Recreational Nitrous Oxide Dosing and Administration and Its Use in Traffic: An Online Survey

Nitrous oxide (N2O) is a popular recreational intoxicant and associated paraphernalia are increasingly being found at road traffic accident scenes in the Netherlands, suggesting that N2O intoxication causally contributes to the occurrence of a significant number of road traffic accidents. However, information on the pharmacodynamics- and kinetic characteristics of recreational N2O use is limited, impeding policy making and enforcement. This investigation aimed to determine a representative dosing method for recreational N2O use and establish a relevant timeframe for assessing psychomotoric functioning in future research. Online survey responses of 511 N2O users revealed that the majority inhaled N2O from party balloons filled with 4-14 L of N2O. Inhalation typically involved a repetitive "rebreathing" technique with 20-30 second breaks every six cycles, or without breaks, for approximately 12 cycles in total. 10.3% of respondents admitted to have inhaled N2O during driving in the past. Driving departure within 1 hour of inhalation was common, providing a relevant timeframe for the investigation of psychomotoric effects of recreational N2O use in future research.