‘Bundle of fun’ or ‘bunch of problems’? Case series of khat-related deaths in the UK

Twenty million people worldwide use khat (Catha edulis). Previously confined to Eastern Africa and Arabia, consumption is spreading to other regions. Chewing khat leaves releases the stimulants cathinone and cathine. Khat consumption has adverse health consequences including myocardial infarction, liver failure, depression, psychoses and dependence. Literature regarding khat-related mortality is scant: only one death (in 1945) due to physiological complications, and a small number of fatalities due to psychological problems associated with long-term khat use have been reported. However, deaths associated with khat do occur. Thirteen deaths in the UK occurring in 2004–2009 associated with khat consumption are described. All decedents were males (mean age 35). Four deaths resulted from the physiopathological consequences of long-term khat use; liver failure (3), left ventricular failure and pulmonary oedema (1). In a further case, the deceased died of a cardiovascular event precipitated by khat use causing ...