Non-medical use of nitrous oxide – a systematic review of motivational drives
Anna E. Schütze, Klara Greisiger, Thomas Günther Riemer, Lukas A Basedow
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Qualitative |
|---|---|
| Key findings | Across 50 included articles, the three survey studies identified enhancement as the major motive for non-medical nitrous oxide use, while qualitative reports most prominently described coping motives; enhancement and expansion motives were also reported and social and conformity motives were nearly absent. The authors propose that recreational, non-problematic use is dominated by enhancement motives, whereas escalated use with adverse consequences is more strongly related to coping motives. |
Abstract
Introduction: Nitrous oxide (N2O) is a psychoactive substance with euphoric and mildly hallucinogenic effects and a variety of medical applications. Non-medical use of N2O is widespread and in recent years, there has been a significant increase across the world. To investigate potential drivers of this increase, this review summarizes the current state of research on use motives for N2O use.Methods: A systematic search was conducted in PubMed, Embase, Web of Science, PubPsych, PsycInfo, and PsycArticles including quantitative and qualitative reports published up to March 28th, 2026. Qualitative reports were coded according to the five-factor model of substance use motives assigning material to the dimensions of enhancement, coping, expansion, conformity, social and other motives.
Results: A total of 50 articles were included. Three survey studies were identified that reported enhancement as the major motivational drive. In contrast, the qualitative reports contained coping motives as the most prominent drive. Enhancement and expansion motives were also reported, while social and conformity motives were nearly absent from the qualitative literature.
Discussion: The non-medical use of N2O is related to a diverse array of motivational forces, with enhancement and coping with negative psychological and physical sensations appearing to be particularly relevant. Recreational non-problematic use seems to be dominated by enhancement motives, while escalated and use with adverse consequences is more strongly related to coping motives. As systematic assessments with validated instruments regarding the motivational drives behind N2O use are lacking, further research is needed to make reliable statements about the motive profile of N2O.