Centre of Expertise Urban Vitality

Increasing recreational nitrous oxide use: Should we worry?

a narrative review


<p>Background: Since 2000, the prevalence of recreational nitrous oxide (N <sub>2</sub>O) use has increased in the Western world. Although N <sub>2</sub>O is a relatively safe drug, the overall increase in the use of N <sub>2</sub>O has concomitantly also initiated a modest but important increase in the number of young excessive users. The recent introduction of large 2 kg N <sub>2</sub>O tanks, allowing high and prolonged dosing, has facilitated this excessive use. This is of concern, because repeated exposure to high doses of N <sub>2</sub>O for a prolonged time is known to induce neurological damage, such as (irreversible) neuropathy and paralysis due to N <sub>2</sub>O-induced vitamin B <sub>12</sub> deficiency. The increasing trend of recreational users with N <sub>2</sub>O-induced neurological damage at emergency departments confirms the urgency of this development. Objective/Methods: This narrative review describes recent trends in N <sub>2</sub>O use and misuse, the adverse health effects associated with excessive use and the risk factors of excessive use. Results: Considering the rising trend in N <sub>2</sub>O use, particularly among young and other vulnerable people, we propose to take legislative action to limit the availability of N <sub>2</sub>O, and also advocate for better and timely education of non-users, users and medical professionals about the serious side-effects associated with excessive N <sub>2</sub>O use. Conclusion: It is concluded that the increase in excessive N <sub>2</sub>O use is of serious concern.</p>

Reference van Amsterdam, J. GC., Nabben, T., & van den Brink, W. (2022). Increasing recreational nitrous oxide use: Should we worry? a narrative review. Journal of Psychopharmacology , 36(8), 943-950. https://doi.org/10.1177/02698811221082442
Published by  Kenniscentrum Maatschappij en Recht 1 January 2022

Publication date

Jan 2022


Jan GC van Amsterdam
Wim van den Brink


Research database