By Lukoye Atwoli
Sunday Nation 13 October 2013
Kenya is a very interesting country. Most citizens will argue about almost anything, which is a healthy and good thing, especially if the arguments are backed by evidence that follows the precepts of logic. Unfortunately, we tend to hold opinions and defend them strongly without much independent evidence. We mistake strong feelings for strong evidence, and dismiss any piece of information that contradicts our already formed positions.
Sadly, this is the case with the ongoing arguments about khat, or miraa. Misleadingly, the argument has been framed as an attempt to answer the very straight-forward question: Is miraa (or does miraa contain) a drug? Subsequent arguments have laid bare the real question being answered, which is: Should miraa be considered a dangerous drug, and be restricted or banned? (READ: Kenyan leaders and farmers challenge miraa ban in UK)
These are obviously two different questions, and attempting to answer them as though they were one and the same thing is bound to lead to confusion. Usually, the first step towards finding a solution to a problem is finding out its source. In this case, the source of the problem is the decision by some countries to ban or restrict the consumption of miraa on the basis that the disadvantages of use far outweigh any benefits.
Let us try and answer these two questions, and perhaps frame the question for argument correctly.
Firstly, is miraa a drug? The simple answer to this question is an unqualified yes! The World Health Organisation defines a drug as “a chemical agent that alters the biochemical or physiological processes of tissues or organisms”. In other words, a drug changes the structure and function of the body.
Since early in the last century, scientists have described the main active ingredients in khat to be cathine and cathinone, which are known psychostimulants that affect the structure and function of the nervous system. Khat ingestion has been shown clinically to result in symptoms similar to those induced by other stimulants, such as restlessness, garrulousness, sleep and mood changes and even psychotic symptoms.
'KHAT PSYCHOSIS'
Indeed, doctors who have worked in areas where miraa use is widespread have numerous anecdotes of “khat psychosis”. To “treat” this condition, relatives often lock up the “sick” individual for a few days and, after the stimulant has worked its way out of the system, they are considered “healed” and resume normal functions.
More studies have described dental and gastrointestinal effects of chronic miraa use, while others have clearly described effects on the reproductive system. In short, there is no doubt in the minds of experts that miraa is a drug!
The only question that needs answering therefore is whether miraa should be considered a dangerous drug and perhaps be restricted or even banned. This is, however, not a medical or scientific question, but a political one.
The scientists must honestly tell the politicians the scientific effects of miraa on the body of the user, which are well established and require no further study. The politicians should then determine whether, in their own opinion, those effects are sufficiently harmful to the physical, psychological, and social well-being of the population to warrant legislative action.
Lawmakers in a number of other countries have made this determination and taken action restricting or banning miraa use. The miraa debate is thus purely political, and has no bearing on whether miraa is a drug or not!
Dr Lukoye Atwoli is a consultant psychiatrist and senior lecturer at Moi University’s School of Medicine. lukoye@gmail.com
Sunday Nation 13 October 2013
Kenya is a very interesting country. Most citizens will argue about almost anything, which is a healthy and good thing, especially if the arguments are backed by evidence that follows the precepts of logic. Unfortunately, we tend to hold opinions and defend them strongly without much independent evidence. We mistake strong feelings for strong evidence, and dismiss any piece of information that contradicts our already formed positions.
Sadly, this is the case with the ongoing arguments about khat, or miraa. Misleadingly, the argument has been framed as an attempt to answer the very straight-forward question: Is miraa (or does miraa contain) a drug? Subsequent arguments have laid bare the real question being answered, which is: Should miraa be considered a dangerous drug, and be restricted or banned? (READ: Kenyan leaders and farmers challenge miraa ban in UK)
These are obviously two different questions, and attempting to answer them as though they were one and the same thing is bound to lead to confusion. Usually, the first step towards finding a solution to a problem is finding out its source. In this case, the source of the problem is the decision by some countries to ban or restrict the consumption of miraa on the basis that the disadvantages of use far outweigh any benefits.
Let us try and answer these two questions, and perhaps frame the question for argument correctly.
Firstly, is miraa a drug? The simple answer to this question is an unqualified yes! The World Health Organisation defines a drug as “a chemical agent that alters the biochemical or physiological processes of tissues or organisms”. In other words, a drug changes the structure and function of the body.
Since early in the last century, scientists have described the main active ingredients in khat to be cathine and cathinone, which are known psychostimulants that affect the structure and function of the nervous system. Khat ingestion has been shown clinically to result in symptoms similar to those induced by other stimulants, such as restlessness, garrulousness, sleep and mood changes and even psychotic symptoms.
'KHAT PSYCHOSIS'
Indeed, doctors who have worked in areas where miraa use is widespread have numerous anecdotes of “khat psychosis”. To “treat” this condition, relatives often lock up the “sick” individual for a few days and, after the stimulant has worked its way out of the system, they are considered “healed” and resume normal functions.
More studies have described dental and gastrointestinal effects of chronic miraa use, while others have clearly described effects on the reproductive system. In short, there is no doubt in the minds of experts that miraa is a drug!
The only question that needs answering therefore is whether miraa should be considered a dangerous drug and perhaps be restricted or even banned. This is, however, not a medical or scientific question, but a political one.
The scientists must honestly tell the politicians the scientific effects of miraa on the body of the user, which are well established and require no further study. The politicians should then determine whether, in their own opinion, those effects are sufficiently harmful to the physical, psychological, and social well-being of the population to warrant legislative action.
Lawmakers in a number of other countries have made this determination and taken action restricting or banning miraa use. The miraa debate is thus purely political, and has no bearing on whether miraa is a drug or not!
Dr Lukoye Atwoli is a consultant psychiatrist and senior lecturer at Moi University’s School of Medicine. lukoye@gmail.com
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ReplyDeleteMeru senator Deputy President William on the left to challenge
ReplyDeleteUK Government decision to ban khat interesting issue is some of the Kenyan leaders who are lobbing for khat and acting like drug dealers they are already WANTED by international criminal court ( ICC ) for crimes against humanity .
My message to my fellow east African gentleman is see you in court if you make it to London ,and remember we welcome this new move for simple reason that their recourse to the law is a tacit admission of responsibility for the harmful effects of the khat trade wrought on our community, which will allow us to submit a counter claim for damages.