1. Introduction 12-17
• Background
• Role of the ACMD
• Remit of review and scope
• Steps taken to implement recommendations from 2005 report
• Quality of research and hierarchies of evidence

2. Khat 18-27
• Khat use – Global
• International comparisons
• Khat use – UK

3. The Pharmacology of Khat 28-30
• The active ingredients
• Pharmacokinetics and pharmacodynamics
• Mechanism of action

4. Medical Harms 31-44
• Dependence
• Cardiovascular effects
• Respiratory system effects
• Oral and gastrointestinal system pathologies
• Liver
• Pregnancy
• Psychiatric effects
• Cognitive impairment
• Links to mortality
• Summary on medical harms

5. Overview of the Societal Harms associated with khat use 45-57
• Unemployment
• Family breakdown
• Income diversion
• Consumption by young persons
• Consumption by women
• Anti-social behaviour
• Violence
• Crime and criminal networks
• Integration
• Summary on social harms

6. International Issues 58-66
• Legislation
• Legislation by Country
• Australia
• Canada
• Denmark
• The Netherlands
• Norway
• Sweden
• United States of America
• Summary on international issues

7. Education and Prevention 67-70

8. Treatment of Khat Use 71-75
• Treatment of dependency
• Implications for khat treatment and recovery interventions

9. Concerns: communities and groups 76-81

10. Summary and recommendations 82-88
Annex A – Quality of Research and Hierarchies of Evidence
Annex B – List of Contributors
Annex C - ACMD Members
Annex D – Education and Prevention Template