Betel nut

How is betel nut used?

The seed is separated from the outer layer of the fruit and may be used fresh, dried, boiled, baked, roasted or cured.²

The most common method of using betel nut is to slice it into thin strips and roll it in a betel leaf with slaked lime (powder) or crushed seashells. This leaf package is known as a betel quid, betel nut chew, betel chew, betel pan or betel paan (India).^2,3

Betel quids may also contain tobacco and other additives such as cloves, cardamom, nutmeg, aniseed, coconut, sugar, syrups and fruit extracts, to enhance the flavour.³

Cultural practice

Betel nut chewing is an important cultural practice in some regions in south and south-east Asia and the Asia Pacific. It has traditionally played an important role in social customs, religious practices and cultural rituals.³

Some people from these regions who have settled in other countries have continued their cultural practice of chewing betel nut.³

Effects of betel nut

There is no safe level of drug use. Use of any drug always carries some risk. It’s important to be careful when taking any type of drug.

Betel nut affects everyone differently, based on:

• Size, weight and health
• Whether the person is used to taking it
• Whether other drugs are taken around the same time
• The amount taken
• The strength of the drug (varies from batch to batch)

The effects of betel nut are not fully understood and further research is needed. However, people who have used the drug have reported the following effects:

• Relaxed, feeling happy
• Feeling alert
• Fast heart rate and palpitations
• High blood pressure
• Red face and feeling warm
• Sweating³

People who use betel nut for the first time, and people who have used it before who take a large amount or a strong batch, may experience the following:

• Tremors
• Dizziness
• Upset stomach, diarrhoea, vomiting
• Psychosis^4,5

Long-term effects

Regular, heavy use of betel nut may eventually cause:

• Discolouration of teeth and gums, sometimes turning them reddish-brown
• Mouth ulcers and gum disease
• Oral cancers or sub mucous fibrosis (a pre-cancer condition)
• Stomach ulcer
• Heart disease⁷
• Needing to use more to get the same effect
• Dependence on betel nut
• Financial, work and social problems

Tolerance and dependence

People who regularly use betel nut can become dependent on the drug. They may feel they need betel nut to go about their normal activities like working, studying and socialising, or just to get through the day. They may also develop a tolerance to it, which means they need to take larger amounts of betel nut to get the same effect.⁷

Mixing betel nut with other drugs

Mixing betel nut with other drugs can be have unpredictable effects and increase the risk of harm.

• Betel nut and tobacco: greatly increases the risk of developing oral cancers.³
• Betel nut and antidepressants/antihistamines/scopolamine: Betel nut may decrease the effects of these types of medications.⁸

Reducing harm

There are ways you can reduce the risk of harm when using betel nut:

• avoid mixing betel nut with tobacco
• avoid use if you have an existing heart problem
• practice good dental health and brush regularly
• people with an existing mental health concern - should avoid use
• avoid using betel nut late at night
• avoid useing during pregnancy
• have regular dental health checks
• maintain good nutrition and drink water and healthy foods
• avoid regular long term use.^{1, 8-10}

Withdrawal

Giving up betel nut after using it for a long time is challenging because the body has to get used to functioning without it.

Betel quid users have reported experiencing withdrawal symptoms that are similar to nicotine withdrawal,¹¹ including:

• cravings
• feelings of distress/discomfort
• dry mouth
• irritability
• anxiety
• fatigue
• inability to concentrate
• altered taste.⁷

Getting help

If your use of betel nut is affecting your health, family, relationships, work, school, financial or other life situations, or you’re concerned about a loved one, you can find help and support.

Call the National Alcohol and Other Drug Hotline on 1800 250 015 for free and confidential advice, information and counselling about alcohol and other drugs

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If you're looking for other information or support options, send us an email at druginfo@adf.org.au