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Observational Study
. 2022 Feb:100:103519.
doi: 10.1016/j.drugpo.2021.103519. Epub 2021 Nov 6.

Alarming increase in poisonings from recreational nitrous oxide use after a change in EU-legislation, inquiries to the Dutch Poisons Information Center

A J H P van Riel  1 , C C Hunault  2 , I S van den Hengel-Koot  2 , J J Nugteren-van Lonkhuyzen  2 , D W de Lange  2 , L Hondebrink  2
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Free article
Observational Study

Alarming increase in poisonings from recreational nitrous oxide use after a change in EU-legislation, inquiries to the Dutch Poisons Information Center

A J H P van Riel et al. Int J Drug Policy. 2022 Feb.
Free article

Abstract

Background: After the change in EU-legislation in 2014, recreational use of nitrous oxide (N2O) increased in the Netherlands from 2015 onwards. We studied the effect on N2O poisonings during an 11 year period.

Methods: A retrospective observational study was performed on the incidence rate of N2O poisonings, relative to all recreational drug poisonings reported to the Dutch Poisons Information Center (DPIC) from 2010-2020. Secondary outcomes were the frequency of heavy use, frequent use, co-exposures, and toxicity in 2019 and 2020.

Results: 433 N2O poisonings were included. The incidence rate increased exponentially from 0.12% in 2010 to 11% in 2020, with an average monthly rate of 3.8%. In 2019 and 2020, 79% of the patients indicated heavy use, frequent use or both, and 42% used from large cylinders. Chronic toxicity (signs of peripheral neuropathy) was reported in 38% of the patients.

Conclusion: The rate of N2O poisonings increased alarmingly in the Netherlands. An increasing proportion of patients reported problematic heavy or frequent use, accompanied by chronic toxicity.

Keywords: Drugs of abuse; Legislation; Neurological damage; Nitrous oxide (N(2)O); Recreational drugs use.

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Conflict of interest statement

Declarations of Interest All authors have completed the ICMJE uniform disclosure form at http://www.icmje.org/coi_disclosure.pdf and declare: no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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