Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Apr;119(4):609-618.
doi: 10.1111/add.16380. Epub 2023 Oct 30.

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  1 , Emese Kroon  1   2 , Karis Colyer-Patel  1 , Janna Cousijn  1   2
Affiliations

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 et al. Addiction. 2024 Apr.

Abstract

Background: Prevalence of nitrous oxide (N2 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 N2 O has addictive potential, we aimed to evaluate the evidence for the presence and prevalence of DSM-5 substance use disorder (SUD) symptoms in N2 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 N2 O users and the prevalence experiencing those symptoms. A substantial part of the studied N2 O users use more than intended (i.e. 46% to 98%) and spend a substantial amount of time using N2 O. At least some of the studied N2 O users experience interpersonal problems (i.e. 13% to 80%) and use N2 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 (N2 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 N2 O users. N2 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.

Keywords: DSM-5; addiction; laughing gas; nitrous oxide; substance use disorder; symptoms.

PubMed Disclaimer

Comment in

Similar articles

See all similar articles

Cited by

References

REFERENCES

    1. Ohashi Y, Guo T, Orii R, Maze M, Fujinaga M. Brain stem opioidergic and GABAergic neurons mediate the antinociceptive effect of nitrous oxide in Fischer rats. Anesthesiology. 2003 Oct 1;99(4):947-954. https://doi.org/10.1097/00000542-200310000-00030
    1. Sanders RD, Weimann J, Maze M, Warner DS, Warner MA. Biologic effects of nitrous oxide. Anesthesiology. 2008 Oct 1;109(4):707-722. https://doi.org/10.1097/ALN.0b013e3181870a17
    1. Emmanouil D, Quock R. Advances in understanding the actions of nitrous oxide. Anesth Prog. 2007;54(1):9-18. https://doi.org/10.2344/0003-3006(2007)54[9:AIUTAO]2.0.CO;2
    1. Randhawa G, Bodenham A. The increasing recreational use of nitrous oxide: history revisited. Br J Anaesth. 2016 Mar;116(3):321-324. https://doi.org/10.1093/bja/aev297
    1. Jay M. Nitrous oxide: recreational use, regulation and harm reduction. Drugs Alcohol Today. 2008 Sep;8(3):22-25. https://doi.org/10.1108/17459265200800022

MeSH terms