Addressing the Global Challenge of Nitrous Oxide Misuse Through a Multidisciplinary Approach: Example of the PROTOSIDE Network

Abstract

Nitrous oxide (N2O) was originally used for medical and industrial purposes, but its recreational use has dramatically increased, raising a major global public health concern. Chronic inhalation is associated with neurological, metabolic, and psychiatric complications, as well as addiction. To address these challenges, the PROTOSIDE network was developed to provide a multidisciplinary approach to management and prevention. This initiative relies on competence centers integrating specialists in emergency medicine, neurology, clinical biochemistry, and addiction medicine. PROTOSIDE aims to standardize diagnostic protocols, optimize patient care pathways, and strengthen addictovigilance. A strong emphasis is placed on prevention, including awareness campaigns and collaboration with healthcare professionals and educators. By facilitating access to advanced biochemical analyses (homocysteine, methylmalonic acid) and promoting international guidelines, PROTOSIDE represents an innovative model for a global response to N2O misuse. This integrated approach enhances clinical management, reduces complications, and harmonizes public health strategies.