Does nitrous oxide addiction exist? An evaluation of the evidence for the presence and prevalence of substance use disorder symptoms in recreational nitrous oxide users

Sammie Back, Emese Kroon, Karis Colyer-Patel, Janna Cousijn*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

12 Citations (Scopus)
56 Downloads (Pure)

Abstract

BACKGROUND:
Prevalence of nitrous oxide (N 2 O) use appears to be increasing in numerous countries worldwide, and excessive use has been associated with physical and mental problems. Because there currently is no consensus whether N 2 O has addictive potential, we aimed to evaluate the evidence for the presence and prevalence of DSM-5 substance use disorder (SUD) symptoms in N 2 O users.

ANALYSIS:
A literature search was conducted to assess the evidence for the presence of any of the 11 DSM-5 SUD symptoms in N 2 O users and the prevalence experiencing those symptoms. A substantial part of the studied N 2 O users use more than intended (i.e. 46% to 98%) and spend a substantial amount of time using N 2 O. At least some of the studied N 2 O users experience interpersonal problems (i.e. 13% to 80%) and use N 2 O in risky situations, such as driving under the influence. Evidence for the other criteria is either insufficient or inconclusive.

CONCLUSIONS:
The literature base for the presence and prevalence of DSM-5 substance use disorder (SUD) symptoms in nitrous oxide (N 2 O) users is limited and largely consists of qualitative studies and case studies, but it provides consistent evidence for the presence of at least four SUD criteria in heavy N 2 O users. N 2 O could well be addictive and should be treated as a potentially addictive substance until systematic assessments can provide evidence-based guidance to users, healthcare professionals and legislators.

Original languageEnglish
Pages (from-to)609-618
Number of pages10
JournalAddiction
Volume119
Issue number4
Early online date30 Oct 2023
DOIs
Publication statusPublished - Apr 2024

Bibliographical note

© 2023 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Research programs

  • ESSB PSY

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