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Pontifications on Poison

Being some ramblings on events associated with poisonous plants.

Thursday 1st November 2012

I realise it would be unfair to complain that a BBC journalist did not have time to fully explore the claims being made by contributors to a story that was reported in one of the local news sections of the BBC website but did not feature in the 30-minute evening TV news for the region. Cost pressures mean that stories have to be produced in the shortest possible time and there is not the luxury to spend even half an hour or so collecting the information to round out a story.

Rather than be unfair in this way, I thought I would invest the half hour required and explore some of the information given in a story1 about a demonstration in London calling for a ban on Catha edulis, khat.

Catha edulis, khat

The headline says ‘Somalis urge government to ban khat’. Headlines have to be punchy and, I suppose, ‘100 Somalis urge government to ban khat’ would have lost the punch. We should be grateful the item began with the words ‘About 100’ making it clear that this was a very small demonstration. Just how small is, helpfully, explained in the piece when Richard Hamilton, Africa editor for the BBC World Service, is quoted as saying that more than a third of the 100,000+ Somalis in the UK have been reported to be regular users.

The report then describes the effects of chewing khat, both physical and social, making it fairly clear that it is giving the views of the demonstrators. Only ‘fairly clear’ because the direct attribution of the third paragraph;

‘The campaigners said it caused medical problems and family breakdowns.’

Is rather woollier by the sixth;

‘Fears have been raised that the stimulant is contributing to mental health problems within the communities that use it.’

Because there is no indication of who has raised these fears.

That third paragraph needs more explanation. Though there are undoubtedly khat users who have suffered medical problems and family breakdowns there is no evidence that khat has been the causal agent. In a very few cases, extremely heavy khat use has been believed to have been a contributory factor.

Catha edulis, khat

Following another couple of paragraphs of unchallenged assertions about things like the claim that khat chewing prevents Somali men from working (most people agree that the absence of work due to the general employment situation is what gives Somali men the time to chew khat) we get to the heart of the report with quotes from Abukar Awale the self-appointed leader of Somalis calling for a ban on khat.

The one I thought worth looking at more closely comes when Awale says;

‘I'd like to bring to your attention a report which came out in 2011, called 'khat related deaths' there are fourteen cases - all young men, all of them died of liver failure.’

‘Khat related deaths’ looked like an obvious search term and so it proved. Very quickly I found this pdf2 entitled ‘Assessing khat-related death, with special reference to the UK situation’ presented to a conference on ‘Regulating khat’ and based on work done for a paper ‘Bundle of fun’ or ‘bunch of problems’? Case series of khat-related deaths in the UK’.3

Catha edulis, khat

The presentation says that there were 14 ‘khat related’ deaths in the UK in the period 2004-2009. Table 2 of the presentation, however, says that in three of the fourteen cases there was no evidence of using khat so I can’t help wondering why they were counted.

‘Khat related’ means only that khat was mentioned at some point in the investigations of these deaths. Of the fourteen, only one was given as being due to ‘non-dependent abuse of drugs’ with a second as ‘drug abuse and natural causes’. The rest were all ascribed to causes that have no necessary relationship to drug use of any kind.

Corkery then gives a breakdown of the fourteen deaths but it must be remembered these are his conclusions not official verdicts. In seven of the fourteen cases, other intoxicants were present including one case where death was due to an overdose of heroin though the toxicological examination found evidence of khat. One death was a suicide where no khat was present in the body but previous khat use was taken as sufficient to classify this as a ‘khat-related’ death. And in one case the khat use was stated as ‘possible’.

One victim was murdered and Corkery suggests that this was the result of impaired judgement due to khat leading to him being rude. Though he notes that this man had also consumed alcohol and cannabis, he lists this as ‘khat-related’.

The slides in the presentation all carried the footing ‘St George’s University of London – International Centre for Drug Policy’. I hadn’t heard of that body before so I looked it up and found that the centre's director is Professor Hamid Ghodse. Prof Ghodse is a past president of the International Narcotics Control Board (INCB).

I’ve written before about the INCB and, on that occasion, I quoted what Ghodse had to say about 100 years of prohibition;

‘Prior to the adoption of the 1912 Convention, the world was experiencing an abysmal situation with regard to drugs. In most countries, trade in drugs was not regulated and substance abuse was widespread.’

‘Over the past 100 years, significant achievements have been made in international drug control’

I think that a body with such a man as this as its director tells us all we need to know about the ICDP.

So, Mr Awale was citing an uncertain piece of research from a body with strong prohibitionist leanings and, to compound the misrepresentation, wrongly stating what that research claimed to have found. Rather than ‘all of them died of liver failure’ we find that Corkery describes only three cases where any form of liver disease was involved.

There’s little doubt that the BBC’s report would leave a casual reader with the impression that there was an established link between khat and death. Fourteen deaths in six years counted by taking the widest possible interpretation of ‘khat-related’ do not justify that impression.

I hope I don’t need to go into all the reasons why, even if khat were as harmful as Mr Awale likes to claim, making it illegal would only add to those harms.

References

1.Somalis urge government to ban khat BBC 1st November 2012
2.Assessing khat-related death, with special reference to the UK situation John M. Corkery, International Centre for Drug Policy March 2011
3.Bundle of fun’ or ‘bunch of problems’? Case series of khat-related deaths in the UK Corkery et al Drugs: Education, Prevention, and Policy Vol 18 No 6 2011  

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