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Betel Nut – Dangerous Import from Asia

Betel Nut – Dangerous Import from Asia

Table of Contents

What is Betel Nut?

According to the Alcohol and Drug Foundation, betel nut, also called areca nut, is actually the seed from the fruit of the areca palm.1 Betel nut has a stimulant effect, just like drugs such as khat, amphetamines, and cocaine.

Most people use betel nut by cutting it into thin slices and rolling it into a leaf with other materials, such as lime powder or crushed seashells. Sometimes people add tobacco or other flavorings, such as cloves, nutmeg, syrup, or fruit extracts, when rolling betel leaves.1

Users typically refer to rolled betel leaves with the following terms:1

Betel quid

Betel nut chew

Betel chew

Betel pan

Betel Paan

What are the Effects of Betel Nut?

People who use areca nut may experience euphoria, as well as feelings of increased wellbeing after using the drug.

Additional short-term effects of betel nut use include:1

Alertness
Increased heart rate and blood pressure
Chest palpitations
Sweating and feeling warm
Flushing in the face

Large doses can cause rather unpleasant effects, such as tremor, dizziness, gastrointestinal problems like nausea and vomiting, and psychotic behavior.1

Is Betel Nut the Original Energy Drink?

Areca nut has rich cultural roots, and there is some speculation that because of the stimulant effects of areca nut, people may view it like an energy drink. In fact, according to research, areca nut can improve mental sharpness, increase the ability to perform physical exercise, and reduce fatigue, making it seem similar to an energy drink.2

This finding was confirmed in a 2019 study in the Indo American Journal of Pharmaceutical Sciences. The study assessed the use of energy drinks, soda, and betel nut among medical students attending the Liaquat University of Medical & Health Sciences in Pakistan and found that 43% of the students used betel. Most users indicated they used the substance twice per day, but one-third stated they used it even more often than this.3 Among certain cultures, areca nut may be used like an energy drink that can increase alertness and improve mental and physical performance.

History of Betel Nut Use

People have traditionally used areca nut in Southeastern Asia and the Asia Pacific region. In these areas, areca nut chewing is a cultural practice that has a place in religious ceremonies and social activities. Some people who use areca nut as a cultural practice have moved out of these areas into other countries, bringing this cultural ritual along with them.1

According to a 2014 report in the Asia-Pacific Development Journal, betel nut has historically been used to help disagreeing tribes make negotiations, and it has a role in political processes and speechmaking. Also, betel nut serves as a cultural symbol, with people consuming it during weddings, funerals, and ceremonies to honor ancestors.2

Folk Remedy for Ailments

In addition to its status as an energy booster, areca nut has a place in the Asia Pacific culture as a folk remedy for various maladies. According to the report in the Asia-Pacific Development Journal, people have used areca nut to treat rheumatism, constipation, headaches, itching, bad breath, boils, abscesses, pink eye, and mastitis. In some cultures, it is even used to aid in the menstruation process or to treat diarrhea, dysentery, and scurvy. In Chinese folk medicine, areca nut is believed to treat parasites, such as roundworms and tapeworms.2

Dangers of Betel Nut Usage

Even though people believe areca nut provides a remedy for various health ailments, it can increase the risk of serious diseases. According to a report from the World Health Organization, using areca nut can increase the risk of HIV, tuberculosis, dengue, and typhoid. In fact, research shows that betel nut users are 2.6 times more likely to have HIV/AIDS, 2.4 times more likely to be diagnosed with dengue, 1.5 times more likely to have tuberculosis, and at 1.48 times the risk of developing typhoid.4

The Drug and Alcohol Foundation has reported additional health problems linked to long-term betel nut use:4

Mouth ulcers

Gum disease

Cancer of the mouth

Stomach ulcers

Heart disease

Discolored teeth

In addition to the above dangers, research has shown that the use of areca nut causes both oral and esophageal cancers and is linked to asthma as well as cancer in the pharynx. Given the fact that it raises blood pressure, areca nut also increases the risk of hypertension.2

Another danger associated with areca nut is its harmful effects on pregnant women and their growing babies. A 2008 study in Drug and Alcohol Dependence found that babies born to women who used areca nut during pregnancy were 2.4 times more likely to be low birth weight.5 Experts, therefore, discourage the use of areca nut during pregnancy.

The Extent of Betel Nut Use in Asia

Despite its dangers, areca nut use is highly prevalent in Asia. According to the World Health Organization report, up to half of the adults in Palau, Papua New Guinea and the Solomon Islands use areca nut, either on its own or mixed with tobacco. Furthermore, 63% of middle schoolers and 75% of high schoolers in these regions have used areca nut. Of the high schoolers who use this substance, half of them use it alongside tobacco.4

To combat the widespread use of areca nut, Dr. Shin Young-soo of the World Health Organization recommends that governments impacted by areca nut abuse adopt tobacco control measures. These include raising taxes on tobacco, prohibiting sales to those under the age of 18, stopping the sale of single-stick and loose tobacco, and controlling sales of areca nut.4 Given the fact that areca nut and tobacco are often used together, tobacco control measures could help governments combat areca nut abuse.

How Betel Nut Abuse is Growing in the United States

Areca nut has historically been a cultural fixture in the Asia-Pacific region, but that does not mean it has not come to the United States. As the authors of a study in the Journal of Psychoactive Drugs have explained, research shows that as people from Southeast Asia and India have migrated, they have brought their areca nut traditions with them, causing the drug to spread to the United States.6

In their study, the aforementioned authors found that every East Asian grocery store they visited in the Richmond, Virginia, community offered betel products for sale, most often in plain view on store counters. Betel was relatively inexpensive to buy, with boxes containing as many as 48 pouches available for $5.00. Unfortunately, sometimes betel packaging contained ingredients listed only in the Hindi language, making it difficult for English-speakers to know exactly what they were buying.6 Given the availability and low cost of betel in the United States, its abuse may grow because it provides a cheap, accessible method of achieving a high.

Treatment for Betel Nut Abuse

Those who abuse areca nut may find that they become addicted and need professional treatment to stop using this drug. In fact, a study conducted at the National Institute of Mental Health and Neuroscience in Bangalore evaluated areca nut abuse in psychiatric patients. The study results showed the following evidence that areca nut is addictive:7

Those Who Used Betel Nut

Used it more than one time per day, the average user taking it about 6 times per day
Betel Nut Users 48%
Indicated they had cravings for the drug
Betel Nut Users 45%
Made multiple attempts to stop using the substance
Betel Nut Users 74%
Developed tolerance
Betel Nut Users 44%
%

Used Betel Nut alone and met the criteria for dependence

%

Mixed Betel Nut with tobacco and were dependent

When Not Using the Drug

%

Suffered from aches and pains during withdrawal

%

Became fatigued

%

Became sad or down

Easing Withdrawal Symptoms

Based on the research, it appears that betel nut can be addictive, especially among those who combine it with tobacco. Given the fact that areca nut abuse can lead to withdrawal symptoms when a person stops using, it may be necessary for people to complete a detox program when they stop using betel nut. During such a program, medical staff can provide care and supervision and give medications to help patients to remain as comfortable as possible while the body rids itself of betel nut and other substances, such as the nicotine in tobacco.

Detox is only the first step in the treatment process for betel nut abuse, so after a person completes withdrawal, it is necessary to engage in ongoing addiction treatment services to address any underlying psychological issues that led to drug abuse. People who are in treatment for betel nut abuse may attend group counseling sessions in which they learn about drug use and ways to prevent relapse. Treatment will also likely involve individual therapy, in which people can confront past traumas or current mental health issues that have contributed to addiction and learn better ways of coping.

Getting Help

If you are struggling with betel nut abuse and find that you are unable to stop, now is the time to reach out for treatment. Even though betel nut comes from a fruit, it can be a dangerous and addictive substance, leading to a variety of health problems. Enter treatment to begin your journey toward a drug-free life.