Abstract:
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 im-
potence in men in addition to other health complications. Although khat is
legal in Kenya, some countries have outlawed the cultivation, sale and posses-
sion 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 chemi-
cal compounds generated responsible for psychoactive behaviour. Nonethe-
less, the health implications of repeated khat use and the challenges it poses in
the management of the Coronavirus disease-2019 (Covid-19) have been re-
viewed and reported in this work. Possible toxicological consequences are
discussed in detail. A literature search was done by targeting articles pub-
lished 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 us-
ing 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 as-
pects of khat use with recommendations from a medical perspective are also
discussed. Molecular modelling of selected psychoactive compounds gener-
ated 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. Fur-
thermore, the HOMO an LUMO structures for these organic molecules illu-
strates that they act as nucleophiles that can react with electrophilic unsatu-
rated human bio-molecules such as amino acids and lipids to initiate shifts in
pi-electrons and dienophile electrons resulting in gene alterations and muta-
tion. 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.