It is time to take nitrous oxide seriously
Background: Nitrous Oxide (N2O) is a dissociative anaesthetic that can be used for both medical and recreational purposes. Recent research indicates that recreational use of N2O, primarily by young people, is increasing rapidly. Minimal research has been conducted on N2O use and an understanding of the motivations for, and contexts of N2O use is needed. This presentation combines the findings of a systematic review and an exploratory qualitative study conducted by a peer researcher to develop practical harm reduction strategies for young people, alcohol and drug practitioners, and other health professionals.
Methods: For the systematic review a search of public health, psychology and social science databases was conducted. A thematic synthesis extracted descriptive and analytical themes from the selected studies. Quality appraisal was conducted using the CASP Tool for Qualitative studies and the Joanna Briggs Institute case report assessment tool. The qualitative study employed a peer researcher to undertake a qualitative exploration of N2O use with seven young people aged between 18-25 years. In-depth interviews were transcribed and inductively analyzed by the research team.
Results: In the thirty-four studies included in the systematic review there was limited reference to policy or legislative responses, no suggestions for harm reduction strategies or application of service level responses. In general, individuals lacked awareness of N2O-related harms. Three key themes emerged from the interviews -The appeal of N2O, experiences of risks and harms and context of use. Easy accessibility and short-lived effects of N2O meant it was perceived as less harmful than other drugs, even though all study participants described multiple harms experienced including lingering negative effects on brain function. Study participants generated six harm reduction recommendations with a rationale for each - sit down, clean the equipment, use with others, use in moderation, keep it social, and use a balloon to inhale. A further recommendation is to avoid driving during and after using N2O.
Conclusion: Perception of N2O risk is low among young people despite harms experienced. Population specific harm reduction strategies and psychoeducation are needed in healthcare and youth settings to ensure that young people are informed of N2O risks and safer use practices. While N2O may cause fewer harms than other drugs, increasing prevalence, larger quantities used and lack of information are contributing to easily reducible harms if N2O is taken seriously.
