title: Up: The rise of nitrous oxide abuse. An international survey of contemporary nitrous oxide use.
abstract: In recent years the recreational use of inhaled nitrous oxide gas (N2O) is becoming increasingly popular, yet little is known about the characteristics of its users or the effects they experience. This paper presents original research from the 2014 Global Drug Survey (GDS) (n=74,864). GDS runs the largest survey of recreational drug use in the world. The findings confirm N2O as a very common drug of use, in particular in the UK and US (38.6% and 29.4% lifetime prevalence). In the UK N2O was reported to be the eighth most commonly used substance. N2O was generally consumed via gas-filled balloons, at festivals and clubs where use of other substances was common. The vast majority of users use infrequently, and their use is not associated with significant harm. However, there appears to be a subpopulation of heavy users who may be using in a dependent pattern. Analysis of last year N2O users (n=4883), confirms that N2O is associated with hallucinations and confusion (which may be the desired effects) and persistent numbness and accidental injury (27.8%, 23.9%, 4.3% and 1.2% of last year users, respectively). Accidental injury is associated with the highest number of 'hits' per session, suggesting a dose-response relationship. The presence of significant harm is discussed in the light of public education on the risks of N2O use and harm-reduction strategies appropriate to N2O use. Further work needs to be completed to confirm the presence of persistent neurological symptoms in recreational users.
authors.affiliation: Addiction CAG, South London and Maudsley NHS Trust, London, UK Global Drug Survey, London, UK stephen.kaar@kcl.ac.uk.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Kaar
authors.affiliation: Institute for Social Science Research, The University of Queensland, Brisbane, QLD, Australia ARC Centre of Excellence for Children and Families over the Life Course, Institute for Social Science Research, The University of Queensland, Brisbane, QLD, Australia.
authors.forename: Jason
authors.initials: J
authors.lastname: Ferris
authors.affiliation: Global Drug Survey, London, UK.
authors.forename: Jon
authors.initials: J
authors.lastname: Waldron
authors.affiliation: Institute for Social Science Research, The University of Queensland, Brisbane, QLD, Australia.
authors.forename: Madonna
authors.initials: M
authors.lastname: Devaney
authors.affiliation: Global Drug Survey, London, UK TICTAC Communications Ltd, St George's, University of London, London, UK.
authors.forename: John
authors.initials: J
authors.lastname: Ramsey
authors.affiliation: Addiction CAG, South London and Maudsley NHS Trust, London, UK Global Drug Survey, London, UK.
authors.forename: Adam R
authors.initials: AR
authors.lastname: Winstock
mesh_terms: D000328:Adult; D004305:Dose-Response Relationship, Drug; D005260:Female; D006212:Hallucinations / Q000139:chemically induced; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D008297:Male; D009609:Nitrous Oxide / Q000009:adverse effects*; D019966:Substance-Related Disorders / Q000209:etiology; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D013287:Illicit Drugs; D009609:Nitrous Oxide
keywords: Nitrous oxide; addictions; anaesthetic; drugs of misuse; psychedelic