Nitrous oxide: What do we know about its use disorder potential? Results of the French Monitoring Centre for Addiction network survey and literature review.

Nitrous oxide (NO) is used worldwide for analgesia and anesthesia. It is also used for recreational purposes by some people. NO can have major side effects (myeloneuropathy, delusions, emphysema) when used to excess. In France, NO is available as an equimolar mixture of oxygen and nitrous oxide (EMONO). Its substance use disorder potential is monitored by the French Monitoring Centre for Addiction (CEIP-A) network. Our objective is to provide an overview of the substance use disorder potential of NO in general, and of EMONO in particular. This paper is based on a systematic review of the literature for case reports involving NO use disorder and on CEIP-A network cases involving EMONO use disorder. We characterized use disorder in accordance with DSM-5 () criteria. Furthermore, we considered data relating to medical history, age, gender, and NO consumption habits. We identified 59 cases of NO use disorder in the literature and 17 cases of EMONO use disorder from the CEIP-A network. More than 90% of the cases used NO in larger quantities and for longer than intended. Conversely, more negative as opposed to positive cases have been documented regarding tolerance and failed attempts to reduce usage. A specific profile of substance use disorder starts to emerge from all the cases studied here. Furthermore, we identified another way NO use disorder can appear: through exposure for medical purposes.