Nitrous oxide, a popular recreational drug particularly among teenagers, can result in serious and sometimes permanent neurological defects.
A new review published in the Canadian Medical Association Journal aims to assist clinicians in recognising signs of nitrous oxide toxicity.
In the 2021 Global Drug Survey, 10 per cent of all respondents, and 15 per cent of Canadian respondents, indicated having used the drug in the previous year.
“The low cost of and ease of access to nitrous oxide make it a popular recreational drug, especially among younger people,” wrote Dr Cyrille De Halleux, a specialist in internal medicine, critical care and resident at The Hospital for Sick Children (SickKids) and chief fellow in the Division of Clinical Pharmacology and Toxicology at the University of Toronto, Toronto, Ontario.
Chronic use of nitrous oxide can cause functional vitamin B12 deficiency, which can result in long-term health effects, especially neurological consequences.
The three most common presentations of toxicity are damage to the spinal cord (myelopathy), nerve damage affecting strength and sensation (neuropathy) and behavioural abnormalities (encephalopathy). Treatment includes stopping the use of the substance, vitamin B12 supplementation and methionine.
“Clinicians should enquire about nitrous oxide use in patients with unexplained findings suggestive of vitamin B12 deficiency or other compatible neurologic symptoms,” the authors concluded.
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