Driving under influence of nitrous oxide – a case series

Unlike previous reports, the present study combines analytical findings with observations of unusual behavior occurring while driving, during a police stop, or during blood sampling. Thirteen subjects were involved in a traffic accident, whereas among the remaining subjects, driving abnormalities such as weaving across lanes or red-light violations were observed. Also, other psychophysical performance deficits were identified, among others somnolence, confusion, disorientation, impaired cognitive responsiveness, lack of concentration, slurred speech or balance problems.

Such deficits indicate an impairment of the central nervous system that is incompatible with the safe operation of a vehicle.</p> <p>The determination of N₂O in the blood samples of road users proves recent exposure and provides important forensic-toxicological evidence when interpreting accidents or erratic driving following suspected N₂O use. Analytical verification increases the evidentiary value and should therefore be routinely performed in cases where there is suspicion of N₂O use.</p>