Nitrous oxide users are presenting with psychosis at a Melbourne hospital

Topic: Drugs

At a hospital in Melbourne's western suburbs, doctors have noticed a trend: patients who use nitrous oxide are presenting with symptoms that look like psychosis.

Some patients were referred to the emergency mental health team with symptoms like delusions and suspiciousness.

The hospital's psychiatrist, Soumitra Das, said there has been a trend that is going up every year.

Nitrous oxide is a dissociative anaesthetic used for sedation.

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Nitrous oxide is also known as laughing gas and is widely available.

The gas has a long history of recreational use.

It is sold legally in cylinders and small metal bulbs because it has legitimate uses in food preparation.

Inhaling it can cause mild sedation and psychedelic dissociation.

The effect of the drug generally only lasts for a few minutes.

But when used in an unsafe environment, it can cause serious harm.

The inhalant has been linked to multiple accidental deaths.

Harm reduction resources are available.

If you or anyone you know needs help, you can find harm reduction information.

A 26-year-old Melbourne man died after using a mask to inhale the gas at home alone.

Fresh data shows a jump in deaths where nitrous oxide was suspected to have played a role.

By comparison, the same number of nitrous oxide-linked deaths were recorded in Victoria between 2000 and 2019.

The deaths involved accidents like drowning and suffocation.

Prolonged nitrous oxide abuse can cause brain and spinal damage.

It can also trigger mental health episodes like psychosis.

Small numbers of patients are presenting with serious harms.

Dr Das's team looked through the records of patients referred for mental health support.

While the overall numbers were small, the associated impacts were significant.

Soumitra Das is the co-author on a recent study examining mental health presentations.

Almost half of the patients presented with psychosis.

The study has some limitations, given it relies on previous note-taking.

Symptoms were associated with recent nitrous oxide use, but not definitively caused by it.

The study found many of the recent nitrous oxide users were from culturally diverse backgrounds.

Dr Das said he had come across patients reporting heavy nitrous oxide use.

While many recovered with time away from the substance and treatment, the trend is worrying.

It is hard to predict the safe level of use for any individual.

A jump in nitrous-oxide linked deaths and rising harms is a concern.

Recent media reports have suggested nitrous oxide harms have been increasing.

The actual numbers are still quite small, but they do show an upward trend.

Some recent figures from Victoria show an uptick in cases.

When doctors suspect nitrous oxide toxicity, they may contact the Victorian Poisons Centre.

Victorian coronial data also shows an increase in the number of unintentional nitrous oxide-linked deaths.

A Victorian coroner said the growing number of deaths was particularly concerning.

Since then, there have been six more unintentional deaths linked to nitrous oxide use.

Bigger canisters are linked to increasing harms.

UNSW research fellow Rachel Sutherland is one of the lead authors involved in the national Ecstasy and Related Drugs Reporting System.

Data from this sample suggests nitrous oxide use might have peaked during the pandemic.

However, even if use was decreasing, the latest data showed a substantial shift towards larger nitrous oxide canisters.

Dr Sutherland said this shift was concerning.

These canisters allow for much greater exposure in a short period of time.

And she said more nitrous oxide users were reporting new and persistent neurological symptoms.

If you or anyone you know needs help, you can find harm reduction information.

Several states have recently taken action to reduce harms associated with nitrous oxide.

Consultation is underway on possible reforms in New South Wales.

Dr Sutherland said any policy responses should focus on the availability of larger canisters.

She said the most important thing was for nitrous oxide users to seek help early.

Data notes are available.

If you need someone to talk to, you can call.

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