Increasing illicit use of nitrous oxide in presentations to NSW emergency departments

To the Editor: Recreational use of nitrous oxide is increasing among regular drug users in Australia1 and internationally.2 In a New South Wales survey of participants who had used ecstasy or other stimulants in the past 6 months, 75% of respondents reported recent use of nitrous oxide in 2018, up from 20% in 2013.3 Nitrous oxide use while bingeing on stimulants rose from 4% of respondents in 2013 to 16% in 2017.4,5 Access to nitrous oxide has been facilitated by businesses offering 24/7 delivery of large quantities of canisters, ostensibly for whipping cream.6