The consumption of khat and other drugs in Somali combatants: a cross-sectional study

Odenwald M, Hinkel H, Schauer E, Neuner F, Schauer M, Elbert T, Rockstroh B (2007)
PLoS medicine 4(12).

Journal Article | Published | English

No fulltext has been uploaded

Author
; ; ; ; ; ;
Abstract
BACKGROUND: For more than a decade, most parts of Somalia have not been under the control of any type of government. This "failure of state" is complete in the central and southern regions and most apparent in Mogadishu, which had been for a long period in the hands of warlords deploying their private militias in a battle for resources. In contrast, the northern part of Somalia has had relatively stable control under regional administrations, which are, however, not internationally recognized. The present study provides information about drug abuse among active security personnel and militia with an emphasis on regional differences in relation to the lack of central governmental control-to our knowledge the first account on this topic. METHODS AND FINDINGS: Trained local interviewers conducted a total of 8,723 interviews of armed personnel in seven convenience samples in different regions of Somalia; 587 (6.3%) respondents discontinued the interview and 12 (0.001%) were excluded for other reasons. We assessed basic sociodemographic information, self-reported khat use, and how respondents perceived the use of khat, cannabis (which includes both hashish and marijuana), psychoactive tablets (e.g., benzodiazepines), alcohol, solvents, and hemp seeds in their units. The cautious interpretation of our data suggest that sociodemographic characteristics and drug use among military personnel differ substantially between northern and southern/central Somalia. In total, 36.4% (99% confidence interval [CI] 19.3%-57.7%) of respondents reported khat use in the week before the interview, whereas in some regions of southern/central Somalia khat use, especially excessive use, was reported more frequently. Self-reported khat use differed substantially from the perceived use in units. According to the perception of respondents, the most frequent form of drug use is khat chewing (on average, 70.1% in previous week, 99% CI 63.6%-76.5%), followed by smoking cannabis (10.7%, 99% CI 0%-30.4%), ingesting psychoactive tablets (8.5%, 99% CI 0%-24.4%), drinking alcohol (5.3%, 99% CI 0%-13.8%), inhaling solvents (1.8%, 99% CI 0%-5.1%), and eating hemp seeds (0.6%, 99% CI 0%-2.0%). Perceived use of khat differs little between northern and southern Somalia, but perceived use of other drugs reaches alarmingly high levels in some regions of the south, especially related to smoking cannabis and using psychoactive tablets. CONCLUSIONS: Our data suggest that drug use has quantitatively and qualitatively changed over the course of conflicts in southern Somalia, as current patterns are in contrast to traditional use. Although future studies using random sampling methods need to confirm our results, we hypothesize that drug-related problems of armed staff and other vulnerable groups in southern Somalia has reached proportions formerly unknown to the country, especially as we believe that any biases in our data would lead to an underestimation of actual drug use. We recommend that future disarmament, demobilization, and reintegration (DDR) programs need to be prepared to deal with significant drug-related problems in Somalia.
Publishing Year
ISSN
eISSN
PUB-ID

Cite this

Odenwald M, Hinkel H, Schauer E, et al. The consumption of khat and other drugs in Somali combatants: a cross-sectional study. PLoS medicine. 2007;4(12).
Odenwald, M., Hinkel, H., Schauer, E., Neuner, F., Schauer, M., Elbert, T., & Rockstroh, B. (2007). The consumption of khat and other drugs in Somali combatants: a cross-sectional study. PLoS medicine, 4(12).
Odenwald, M., Hinkel, H., Schauer, E., Neuner, F., Schauer, M., Elbert, T., and Rockstroh, B. (2007). The consumption of khat and other drugs in Somali combatants: a cross-sectional study. PLoS medicine 4.
Odenwald, M., et al., 2007. The consumption of khat and other drugs in Somali combatants: a cross-sectional study. PLoS medicine, 4(12).
M. Odenwald, et al., “The consumption of khat and other drugs in Somali combatants: a cross-sectional study”, PLoS medicine, vol. 4, 2007.
Odenwald, M., Hinkel, H., Schauer, E., Neuner, F., Schauer, M., Elbert, T., Rockstroh, B.: The consumption of khat and other drugs in Somali combatants: a cross-sectional study. PLoS medicine. 4, (2007).
Odenwald, Michael, Hinkel, Harald, Schauer, Elisabeth, Neuner, Frank, Schauer, Margarete, Elbert, Thomas, and Rockstroh, Brigitte. “The consumption of khat and other drugs in Somali combatants: a cross-sectional study”. PLoS medicine 4.12 (2007).
This data publication is cited in the following publications:
This publication cites the following data publications:

15 Citations in Europe PMC

Data provided by Europe PubMed Central.

Cannabis use among Navy personnel in Sri Lanka: a cross sectional study.
de Silva VA, Jayasekera N, Hanwella R., BMC Res Notes 9(), 2016
PMID: 26987474
Use of a bibliometric literature review to assess medical research capacity in post-conflict and developing countries: Somaliland 1991-2013.
Boyce R, Rosch R, Finlayson A, Handuleh D, Walhad SA, Whitwell S, Leather A., Trop. Med. Int. Health 20(11), 2015
PMID: 26293701
Increased drug seizures in Hatay, Turkey related to civil war in Syria.
Arslan MM, Zeren C, Celikel A, Ortanca I, Demirkiran S., Int. J. Drug Policy 26(1), 2015
PMID: 24947994
Khat Use, PTSD and Psychotic Symptoms among Somali Refugees in Nairobi - A Pilot Study.
Widmann M, Warsame AH, Mikulica J, von Beust J, Isse MM, Ndetei D, al'Absi M, Odenwald MG., Front Public Health 2(), 2014
PMID: 25072043
Effects of chronic khat use on cardiovascular, adrenocortical, and psychological responses to stress in men and women.
al'Absi M, Khalil NS, Al Habori M, Hoffman R, Fujiwara K, Wittmers L., Am J Addict 22(2), 2013
PMID: 23414493
Does perpetrating violence damage mental health? Differences between forcibly recruited and voluntary combatants in DR Congo.
Hecker T, Hermenau K, Maedl A, Hinkel H, Schauer M, Elbert T., J Trauma Stress 26(1), 2013
PMID: 23319373
A pilot study on community-based outpatient treatment for patients with chronic psychotic disorders in Somalia: Change in symptoms, functioning and co-morbid khat use.
Odenwald M, Lingenfelder B, Peschel W, Haibe FA, Warsame AM, Omer A, Stockel J, Maedl A, Elbert T., Int J Ment Health Syst 6(1), 2012
PMID: 22747911
Khat use among Somali mental health service users in South London.
Tulloch AD, Frayn E, Craig TK, Nicholson TR., Soc Psychiatry Psychiatr Epidemiol 47(10), 2012
PMID: 22249804
Exposure to violence and PTSD symptoms among Somali women.
de Jong K, van der Kam S, Swarthout T, Ford N, Mills C, Yun O, Kleber RJ., J Trauma Stress 24(6), 2011
PMID: 22144120
Psychoses, PTSD, and depression in Somali refugees in Minnesota.
Kroll J, Yusuf AI, Fujiwara K., Soc Psychiatry Psychiatr Epidemiol 46(6), 2011
PMID: 20354676
Drug consumption in conflict zones in Somalia.
Bhui K, Warfa N., PLoS Med. 4(12), 2007
PMID: 18076283

75 References

Data provided by Europe PubMed Central.

The 'number needed to sample' in primary care research. Comparison of two primary care sampling frames for chronic back pain.
Smith BH, Hannaford PC, Elliott AM, Smith WC, Chambers WA., Fam Pract 22(2), 2005
PMID: 15722397
Self-reported alcohol use and sexual behaviors of adolescents.
Dunn MS, Bartee RT, Perko MA., Psychol Rep 92(1), 2003
PMID: 12674302
Khat habit and its health effect. A natural amphetamine.
Dhaifalah I, Santavy J., Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 148(1), 2004
PMID: 15523540
The potential adverse effects of habitual use of Catha edulis (khat).
Al-Habori M., Expert Opin Drug Saf 4(6), 2005
PMID: 16255671
Pharmacokinetics of cathinone, cathine and norephedrine after the chewing of khat leaves.
Toennes SW, Harder S, Schramm M, Niess C, Kauert GF., Br J Clin Pharmacol 56(1), 2003
PMID: 12848785
Psychiatric morbidity among khat chewers.
Dhadphale M, Omolo OE., East Afr Med J 65(6), 1988
PMID: 3181055
Screening for posttraumatic stress disorder among Somali ex-combatants: a validation study.
Odenwald M, Lingenfelder B, Schauer M, Neuner F, Rockstroh B, Hinkel H, Elbert T., Confl Health 1(), 2007
PMID: 17822562
Perceived social norms and their relation to university student drinking.
Kypri K, Langley JD., J. Stud. Alcohol 64(6), 2003
PMID: 14743946
Gender-specific misperceptions of college student drinking norms.
Lewis MA, Neighbors C., Psychol Addict Behav 18(4), 2004
PMID: 15631605
Cannabis and schizophrenia: impact on onset, course, psychopathology and outcomes.
Bersani G, Orlandi V, Kotzalidis GD, Pancheri P., Eur Arch Psychiatry Clin Neurosci 252(2), 2002
PMID: 12111342
Marijuana use and car crash injury.
Blows S, Ivers RQ, Connor J, Ameratunga S, Woodward M, Norton R., Addiction 100(5), 2005
PMID: 15847617

Patel SL, Wright S, Gammampila A., 2005
Qat use in London: a study of qat use among a sample of Somalis living in London
Griffiths P., 1998

AUTHOR UNKNOWN, 2006
Khat: pharmacological and medical aspects and its social use in Yemen.
Al-Motarreb A, Baker K, Broadley KJ., Phytother Res 16(5), 2002
PMID: 12203257
[Epidemiologic study of qat use in the National Army of Djibouti]
Mion G, Oberti M., Med Trop (Mars) 58(2), 1998
PMID: 9791597
Poverty and mental illness.
Saraceno B, Barbui C., Can J Psychiatry 42(3), 1997
PMID: 9114944
Experience in the control of khat-chewing in Somalia.
Elmi AS, Ahmed YH, Samatar MS., Bull Narc 39(2), 1987
PMID: 2896525

Export

0 Marked Publications

Open Data PUB

Web of Science

View record in Web of Science®

Sources

PMID: 18076280
PubMed | Europe PMC

Search this title in

Google Scholar