High lifetime prevalence of regular nitrous oxide use in French medical students

<i>Background:</i> Although nitrous oxide (N₂O) is increasingly misused recreationally, its use and risks among medical students who have professional access to it are rarely explored. <i>Objectives:</i> To investigate the recreational use of N₂O among medical students in Paris Region (France). <i>Methods:</i> This cross-sectional study used an online questionnaire distributed in 2022 through social networks, to all medical students (undergraduate student from the 2nd year of medical studies to residents until the end of the residency) from the six medical universities in Paris Region. We collected demographic characteristics, patterns of N₂O consumption, co-consumptions, and N₂O training (academic course or self-training). Factors associated with N₂O consumption and complications were analyzed using multivariable logistic regressions. <i>Results:</i> The questionnaires of 444 students (mean age: 25.9 years (SD = 2.69), 75.5% female, and 63.74% residents) were analyzed. Recreational N₂O consumption was reported by 71.85% of students and 20.50% consumed at least monthly. N₂O consumption was associated with being a resident (versus undergraduate student) (adjusted OR (aOR) = 3.07[1.45–6.72]; <i>p</i> &lt; .01), receiving training on N₂O (aOR) = 3.13[1.84–6.24]; <i>p</i> &lt; .01), and consumption of cannabis (aOR = 18.21[3.47–104.26]; <i>p</i> &lt; .01), ecstasy (aOR = NA, <i>p</i> = .048) and poppers (aOR = 13.9[2.64–77.94]; <i>p</i> &lt; .01). Complications (mainly dizziness, paresthesia and burns) were reported in 8.15% of students consuming N₂O. They were associated with consuming more than 10 balloons per intake (aOR = 6.04[1.32–25.00); <i>p</i> &lt; .01) and inversely associated with receiving training (aOR = 0.35[0.14–0.86]; <i>p</i> = .01). <i>Conclusions:</i> Almost three-quarters of medical students experienced recreational N₂O consumption, particularly with poly-drug use. Given that complications were associated with high consumption and lack of education, risk training and screening for N₂O consumption could be beneficial.

背景：尽管一氧化二氮（nitrous oxide, N₂O）的娱乐性滥用情况日益增多，但针对有专业接触渠道的医学生群体中该物质的使用现状与相关风险，目前相关研究仍较为匮乏。研究目的：探讨法国巴黎地区医学生的一氧化二氮娱乐性使用现状。研究方法：本研究为横断面研究，于2022年通过社交网络向巴黎地区六所医科大学的全体医学生（涵盖医学本科二年级至住院医师培训结业的住院医师）发放线上问卷进行调查。本研究收集的内容包括人口学特征、一氧化二氮使用模式、联合物质使用情况以及一氧化二氮相关培训（学术课程或自主培训）情况，并采用多变量logistic回归分析一氧化二氮使用及相关并发症的影响因素。研究结果：最终回收有效问卷444份，受访学生平均年龄为25.9岁（标准差SD=2.69），其中女性占比75.5%，住院医师占比63.74%。71.85%的学生报告存在娱乐性一氧化二氮使用行为，20.50%的学生至少每月使用一次。一氧化二氮使用与以下因素显著相关：身份为住院医师（相较于本科医学生，校正比值比aOR=3.07[95%CI:1.45~6.72]，p<0.01）、接受过一氧化二氮相关培训（aOR=3.13[95%CI:1.84~6.24]，p<0.01）、同时使用大麻（cannabis，aOR=18.21[95%CI:3.47~104.26]，p<0.01）、摇头丸（ecstasy，aOR无有效数据NA，p=0.048）以及烷基亚硝酸酯类吸入剂（poppers，aOR=13.9[95%CI:2.64~77.94]，p<0.01）。在使用一氧化二氮的学生中，8.15%报告出现相关并发症，主要表现为头晕、感觉异常与灼伤。并发症发生与每单次吸入超过10个笑气球显著相关（aOR=6.04[95%CI:1.32~25.00]，p<0.01），而与接受过一氧化二氮相关培训呈负相关（aOR=0.35[95%CI:0.14~0.86]，p=0.01）。研究结论：近四分之三的医学生存在娱乐性一氧化二氮使用行为，且多伴随多药联用情况。鉴于并发症发生与高剂量使用及缺乏相关教育密切相关，开展一氧化二氮使用风险培训与使用筛查或可产生临床获益。