Nitrous oxide in France: Evolution of complications reported to the French monitoring system in the context of information from health authorities and regulatory measures

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Guerlais, Marylène | Aquizerate, Aurélie | Daveluy, Amélie | Lionnet, Arthur | Gerardin, Marie | Duval, Mélanie | Istvan, Marion | Laforgue, Edouard-Jules | Victorri-Vigneau, Caroline

Edité par CCSD ; Elsevier -

International audience. BackgroundIn France, the increasing use of nonmedical nitrous oxide (N2O) among young consumers has become a concern. Faced with this increase in consumption, authorities have set up information campaigns and have taken regulatory measures to limit this phenomenon. The addictovigilance network is the French health monitoring system dedicated to the surveillance of psychoactive substances coordinated by the French National Agency for the safety of Medicines and Health Products (ANSM). We describe and discuss the evolution of notifications to the French addictovigilance network for N2O in the context of policy changes aiming to limit nonmedical use.MethodsThe monthly number of N2O notifications and clinical complications of N2O reported to French addictovigilance centres, between 2018 and 2022, were analyzed. In parallel, information from health authorities (i.e ANSM, French National Agency for Food, Environmental and Occupational Health Safety and French Ministry of health) and regulatory changes were described.ResultsThe number of addictovigilance notifications increased almost 35-fold between 2018 (n=10) and 2022 (n=345), which corresponds to a slope coefficient of 0.6448 (R2) dependent on complication type: use disorders or associated criteria (+4257%, R2= 0.6366), neurological complications (+4883%, R2=0.6397), psychiatric manifestations (+650%, R2=0.2847) and cardiovascular complications (+867%, R2=0.3061). Between November 2019 and 2022, four information alerts about serious health consequences (in the form of 2 press releases and information on the health authority website) were issued by French health authorities, and a law prohibiting sales to minors (i.e. under 18 years old) and to prohibit sales in high risk locations (for example bars, tobacco shops, student parties) was introduced in France in June 2021.ConclusionDespite the various measures taken, there has been no decrease in the number of notifications and complications reported to the French addictovigilance network. The pattern of increasing notifications is in line with global trends.

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