[Life style drug laughing gas (nitrous oxide, N2O) and the dependency criteria according to ICD-10].

Abstract

Objective: The increasing popularity of nitrous oxide (N₂O) as a recreational drug raises questions about its potential for dependency. This narrative review examines the dependency risk of N₂O using the ICD-10 criteria for substance use disorders and evaluates the current literature.

Material and methods: A comprehensive literature search until April 2024 was conducted to identify publications addressing N₂O consumption in the context of dependency criteria. The results were analyzed based on the ICD-10 criteria.

Results: Studies showed mixed results regarding craving and loss of control among N₂O users. There is evidence of neglect of other interests and potential tolerance development, while data on withdrawal symptoms are limited. Persistent consumption despite harmful consequences has been described but objective diagnostic methods to determine consumption intensity are lacking.

Discussion: The data on the dependency potential of N₂O are inconsistent. The discussion on its classification as an addictive substance remains controversial; however, the clinical indications suggest a possible risk of dependency, especially with excessive consumption.

Conclusion: Nitrous oxide is currently primarily regarded as a substance of abuse with the potential to foster psychological dependence, manifesting particularly through loss of control and neglect; however, the criteria for physical dependence, such as the occurrence of withdrawal syndromes and the development of tolerance, have not yet been convincingly documented. Further research is needed to better understand the dependency potential of N₂O and develop appropriate preventive and therapeutic measures.