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Substance Abuse Treatment, Prevention, and Policy
Published in: Substance Abuse Treatment, Prevention, and Policy 1/2017

Open Access 01-12-2017 | Research

Problematic khat use as a possible risk factor for harmful use of other psychoactive substances: a mixed method study in Ethiopia

Authors: Awoke Mihretu, Solomon Teferra, Abebaw Fekadu

Published in: Substance Abuse Treatment, Prevention, and Policy | Issue 1/2017

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Abstract

Background

Substance use disorders along with neuropsychiatric disorders contributed about 14% of the global burden of disease. Harmful alcohol use, is a known contributor for many harms (accidents, suicide, violence, and complication of other psychiatric and medical disorders). In the Western countries, alcohol and nicotine are gateway drugs to cannabis use, and cannabis use is a risk factor for other illicit drugs such as cocaine and heroin. Khat use is another psychoactive substance which is common in East African and Arabian Peninsula. But there is a knowledge gap regarding the position of khat use or problematic khat use in sequential progression of different psychoactive substances. Therefore, we aimed to understand and investigate the relationship of problematic khat use and other psychoactive substances in Ethiopia.

Methods

Exploratory mixed methods study was employed. Quantitative cross sectional survey was done among 102 khat users, and 4 focus group discussions and 11 in-depth interviews were conducted to understand the pathways between khat use and other psychoactive substances use in 2014. Non random sampling (purposive and snowballing) was employed for both quantitative and qualitative studies. Khat users from khat cafeterias, shops, and from other open markets of khat in Addis Ababa were invited to participate.

Result

Currently significant majorities of khat users (86.3%) used at least one other psychoactive substance after they started khat use. The prevalence of harmful drinking was 53.9% among khat users. Problematic khat use was a significant predictor of harmful drinking (p < 0.05). About one from ten respondents engaged to risky sexual behavior pushed by the effect of khat after chewing.

Conclusion

The proportion of psychoactive substances use especially harmful drinking among khat users was observed higher compared to other cross sectional surveys conducted among general population. In Ethiopia, intervention and policy on harmful alcohol use could consider problematic khat use as one possible risky factor. A rigorous methodology which could test gateway hypothesis of problematic psychoactive substances use could be warranted.
Literature
1.
Prince M, Patel V, Saxena S, Maj M, Maselko J, Phillips MR, et al. No health without mental health. Lancet. 2007;370(9590):859–77.CrossRefPubMed
2.
3.
Kirby T, Barry AE. Alcohol as a gateway drug: a study of US 12th graders. J Sch Health. 2012;82(8):371–9.CrossRefPubMed
4.
Fergusson DM, Boden JM, Horwood LJ. Cannabis use and other illicit drug use: testing the cannabis gateway hypothesis. Addiction. 2006;101(4):556–69.CrossRefPubMed
5.
Mihretu A, Teferra S, Fekadu A. What constitutes problematic khat use? An exploratory mixed methods study in Ethiopia. Subst Abuse Treat Prev Policy. 2017;12(1):17.CrossRefPubMedPubMedCentral
6.
Kassim S, Croucher R. Khat chewing amongst UK resident male Yemeni adults: an exploratory study. Int Dent J. 2006;56(2):97–101.CrossRefPubMed
7.
Haile D, Lakew Y. Khat chewing practice and associated factors among adults in Ethiopia: further analysis using the 2011 demographic and health survey. PLoS One. 2015;10(6):e0130460.CrossRefPubMedPubMedCentral
8.
FACJT M. Khat chewing among Agaro secondary school students. Ethiop Med J. 1994;32:161–6.
9.
Aklog T, Tiruneh G, Tsegay G. Assessment of substance abuse and associated factors among students of debre markos poly technique college in debre markos town, East Gojjam Zone, Amhara Regional State, Ethiopia, 2013. Global journal of medical research. 2013;13:4-B
10.
Hagos EG, Asfeha GG, Berihu BA. Prevalence of substance abuse among regular degree health science students in Sheba University College in Mekelle Town, Tigray-Ethiopia. Journal of neurosciences in rural practice. 2016;7(2):200.
11.
Fekadu A, Alem A, Hanlon C. Alcohol and drug abuse in Ethiopia: past, present and future. Afr J of Drug Alcohol Stud. 2007;6(1):39–53.
12.
Nutt D, King LA, Saulsbury W, Blakemore C. Development of a rational scale to assess the harm of drugs of potential misuse. Lancet. 2007;369(9566):1047–53.CrossRefPubMed
13.
Alem A, Kebede D, Kullgren G. The epidemiology of problem drinking in Butajira. Ethiop Acta Psychiatr Scand. 1999;100(S397):77–83.CrossRef
14.
Fekadu A, Alem A, Hanlon C. Alcohol and drug abuse in Ethiopia: past, present and future. Afr J Drug Alcohol Stud. 2007;6(1):40–53.
15.
Duresso SW, Matthews AJ, Ferguson SG, Bruno R. Is khat use disorder a valid diagnostic entity? Addiction. 2016;111(9):1666–76.CrossRefPubMed
16.
Kassim S, Islam S, Croucher RE. Correlates of nicotine dependence in U.K. resident Yemeni khat chewers: a cross-sectional study. Nicotine Tob Res. 2011;13(12):1240–9.CrossRefPubMed
17.
Nakajima M, al’Absi M. Psychosocial deterrents of tobacco and khat use among men and women. Public Health. 2013;127(7):684–6.CrossRefPubMed
18.
Griffiths P, Gossop M, Wickenden S, Dunworth J, Harris K, Lloyd C. A transcultural pattern of drug use: Qat (khat) in the UK. Br J Psychiatry. 1997;170(3):281–4.CrossRefPubMed
19.
Tesfaye F, Byass P, Wall S, Berhane Y, Bonita R. Association of smoking and khat (Catha edulis Forsk) use with high blood pressure among adults in Addis Ababa, Ethiopia, 2006. Preventing chronic disease. 2008;5(3):A89.
20.
Odenwald M, Hinkel H, Schauer E, Neuner F, Schauer M, Elbert TR, et al. The consumption of khat and other drugs in Somali combatants: a cross-sectional study. PLoS Med. 2007;4(12):e341.CrossRefPubMedPubMedCentral
21.
Odenwald M, Neuner F, Schauer M, Elbert T, Catani C, Lingenfelder B, Hinkel H, Häfner H, Rockstroh B. Khat use as risk factor for psychotic disorders: a cross-sectional and case-control study in Somalia. BMC medicine. 2005;3(1):5.
22.
Duresso SW, Matthews AJ, Ferguson SG, Bruno R. Is khat use disorder a valid diagnostic entity? Addiction. 2016;111(9):1666-76.
23.
Fekadu A, Medhin G, Selamu M, Hailemariam M, Alem A, Giorgis TW, et al. Population level mental distress in rural Ethiopia. BMC Psychiatry. 2014;14(1):194.CrossRefPubMedPubMedCentral
24.
Schumacker RE, Lomax RG. A beginner's guide to structural equation modeling. London: Psychology Press; 2004.
25.
Boys A, Marsden J, Strang J. Understanding reasons for drug use amongst young people: a functional perspective. Health Educ Res. 2001;16(4):457–69.
26.
27.
Al-Motarreb A, Baker K, Broadley KJ. Khat: pharmacological and medical aspects and its social use in Yemen. Phytother Res. 2002;16(5):403–13.CrossRefPubMed
28.
Alem A, Kebede D, Kullgren G. The prevalence and socio-demographic correlates of khat chewing in Butajira. Ethiop Acta Psychiatr Scand Suppl. 1999;100:84–91.CrossRef
29.
Gelaw Y, Haile-Amlak A. Khat chewing and its socio-demographic correlates among the staff of Jimma University. Ethiop J Health Dev. 2004;18(3):179–84.
30.
Manghi RA, Broers B, Khan R, Benguettat D, Khazaal Y, Zullino DF. Khat use: lifestyle or addiction? J Psychoactive Drugs. 2009;41(1):1–10.CrossRefPubMed
31.
Teferra S, Medhin G, Selamu M, Bhana A, Hanlon C, Fekadu A. Hazardous alcohol use and associated factors in a rural Ethiopian district: a cross-sectional community survey. BMC Public Health. 2016;16(1):218.CrossRefPubMedPubMedCentral
32.
Gebreslassie M, Feleke A, Melese T. Psychoactive substances use and associated factors among Axum university students, Axum town, North Ethiopia. BMC Public Health. 2013;13:693.CrossRefPubMedPubMedCentral
33.
Kebede Y. Cigarette smoking and khat chewing among college students in Northwest Ethiopia. Ethiop J Health Dev. 2002;16(1):9–17.CrossRef
34.
Stevenson M, Fitzgerald J, Banwell C. Chewing as a social act: cultural displacement and khat consumption in the east African communities of Melbourne. Drug Alcohol Rev. 1996;15(1):73–82.CrossRefPubMed
35.
Abebe, et al. Khat chewing habit as possible risk behaviour for HIV infection: a case-control study. Ethiop J Health Dev. 2005;19(3):174–81.
36.
Kebede D, Alem A, Mitike G, Enquselassie F, Berhane F, Abebe Y, Ayele R, Lemma W, Assefa T, Gebremichael T. Khat and alcohol use and risky sex behaviour among in-school and out-of-school youth in Ethiopia. BMC public health. 2005;5(1):109.
Metadata
Title
Problematic khat use as a possible risk factor for harmful use of other psychoactive substances: a mixed method study in Ethiopia
Authors
Awoke Mihretu
Solomon Teferra
Abebaw Fekadu
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Substance Abuse Treatment, Prevention, and Policy / Issue 1/2017
Electronic ISSN: 1747-597X
DOI
https://doi.org/10.1186/s13011-017-0132-3

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