried out their duties within the study. The group included three government officials as well as two workers from private institutions alongside a private company owner but retirement was chosen by one participant and three remained unemployed.
4.2. The Process of Khat Use Addiction
All interview participants admitted they used Khat on a standard basis. Based on their self-assessment this user did not view their habit as addictive although they maintained regular consumption patterns. Participants gave varying reasons for beginning khat use yet most people described starting for pleasure. Two participants said they started using khat when they were studying at college to improve their concentration capabilities. A participant described their khat initiation experience through glimpses of their father's ongoing khat use while promoting its advantages to them.
Every interview participant understood khat use as an ongoing addiction. Protective environments offered one of the main factors that led users to continue their khat use. Participants used khat to both handle adverse life events and reach personal objectives. Participants displayed progressively rising requirements for khat use as time passed to achieve similar outcomes from its use.
For instance, one participant expressed the belief that they were not addicted and perceived their use as a harmless hobby:
"I don't think I'm addicted to khat, and I'm sure I'm taking it willingly, and it’s just a pleasurable hobby" (Participant 005).
Conversely, a participant who recognized their addiction stated:
"I began eating khat for fun, and I just wanted to discover what it felt like and I never thought I would become involved" (Participant 001).
Another stated:
"I started chewing khat when I was a first-year college student with my friends pushing me. They convinced me khat makes what you are reading clear and useful for concentration" (Participant 007).
The youngest participant recounted their early exposure to khat:
"My father was a khat user, and he sometimes chewed khat at home. When I was 16, I tested the leftover khat of my father, and I felt good with my first test" (Participant 009).
4.3. Psychological, Health, and Social Effects of Khat Use
Khat use led to harmful outcomes according to every research participant. The research analysis revealed multiple important adverse effects across health categories and social structure together with psychological aspects and financial parameters. Participants expressed many mental health conditions which included depression and psychosis. Most cases of depression in khat users either stemmed from their withdrawal period or emerged because khat consumption caused financial crises. People who took large amounts of khat without eating first developed psychotic symptoms.
The more advanced their addiction becomes several participants admit that people start selling their personal belongings and household items for khat purchases. Weight loss alongside malnutrition developed from the widespread appetite loss experienced by users. Study participants indicated khat use drains fluids from their bodies causing weakness along with multiple health risks for illnesses. The participants discussed frequently how khat use led to gastrointestinal problems which included halitosis as well as tongue discoloration and dental decay while causing tooth disintegration.
4.4. Motives and Experiences to Quit Khat
Most participants tried to give up khat intake but various obstacles in their life served as barriers that prevented them from succeeding at stopping their use. Participants showed mixed feelings about quitting but kept their priorities on handling the problems that existed in their actual life circumstances. The medical dangers connected to extended khat usage were recognized by the population but few people understood effective ways to break the habit.
Most participants looked for opportunities to stop khat consumption yet no approach proved effective for them. A female participant mentioned she uses khat as her primary restorative remedy for her sleeping issues because rest has become very difficult for her.
"A female participant reported difficulty sleeping and resting when trying to stop chewing khat. So, to sleep, she must take khat, but in the other way. She believes that consuming khat is causing her to lose her appetite" (Participant 002).
Another participant shared their struggle with the emotional effects of quitting:
"Without khat, I feel unstable, under pressure, and easily irritated. I lost my mood until I found khat and felt better. So, for me, it is hard to quit khat even for one day" (Participant 005).
These findings indicate that quitting khat presents significant challenges for individuals engaged in habitual chewing, with many participants expressing the compounded difficulties associated with cessation.
5. Discussion
The study's data provides essential insights about the characteristics of the study participants and their patterns of khat addiction together with psychological effects and social consequences of khat use and methods that prompt users to quit. Participant statistics demonstrate that the participants' average age matches the previous findings about population-based khat usage during youth primarily among young men in Ethiopia
[14] | Reda, A. A., & Aderaw, A. (2021). Khat chewing patterns in Ethiopia: A nationwide survey. Addictive Behaviors Reports, 13, 100332. https://doi.org/10.1016/j.abrep.2021.100332 |
[16] | Wondemagegn, A., Jin, G., & Lichtenberger, J. (2017). Khat use and its socio-economic impact in Ethiopia: Findings from a qualitative study. BMC Public Health, 17(1), 1-10. https://doi.org/10.1186/s12889-017-4900-4 |
[14, 16]
.
5.1. Demographic Characteristics and Khat Use
The dominant male composition of research participants who showed different educational levels matches previous findings showing males and disadvantaged socio-economic groups more likely to use khat
[9] | Ismail, N. A., Ibrahim, S., & Mohamed, S. (2022). A systematic review of drug abuse and its health implications globally. International Journal of Health Sciences, 16(4), 75-88. https://doi.org/10.53730/ijhs.v16n4.7167 |
[9]
.
Khat consumption behaves strongly with educational background indicating educational programs should become crucial in developing alternative behaviors
.
5.2. Understanding Khat Addiction
Habitual khat users expressed their understanding about khat through their self-identification as drug users who view khat as an addictive substance and a tool for coping with life. Most study participants realized khat has addictive qualities yet their personal engagement with the drug often undermines their understanding of self-addiction. The discrepancy regarding khat user perceptions exists in multiple research studies since consumers view their drug use as traditional cultural behavior or recreational activity which reduces their perceived need for treatment along with heightening health dangers
[8] | Hassen, H. A., Khatib, M., & Khalid, M. (2021). Mental health consequences of khat use: Evidence from studies in Ethiopia. International Journal of Mental Health Systems, 15(1), 1-10. https://doi.org/10.1186/s13033-021-00457-7 |
[2] | Al’Absi, M., & Khalil, N. S. (2023). The addictive potential of khat and implications for health. Journal of Substance Use Disorders, 15(2), 45-58. https://doi.org/10.1177/0192513X11437145 |
[8, 2]
.
The findings from this research-supported the previous works on khat usage by showing social enjoyment and concentration elevation as main reasons
[7] | Edward, J. D., & Atkins, J. K. (2022). The psychological health impacts of khat use: New findings from recent studies. The Journal of Drug Issues, 52(1), 23-37. https://doi.org/10.1177/00220426211059362 |
[3] | Bahhawi, T. A., & Al-Ahmadi, Y. S. (2018). Khat consumption and mental health: A review of issues and implications in the Arabian Peninsula. Journal of Substance Abuse Treatment, 95, 38-43. https://doi.org/10.1016/j.jsat.2018.01.014 |
[7, 3]
. Future intended interventions to reduce adolescent drug initiation should focus on social networks since peer pressure stands as a leading factor for starting khat consumption.
Participants who regularly used khat identified themselves according to these patterns while expressing contradictory attitudes about khat addiction. Most study participants recognized khat's addictive properties yet their lived experiences regularly diminish their personal addiction self-diagnosis. Multiple research studies have documented this inconsistency which causes users to define their consumption habits as either regular cultural behavior or ordinary entertainment prompting complications in treatment methods while increasing health dangers
[8] | Hassen, H. A., Khatib, M., & Khalid, M. (2021). Mental health consequences of khat use: Evidence from studies in Ethiopia. International Journal of Mental Health Systems, 15(1), 1-10. https://doi.org/10.1186/s13033-021-00457-7 |
[2] | Al’Absi, M., & Khalil, N. S. (2023). The addictive potential of khat and implications for health. Journal of Substance Use Disorders, 15(2), 45-58. https://doi.org/10.1177/0192513X11437145 |
[4] | Borelli, V. W. (2009). Confounding variables and causal inference in drug addiction studies. Substance Abuse, 30(4), 345-355. https://doi.org/10.1080/08897070903353934 |
[8, 2, 4]
.
The findings regarding khat consumption motives presented in this research match previous studies about peer relationships leading individuals to use khat along with cultural acceptance trends
[6] | Efrem, A., Yitayih, M., & Van, J. M. (2022). Khat consumption in Ethiopia: A mixed-method study. Global Health Research and Policy, 7(1), 10-20. https://doi.org/10.1186/s41256-021-00237-3 |
[15] | United Nations Office on Drugs and Crime. (2021). World Drug Report 2021. UNODC. |
[6, 15]
. Future targeted interventions to reduce adolescent initiation rates of khat consumption should prioritize peer networks because social pressure now drives new use of this drug substance.
5.3. Psychological and Physical Consequences of Khat Use
Observations of psychological as well as health and social consequences among participants support existing literature which explains multiple harmful khat use outcomes including depression and psychosis (Zyoud et al., 2017; Al'Absi et al., 2021). Studies show khat-related financial hardship causes depressive symptoms as demonstrated by these current findings; this result matches previous documentation of how economic strain aggravates mental health problems in khat users
[16] | Wondemagegn, A., Jin, G., & Lichtenberger, J. (2017). Khat use and its socio-economic impact in Ethiopia: Findings from a qualitative study. BMC Public Health, 17(1), 1-10. https://doi.org/10.1186/s12889-017-4900-4 |
[9] | Ismail, N. A., Ibrahim, S., & Mohamed, S. (2022). A systematic review of drug abuse and its health implications globally. International Journal of Health Sciences, 16(4), 75-88. https://doi.org/10.53730/ijhs.v16n4.7167 |
[16, 9]
.
Participants documented physical health consequences of khat use which include minimized hunger and improved health together supporting knowledge about its harmful effects
[8] | Hassen, H. A., Khatib, M., & Khalid, M. (2021). Mental health consequences of khat use: Evidence from studies in Ethiopia. International Journal of Mental Health Systems, 15(1), 1-10. https://doi.org/10.1186/s13033-021-00457-7 |
[10] | Maghsoudi, A., Rashidian, A., & Yarmohammadian, M. H. (2019). The economic burden of substance use disorder treatment in healthcare systems. Health Policy and Planning, 34(9), 642-653. https://doi.org/10.1093/heapol/czz069 |
[8, 10]
. The joint physical and mental health risks established the demand for broad-based health promotion campaigns to teach users about khat intake dangers.
5.4. Challenges in Quitting Khat
Several reports including detailed obstacles to stoppage efforts failed to demonstrate the intended objectives of cessation. People face increased complexity in achieving drug abstinence because khat fosters permanent psychological dependency which users employ to regulate their stress and emotional issues
[16] | Wondemagegn, A., Jin, G., & Lichtenberger, J. (2017). Khat use and its socio-economic impact in Ethiopia: Findings from a qualitative study. BMC Public Health, 17(1), 1-10. https://doi.org/10.1186/s12889-017-4900-4 |
[15] | United Nations Office on Drugs and Crime. (2021). World Drug Report 2021. UNODC. |
[16, 15].
The emergence of withdrawal symptoms and cravings identifies crucial intervention periods but specifies exactly how research should create support networks for khat abstinence efforts
[13] | Perkins, M. E., Mendoza, M., & Kinsella, R. (2022). Withdrawal and recovery: Challenges in treating khat addiction. Substance Abuse Policy Research, 14(1), 55-71. https://doi.org/10.1186/s13011-022-00545-5 |
[18] | Zyoud, S. H., et al. (2017). Association of khat use with mental health issues: A systematic review and meta-analysis. Journal of Herbal Medicine, 7, 43-46. https://doi.org/10.1016/j.hermed.2017.10.001 |
[13, 18]
.
Detectable changes in mood and sleep patterns show similar tendencies to previous findings on khat withdrawal effects that generate mental health issues therefore upcoming treatment approaches need to provide comprehensive treatment of both physical and psychological consequences
[2] | Al’Absi, M., & Khalil, N. S. (2023). The addictive potential of khat and implications for health. Journal of Substance Use Disorders, 15(2), 45-58. https://doi.org/10.1177/0192513X11437145 |
[11] | Mihretu, B., Beyene, Y., & Mulugeta, A. (2017). Khat (Catha edulis) leaves use and its impact on mental health in Eastern Ethiopia. Ethiopian Journal of Health Sciences, 27(6), 657-666. https://doi.org/10.4314/ejhs.v27i6.8 |
[2, 11].
This research establishes the fundamental connection between individual khat usage experiences along with environmental influences which produce health-related effects in the study subjects. An ongoing khat user consumption creates substantial public health problems in specific cultural regions which require tailored treatment solutions incorporating education and resources for users attempting to quit their habit to address related economic and medical consequences.
6. Summary and Conclusion
The research analyzes psychological variables alongside demographic characteristics alongside khat usage patterns together with the reason for its addictive nature using a population sample of ten participants. The study includes ten mainly male participants who reached an average age of 35.6 years. These participants provided life experiences that reflect nationwide khat usage behavior among the relevant target groups. The participants demonstrated 11-year khat use patterns on average but their varied levels of education resulted from their socioeconomic conditions.
Many participants comprehended khat addiction well because they used khat to overcome difficult life situations. The attraction to white powder addiction begins through social activities combined with peer pressures thus rendering addiction treatment more complicated to administer. Users documented negative mental and physical khat effects that led to both anxiety and depressive symptoms as well as various health problems that emerged during financial difficulties.
Rationales of psychological dependency for emotional care combined with withdrawal symptoms were identified as major barriers to quitting by participants who recognized their helping ability and desire to stop khat consumption. The complex relationship of addiction stimulates by social economic factors and psychiatric conditions proves to make successful treatment challenging.
The results of this research add to our understanding both of khat use experiences and their associated effects. Khat consumption as a regular practice continues to endanger public health among communities which accept its traditions requiring specific health interventions. The proposed initiatives need to deliver lessons about khat dangers with busting resources and support systems designed to treat physical and mental effects of withdrawal. Future research needs to explore whole-system solutions because they help reduce health problems and socio-economic effects which result from khat addiction so communities can better respond to this issue.
Abbreviations
DSU | Drug and Substance Use |
PTSD | Post-traumatic Stress Disorder |
HIV/AIDS | Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome |
TB | Tuberculosis |
UNODC | United Nations Office on Drugs and Crime |
Author Contributions
Yedilfana Adinew is the sole author. The author read and approved the final manuscript.
Conflicts of Interest
The author declares that there are no financial, professional, or personal conflicts of interest that could have influenced the design, execution, analysis, or reporting of this study. This research was conducted independently without funding or support from any organization with a vested interest in the outcomes. All participants provided informed consent, and ethical guidelines were strictly followed to ensure the integrity and confidentiality of the study. The findings and conclusions presented are solely those of the authors.
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Cite This Article
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ACS Style
Adinew, Y. Psychosocial Consequences, Experiences, and Motives in Quitting Khat Among Daily Users: A Qualitative Study in Gondar City. Innovation. 2025, 6(3), 55-62. doi: 10.11648/j.innov.20250603.12
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@article{10.11648/j.innov.20250603.12,
author = {Yedilfana Adinew},
title = {Psychosocial Consequences, Experiences, and Motives in Quitting Khat Among Daily Users: A Qualitative Study in Gondar City
},
journal = {Innovation},
volume = {6},
number = {3},
pages = {55-62},
doi = {10.11648/j.innov.20250603.12},
url = {https://doi.org/10.11648/j.innov.20250603.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.innov.20250603.12},
abstract = {The study examines psychological and social effects on married adult males who consume khat (Catha edulis) throughout Gondar City Ethiopia. The research demonstrates khat serves as a substantial public health concern because it triggers various adverse mental health impacts affecting individuals at all life stages and extended family and community members. Using both snowball sampling and convenience methods researchers gathered ten regular khat users for an investigation on addiction patterns and psychological symptoms and social effects and withdrawal mechanisms. The study implemented Amharic participants who received transcription services as well as thematic structural analysis. Those who use khat understand it serves as an addictive substance while using it to battle their life stress. The research revealed that repetitive unfortunate encounters caused both mental diseases and depression and psychosis and led to household ruptures and financial ruin. Subjects experienced major obstacles in ending their khat consumption since their bodies reacted with physical withdrawal symptoms and their minds remained addicted to its effects. The study demonstrates that health authorities should create personalized intervention programs which inform users about khat dangers and offer retreatment solutions to address addiction symptoms across physical and mental health domains. The study works to develop new public health policies and increase knowledge about khat behavioral effects within affected demographic groups.},
year = {2025}
}
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TY - JOUR
T1 - Psychosocial Consequences, Experiences, and Motives in Quitting Khat Among Daily Users: A Qualitative Study in Gondar City
AU - Yedilfana Adinew
Y1 - 2025/08/07
PY - 2025
N1 - https://doi.org/10.11648/j.innov.20250603.12
DO - 10.11648/j.innov.20250603.12
T2 - Innovation
JF - Innovation
JO - Innovation
SP - 55
EP - 62
PB - Science Publishing Group
SN - 2994-7138
UR - https://doi.org/10.11648/j.innov.20250603.12
AB - The study examines psychological and social effects on married adult males who consume khat (Catha edulis) throughout Gondar City Ethiopia. The research demonstrates khat serves as a substantial public health concern because it triggers various adverse mental health impacts affecting individuals at all life stages and extended family and community members. Using both snowball sampling and convenience methods researchers gathered ten regular khat users for an investigation on addiction patterns and psychological symptoms and social effects and withdrawal mechanisms. The study implemented Amharic participants who received transcription services as well as thematic structural analysis. Those who use khat understand it serves as an addictive substance while using it to battle their life stress. The research revealed that repetitive unfortunate encounters caused both mental diseases and depression and psychosis and led to household ruptures and financial ruin. Subjects experienced major obstacles in ending their khat consumption since their bodies reacted with physical withdrawal symptoms and their minds remained addicted to its effects. The study demonstrates that health authorities should create personalized intervention programs which inform users about khat dangers and offer retreatment solutions to address addiction symptoms across physical and mental health domains. The study works to develop new public health policies and increase knowledge about khat behavioral effects within affected demographic groups.
VL - 6
IS - 3
ER -
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