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Betel nut use refers to a combination of three ingredients: the nut of the betel palm ( Areca catechu ), part of the Piper betel vine, and lime. Anecdotal reports have indicated that small doses generally lead to euphoria and increased flow of energy while large doses often result in sedation. Although all three ingredients may contribute to these effects, most experts attribute the psychoactive effects to the alkaloids found in betel nuts Betel nut is reportedly used by a substantial portion of the world's population as a recreational drug due to its CNS stimulant activity. Found originally in tropical southern Asia, betel nut has been introduced to the communities of east Africa, Madagascar, and the West Indies. There is little evidence to support clinical use of betel, but the constituents have demonstrated pharmacological actions. The main active component, the alkaloid arecoline, has potent cholinergic activity. Constituents of areca are potentially carcinogenic. Long-term use has been associated with oral submucous fibrosis (OSF), pre-cancerous oral lesions and squamous cell carcinoma. Acute effects of betel chewing include worsening of asthma, low blood pressure, and rapid heart beat.
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