Five years ago, still marginal, the recreational use of nitrous oxide – this laughing gas most often inhaled via balloons – is exploding in France, especially among those under 25. However, this potentially addictive product can cause irreversible damage to the nervous system. The Hospices Civils de Lyon are launching the first teleconsultation in France, for earlier detection of consumers at risk.
Since the start of 2024, more than thirty patients have been hospitalized at the Pierre Wertheimer hospital (Hospices Civils de Lyon) due to the effects linked to the recreational use of nitrous oxide. Among them, a 22-year-old young man now has to move around on crutches, a 16-year-old teenager suffers from serious neurological disorders, and a young patient, so dependent, consumes this gas even during her stay in follow-up and post-operative care. rehabilitation. Faced with the increase in hospitalizations, the Hospices Civils de Lyon (HCL) are inaugurating the first teleconsultation in France specifically dedicated to consumers of nitrous oxide.
“He doesn’t make you laugh at all anymore”
“Laughing gas no longer makes you laugh at all“, warns Dr Christophe Riou. Addictologist at the Hospices Civils de Lyon and member of the University Addictology Service of Lyon (SUAL), this doctor specialized a few months ago in the care of patients affected by “laughing gas”.
Recrudescence in young patients
Problematic cases, often dramatic, are on the rise and mainly affect young patients. In 2017, the HCL poison control center in Lyon (Rhône) recorded only one call for an incident linked to nitrous oxide; in 2022, that number has jumped to 80.”Since 2019, the number of files has increased 20-fold“, confirms Dr Alexandra Boucher, pharmacist in charge of the HCL addictovigilance center.
On a national scale, the alert is similar: clinical cases linked to nitrous oxide have exploded over the last five years, as highlighted by the National Medicines Safety Agency (ANSM) in its study published at the end of 2023 .
“And we are only talking here about the clinical cases recorded, far from reflecting the real extent of consumption“, worries Alexandra Boucher. A study by Santé Publique France published in the fall of 2023 reveals that in 2022, 4.3% of French people had already experimented with nitrous oxide, a figure which rises to 13.7% among 18-24 year olds, 3.2% of whom had inhaled this gas during the year. Consumption increased sharply during the Covid-19 pandemic.
Addictive and neurotoxic
“Because this gas (N2O) is legally accessible and its euphoric effects are ephemeral, users often consider it harmless.warns Dr. Riou. In reality, nitrous oxide is addictive, stimulating pleasure receptors and creating emotional dependence..” It is also neurotoxic: at high doses, it can cause serious and irreversible neurological damage, which can even lead to paralysis of the limbs, psychological distress, malaise and dizziness.
What symptoms?
The opening of the teleconsultation dedicated to this phenomenon was initiated by Dr Christophe Riou, in collaboration with the addictovigilance center of the Hospices Civils de Lyon and the Pierre Wertheimer hospital. This solution, easy to access, discreet, is more suited to a young audience and those around them.
“The problem is that the first symptoms, like tingling in the arms or legs, often seem mild, emphasizes Dr. Riou. Many patients, mostly very young, do not pay attention to it or minimize the signs. And when they turn to us, it is often too late.“With teleconsultation, the objective is to reach consumers from the subclinical stage (a phase where physiological alterations begin to appear in the body, but without visible symptoms for the patient).
Teleconsultation
This teleconsultation has another objective: to allow access to care in the event of detection of abusive use. Indeed, patients, certain health professionals and social workers are often poorly informed about the dangers of nitrous oxide. The patient is then sent to the emergency room, without systematic consideration of the addictological dimension. It is therefore a question of remedying this thanks to this teleconsultation. If problematic use is detected, with or without clinical signs, the patient will be offered a face-to-face consultation. On this occasion, depending on various biological criteria (such as the level of vitamin B12, degraded by nitrous oxide) or neurological (assessed in particular via an electromyogram), several treatment options may be considered: drug treatment, regular monitoring or hospitalization.
