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Over 100 million people live in Ethiopia, a large country in the Horn of Africa. For many Ethiopians, chewing khat is just part of life. Khat is an evergreen shrub native to East Africa and the Arabian Peninsula. The leaves of the khat plant contain two active ingredients, cathine and cathonine, both of which are amphetamine stimulants. In the United States and much of Europe, khat is a controlled substance. However, in Ethiopia and the region where it grows, about 5 to 10 million people use khat everyday to focus, stay awake, relieve pain, and experience euphoria. Some Ethiopians even use khat as an anti-depressant. For these reasons, many Ethiopians describe khat as “green gold.” After coffee, khat is Ethiopia’s second-largest export, mostly to Somalia and other neighboring nations.
Although Ethiopia has the largest population in East Africa, there is only one publicly-operated rehab facility for alcohol and drug addiction in the entire country. The Substance Rehabilitation Center is located in the city of Mekele, hundreds of miles away from Ethiopia’s capital and largest city Addis Ababa. The Center has recently started a program for treating khat addiction, a controversial concept, since experts debate whether khat is addictive, and many Ethiopians consider the drug to be an important part of their culture. Nevertheless, Welday Hagos, a psychologist who serves as the Center’s director, insists that khat is an addictive gateway drug.
According to Hagos, about 500 patients have received treatment at the Center since it opened in 2015, and over 80% of them chewed khat before they developed addictions to other substances. Hagos also says that long-term khat users suffer withdrawal symptoms when they abstain from the drug, a classic sign of addiction. Since khat stimulates the nervous system, many people who chew khat start to drink alcohol, smoke cigarettes, or take other drugs to relax and fall asleep. Before long, they develop co-occurring substance use disorders.
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Much like a treatment facility in the United States, the Substance Rehabilitation Center in Ethiopia uses individual and group therapy, medically-assisted detox, outdoor activities, and job-skills training to help patients overcome addiction and maintain sobriety. The Center has helped many Ethiopians obtain freedom from khat and other drugs.
Yonas Getu Molla is one Ethiopian who has benefited from the Center’s khat addiction program. Like many young Ethiopians, Yonas started chewing khat in college to work and study through the night. He eventually became dependent on the drug to succeed in his classes. Furthermore, after he finished studying, Yonas and his friends would unwind by drinking liquor and smoking marijuana. Yonas says that abusing khat as a student caused him to become an alcoholic and a drug addict, which impacted his career and his relationships. Fortunately, Yonas recovered from his addictions at the Substance Rehabilitation Center. Mohammed Kelifa, another Ethiopian who recovered at the Substance Rehabilitation Center, chewed khat for almost ten years. His addiction destroyed his marriage, but after three months at the facility, Kelifa says he’s ready to restart his life.
I want to remarry and start a family and get my self-respect back. Most people, when they leave this place, they fear that they will relapse, but I don’t have that feeling.
In addition to possibly causing other substance use disorders, khat addiction may be a factor that contributes to persistent poverty in Ethiopia, where the average worker earns only about $750 per year. Habitual khat chewers spend much of their incomes to buy more khat instead of investing in the economy. The efforts of the Substance Rehabilitation Center might help to address this problem. Despite the Center’s promising results, director Hagos believes that khat remains a challenge for Ethiopia. “We are not on the right track,” he warned. “We have to increase the knowledge of our population of the consequences of khat chewing.”
Nathan Yerby is a writer and researcher. He is a graduate of the University of Central Florida.