– At first I thought it was because I was stiff after training. That’s what 19-year-old Axel from Oslo says. We call him Axel, but that is not his real name. He is fond of training. He does strength training and football. The symptoms came creepingly. – It first started with a weak and numb feeling in the toes. Within two days, the sensation spread to the calves and thighs, and up to the middle of the back. His legs failed and he could no longer walk. Eventually he himself had a slight suspicion of what the cause could be. But he refrained from telling anyone. – I felt shame. Axel had been taking nitrous oxide regularly for the past six months. Significant increase And he is not the only one. During the spring and summer of 2022, the neurologists experienced something they had not seen before. – We experienced patients coming to us in wheelchairs and on crutches. They had severe paralysis and could not walk, says My Vuong Hermansen. She is a senior physician at the Department of Neurology at Oslo University Hospital, Ullevål. My Vuong Hermansen, senior physician at the neurology department at Oslo University Hospital, says that the patients have damage to the brain, spinal cord and nerves in the legs and arms. Photo: Anders Fehn / news The patients have continued to come, and they are increasing in number. – We are experiencing a marked increase in admissions due to nerve damage after using nitrous oxide. From no patients to ten in six months. Common to all is that they have used nitrous oxide for a long time. They are both genders, but mainly men in their 20s. She is worried about the development. – They have damage to the brain, spinal cord and nerves in the legs and arms. My Vuong Hermansen, senior physician at the neurology department at Oslo University Hospital. Photo: Anders Fehn / news They also notice an increase at Poison Information. – There has been an increase in the number of inquiries in the last couple of years, says Merethe Midtervoll, senior advisor at Poison Information, Norwegian Institute of Public Health (FHI). The number of inquiries has increased from less than ten in 2021 to close to 45 last year. A new report from the EU Drugs Agency (EMCDDA) (external link) shows that the use of nitrous oxide as an intoxicant among young people is increasing across Europe. – Gone under the radar – Abuse of nitrous oxide among young people has gone under the radar for several years, says Dag Jacobsen. He is head of department at the Department of Emergency Medicine, Oslo University Hospital. Dag Jacobsen, professor emergency medicine department, Oslo University Hospital. Photo: Randi Elise Midtskog In addition, he is a specialist in poisoning medicine at Poison Information. Until recently, nitrous oxide parties were associated with nightlife in the South. – But in recent years, its use has become more common throughout Scandinavia, and now also here in the country, according to Jacobsen. Nitrous oxide is readily available from cream cartridges sold legally in hardware and kitchenware stores. Increasing demand has led to online stores offering larger gas cylinders delivered to your door. Jacobsen believes that nitrous oxide has now established itself as one of the three most common drugs, in addition to alcohol and cannabis. – I know many people who have collided. It turned out that Axel had suffered serious nerve damage after using nitrous oxide. The 19-year-old belongs to a large group of friends with both boys and girls. All are between 15 and 20 years old. Many of his gang take nitrous oxide, and it happens while driving. – When we take nitrous oxide, we get “hyper”, and then you like driving, says Axel. He himself has avoided a collision after inhaling nitrous oxide, but knows several people who have done so. – What happens is that you suddenly fall asleep for a few seconds. It’s enough for you to collide, he says. One person who sees nitrous oxide being used in cars is Mohammed Hersi. He is a minority political adviser in the drug organization RIO. Once a week, he is an external adviser in Oslo for the drug organization. He has seen usage increase every year. – They mostly sit together in cars parked along the roads or in car parks, and inhale from balloons. He is frustrated. Mohammed Hersi, minority political adviser, RIO Photo: Mohammed Hersi / RIO – I have raised it in various committees, but nothing happens. Gives false security The neurologist My Vuong Hermansen at Oslo University Hospital follows up patients who come with spinal cord injuries after using nitrous oxide. – Some get better slowly, while others never fully recover, says Hermansen. – Some slowly get better, while others never get well again, says Hermansen. Photo: Anders Fehn / news She believes that many people take nitrous oxide because it feels safe. Nitrous oxide is a gas used for anesthesia and pain relief in the hospital, for example in connection with childbirth. It is also not considered a drug, and it is not detected in blood or urine tests. – But the nitrous oxide that is used as an intoxicant is much more dangerous, she continues. Medical nitrous oxide is oxygen added. And there are strict requirements for ventilation. Medical nitrous oxide for use in labor. This nitrous oxide has oxygen added, unlike nitrous oxide that can be bought in the shop or online. Photo: Gry Eirin Skjelbred / news – Whereas the nitrous oxide that is bought in shops or online is unmixed and only intended for use in industry. The side effects can occur acutely or after prolonged use. In the short term, nitrous oxide displaces oxygen. In low doses, lack of oxygen can cause confusion and hallucinations. In larger doses, acute suffocation can occur because the brain and internal organs do not receive enough oxygen. This can lead to fainting and, in the worst case, convulsions or cardiac and respiratory arrest. After long-term use, neurological damage such as paralysis occurs – especially in the legs. Want a legal ban on the sale Drugs were difficult to get hold of during the pandemic, and neurologists believe that this is the reason why nitrous oxide consumption increased. According to Hermansen, consumption was clearly visible this summer, in parks and at festivals, including the Roskilde festival. – We are also seeing an increase in student communities, she says. In Denmark, an 18-year-old limit has now been introduced for the purchase of nitrous oxide. In Sweden, the health authorities want a ban on the sale of the large commercial gas cylinders. Dag Jacobsen also wants that in this country. – Everyone knows that the large gas flasks of two to six kilos are used for intoxication and nothing else. And he gets support from RIO. – It must be prohibited to import the large gas cylinders. An age limit should also be introduced for the purchase of gas cartridges, and they should not be visible in the shops, believes Mohammed Hersi. At the Ministry of Health and Care, they are aware and follow the problems related to nitrous oxide, says State Secretary in the Ministry of Health and Care, Ole Henrik Krat Bjørkholt (Ap). State Secretary in the Ministry of Health and Care Ole Henrik Krat Bjørkholt (Ap). Photo: Maria Kommandantvold / news – We are also aware that other Nordic countries have regulated or are considering regulating these products. We update ourselves on the situation and assess the need for possible measures depending on the professional advice we receive. Was frightened For Axel, the paralysis in his legs was frightening. He feared the worst. – I was sure to be paralyzed forever. He was in hospital for a week, and the treatment was injections of B vitamins. But when he got out, he still couldn’t walk. Half a year later things got better, and he could walk on crutches. – I started to build myself up. Eventually I was able to jog, and today I can play football again, he says with a smile. He was one of the lucky ones, and he escaped the horror.
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