The construct of a substance use disorder syndrome for khat using DSM-5 criteria appears valid and performs in a manner consistent with other substances of dependence. Individuals with khat use disorder experience substantial problems in association with khat use. Despite this, there are low levels of help-seeking for these problems.

Regular khat chewers have difficulties in maintaining abstinence despite having motivation and desire to quit. This implies that treatment aids may be needed to assist chewers' in their quit attempts. Controlled experimental trial through the use of available low cost quit aids and behavioural resources is crucial in order to increase success rates for those seeking to desist from khat use.

Although khat is a mild stimulant, there is clear evidence that some consumers are both concerned with their use and experience problems associated with their use. Consistent with its application for other drugs, the SDS is a brief and simple screening tool that appears to validly identify individuals experiencing a khat use disorder syndrome and experiencing high rates of adverse consequences in association with use.

Research reports show increased prevalence of habitual khat chewing among various parts of the community in Ethiopia. Some users experience problems controlling their use; withdrawal symptoms may be adding to difficulties with reducing or ceasing use. We aimed to describe the nature and the time course of any withdrawal syndrome in relation to the cessation of khat use over the first 2 weeks of a quit attempt. Fifty-nine participants between the ages of 18 and 35 and who have already chewed ≥1 bundle of khat in their life with a chewing frequency of ≥3 days per week were recruited from Adama Science and Technology University campus. Participants were predominantly male (n = 45, 75%) and had the mean age of 24.8 years (range = 20-32; SD = 2.8). Participants used smart phones to monitor withdrawal symptoms and cravings. The total assessments were divided in to 3 prequit and 14 postquit days. The development of withdrawal symptoms was evident, and all withdrawal symptoms followed similar overall patterns, with salient elevations after the quit day and curvatures around the first week of postquit period. Depression, craving, nervousness, tiredness, restlessness, poor motivation, irritability, and negative affect substantially increased and reached peak on the first week around Day 7 and remained higher compared with the level at baseline indicating the persistence and severity of these symptoms over time. In addition, craving, irritability, and restlessness had significantly reverted to their baseline level during the second week of the postquit duration. We have demonstrated low rates of success during unaided quite attempts from khat and that the withdrawal syndrome is not trivial. Interventions are necessary to support individuals during the period of increased symptoms of dysphoria and to reduce the risk of relapse. (PsycINFO Database Record

A considerable body of research has accumulated over several decades and altered the current understanding of substance use and its effects on the brain. This knowledge has improved the perception of the disease of addiction and has opened the door to new ways of thinking about diagnosis, prevention, and treatment of substance use disorders. The purpose of the current chapter is to briefly outline and summarize the major psychopharmacological framework underlying substance use disorder (SUD) and the factors that involve in the transformation of some people from recreational use or misuse of alcohol or drugs to SUD. The chapter explains the overall neurocircuitry theories of the addiction cycle: binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation. It briefly discusses how psychoactive substances produce changes in brain functioning that facilitate the development of addiction and contribute to craving which eventually leads to relapse. The chapter also deals with similarities and differences among various classes of addictive substances in their effects on the brain and behavior and briefly describes the main risk factors that involve SUD. Finally, an attempt is made to briefly discuss the major DSM 5 based behavioral criteria that involve SUD, corresponding to the most abused substances worldwide.