Poisonings and Lifetime Use of Nitrous Oxide in the United States from 2021 to 2023

ABSTRACT:

Introduction: Harms associated with recreational nitrous oxide use have been documented. Studies on the prevalence of past-year inhalant use disorder among individuals who have ever used nitrous oxide are lacking. This descriptive study, conducted in the United States from 2021 to 2023, examined the prevalence of ever using nitrous oxide, determined the proportion of people meeting the past-year criteria for an inhalant use disorder, and reported the yearly number of nitrous oxide poisonings.

Methods: This study used a descriptive epidemiological approach to identify and characterize the lifetime use of nitrous oxide and the total number of nitrous oxide poisonings as reported in the United States from 2021 to 2023.

Results: From 2021 to 2023, one in twenty people in the U.S. reported ever using nitrous oxide recreationally. The prevalence of inhalant use disorder in the past year among those who ever used nitrous oxide was 1.1%. However, this diagnosis could be due to the use of other inhalants such as poppers. Among individuals who only used nitrous oxide in their lifetime to the exclusion of all other inhalants, and who reported using inhalants in the past year, approximately 10% met the criteria for inhalant use disorder due to their nitrous oxide use. During this period, there were 937 total poisoning cases involving nitrous oxide, with 712 cases involving nitrous oxide as the only reported substance.

Conclusions: More population-level studies are needed to examine the national harms of problematic nitrous oxide use.