Nitrous Oxide Sourcing, Use and Harms: Insights From Australians Who Use Ecstasy/MDMA and Other Illicit Stimulants
Jodie Grigg, Simon Lenton, Amy Peacock, Jessamine Soderstrom, Cate King, Natalie Thomas, Rachel Sutherland

TL;DR
This study examines how Australians using ecstasy and other stimulants access and use nitrous oxide, finding increased use of larger cylinders and rising neurological harms.
Contribution
The study provides new insights into nitrous oxide sourcing and use patterns among stimulant users, highlighting growing risks and regulatory needs.
Findings
Convenience stores and 24/7 delivery services are the main sources of nitrous oxide, with larger cylinder use increasing from 6% to 26%.
Neurological symptoms rose from 5% to 14% over three years, with few receiving treatment.
Only one-fifth of users recognized the risk of Vitamin B12 depletion, indicating gaps in awareness.
Abstract
Increasing harms associated with nitrous oxide use have raised concerns, but limited evidence exists to inform harm reduction. This study aimed to identify how nitrous oxide is sourced, the products/forms used, awareness of health risks, engagement in harm reduction and experience of neurological symptoms. Data were collected via annual interviews (2021–2023) with cross‐sectional convenience samples of Australians who regularly used ecstasy/MDMA and/or other illicit stimulants and reported past 6‐month use of nitrous oxide (2021 n = 379; 2022 n = 315; 2023 n = 284). The most commonly reported source of nitrous oxide in the past 6 months was convenience stores, followed by 24/7 delivery services. Sourcing from these retailers was also associated with heavier use. Reported use of larger cylinders (> 8 g) increased from 6% in 2021 to 26% in 2023. While most respondents demonstrated…
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Taxonomy
TopicsRestraint-Related Deaths · Forensic Toxicology and Drug Analysis · Opioid Use Disorder Treatment
