When nitrous oxide is no longer a laughing matter: Epidemiology, analytical aspects, clinical and forensic implications

Recreational inhalation of nitrous oxide is an emerging practice in adolescents and young adults. Intoxication is increasing and the effects in terms of neurotoxicity and haematological disorders can be serious. Deaths are also reported. The literature, both in terms of epidemiology and analytical toxicology, remains poor and sometimes old, but the concern of health professionals and health authorities is present and growing. Clinicians need to be alerted to this diversion for fast and optimal patient management. The analyst must be able to respond favourably to a request of nitrous oxide screening in biological matrices, particularly in the forensic context. Finally, public education, through information campaigns for young people, remains a decisive factor in the policy to prevent the use of psychoactive substances. (C) 2020 Societe Francaise de Toxic logie Analytique. Published by Elsevier Masson SAS. All rights reserved.