Confusion as health ministry classifies miraa (khat) a dangerous drug

By Gatonye Gathura

The Ministry of Health has classified miraa as a dangerous drug to human health in line with international conventions.

But this contradicts recent finding by government scientists which gave the shrub a clean bill of health.

It also contradicts claims by the government that it has petitioned the United Nations to remove khat from the international list of psychoactive drugs.

The United Nations classifies khat on Schedule I, indicating miraa among the most dangerous abused substances to human health.

In a national protocol released during this year’s International Day against Drug Abuse and Illicit Trafficking on June 26, Kenya’s health ministry confirmed khat as a psychoactive drug.

In the new National Protocol for Treatment of Substance Use Disorders in Kenya 2017, the ministry classifies miraa alongside, cocaine, ecstasy and amphetamines.

Amphetamines are stimulants that are largely used in treating the mental condition called Attention Deficit Hyperactivity Disorder (ADHD).

But they are in many cases abused for recreation with serious negative health effects.

In the new treatment protocol, the Ministry of Health says the effects of chewing khat are parallel to those of amphetamines. Khat’s active ingredient cathinone is indicated to act like an amphetamine in users.

The new protocol guides health workers on how to treat people who have problems with psychoactive drugs.

These are defined as drugs that can alter moods, emotions, and perceptions. They are put in three major categories; depressants, stimulants and hallucinogens. In this case khat falls in the category of stimulants.

“After ingesting khat, one may present with euphoria, hypervigilance, anxiety, tension, anger, impaired judgment and changes in sociability,” say the ministry document.

The protocol says miraa chewing can cause serious threats to the heart including abnormally slow or rapid beat rates.

Other health problems associated to miraa in the new document include elevated or lowered blood pressure, sweating or chills and weight loss.

If for some reason a serious miraa user stops, the document says they face serious withdrawal symptoms including, fatigue, vivid unpleasant dreams and agitation.

But this seems to contradict a February announcement by the Kenya Medical Research Institute (Kemri) which had given miraa a clean bill of health.

In a Sh 38 million publicly funded two-year study in Embu and Meru, Kemri scientists concluded miraa chewing did not have any negative health consequences.

The study was aimed at discrediting the grounds on which Britain, the US, France, Switzerland, and Sweden have banned use of the stimulant in their territories on grounds that it has adverse health effects.

Buoyed by these findings, while the health ministry was launching their protocol, the Cabinet Secretary for Agriculture Willy Bett was assuring miraa farmers in Nyambene, Embu that the ban could be lifted.

Mr Bet said the government has petitioned the United Nations on the European ban of miraa exports.

Kenya, he said is seeking an interpretation of a convention on drug trade that European nations had used to ban the exports.

“If the interpretation favours Kenya; that miraa is not a psychotic drug, then the government will ask these countries to remove the restrictions,” Bett told the farmers.

Launching the protocol the Head of Curative and Rehabilitative Services, at the ministry Dr Izaq Odongo said all efforts will be made to reduce the demand for substances of abuse and suppress their availability.

This seems to contradict recent pro miraa initiatives including directives by President Uhuru Kenyatta to give the crop high visibility as a significant cash crop.

On receiving a positive report from a presidential taskforce on miraa, the President in April had ordered the releasing of Sh1.2 billion to the subsector and implementation of the reports recommendations.

“Miraa is always a good thing for the people of Meru. We have had to fight false claims of infertility and other health issues, there is no evidence. We believe that this report should put to an end those lies and allow authorities to develop the crop,” MP for Tigania East Mpuru Aburi had said then.

Local politicians who had recommended the development of miraa derived products such as juices and wines may have celebrated a bit too early given the action by the Ministry of Health.

In the new protocol the ministry adopts the international classification of abused substances or psychoactive drugs.

According to this classification the substances are put into three classes starting with depressants, stimulates and hallucinogens.

Khat falls on the second class of stimulants, together with cocaine, nicotine, ecstasy, amphetamine and such others.

In the first group is alcohol alongside cannabis in low doses, inhalants and opioids while cannabis in high doses, ketamine and several others are in the third class of hallucinogens.

This protocol, writes Dr Jackson Kioko the Director of Medical Services, is based on international best practice to manage substance use disorders

 

www.rocketscience.co.ke

 

BOX

The UN Convention on Psychotropic Substances, 1971

The Convention on Psychotropic Substances of 1971 is a United Nations treaty designed to control psychoactive drugs. It was signed in Vienna Austria on 21 February 1971

As of June 2013, there were 183 state parties to the convention including the Holy See. Kenya signed the convention on 18/10/2000

The convention classifies controlled substances into four Schedules ranging from Schedule I (most restrictive) to Schedule IV (least restrictive).

Khat for its active ingredient cathinone falls on Schedule I (most dangerous)

Schedule I includes drugs linked to serious risk to public health. It includes among others cathinone, ecstasy and amphetamines.

The 1993 the US Drug Enforcement Administration (DEA) recommended the placing of cathinone in Schedule I this effectively banning khat.

‘Cathinone is the major psychoactive component of the plant Catha edulis (khat). The young leaves of khat are chewed for a stimulant effect. Enactment of this rule results in the placement of any material which contains cathinone into Schedule I’ – DEA

Source: UN Convention on Psychotropic Substances

Khat is controlled in a number of European countries including Belgium, Denmark, Germany, Greece, France, Ireland, Italy, Latvia, Lithuania, Poland, Slovenia, Finland, Sweden, Norway, and Switzerland.

 

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