11:00 a.m., December 29, 2021
“A young man, in his thirties. He arrived at the hospital with a picture of disturbances in vigilance and quadriplegia, paralysis of the four limbs, recalls Chérif Héroum, head of the neurology department at the hospital of Montélimar ( Drôme). We did not go far from intensive care. ” Faced with this disturbing picture, the doctor explores all the hypotheses, before realizing that his patient is a frenzied consumer of nitrous oxide – a cheap gas used in anesthesia, in industry and even in the kitchen in whipped cream siphons. , but sometimes diverted from its classic uses for its euphoric properties.
“Quite miraculously”, the young man recovers the use of his limbs in a few days. But three months later, a thirty-something who consumes laughing gas in turn comes to the emergency room with “a picture of acute ataxia: she could no longer walk coherently, no longer perceived the position of her limbs”. Less fortunate, she is still in rehabilitation. Alarming as it is, the mechanism is well known to neurologists. “Inhaled in large quantities, nitrous oxide inactivates vitamin B12” in the spinal cord, explains Thomas de Broucker, head of department in the neurology department at Pierre-Delafontaine hospital (Saint-Denis). A supply of fresh vitamins prevents further damage, but those already done do not always disappear without a long treatment. An expensive price paid for a few minutes of euphoria and sensory distortion.
This practice has existed for a long time but had never gained the scale that we have observed for a few years.
While “the consumption of a single capsule will not have these deleterious effects”, reassures Chérif Héroum, the frequent and massive intake of laughing gas – via balloons in which we breathe – is no longer so rare. “This practice has existed for a long time in certain student circles, but it had never gained the magnitude that we have observed for a few years”, deciphers Nicolas Prisse, president of the Interministerial Mission for the fight against drugs and addictive behaviors (Mildeca ), for whom 2018 “was probably the turning point”.
A territorial disparity
But behavior towards the “proto” seems to have changed with the Covid crisis. From a handful of balloons during a party, some young people went to several dozen, even several hundred a day, often alone and at home. In a report published last month, the National Medicines Safety Agency and the National Health Safety Agency (ANSES) warn about the “very marked increase in cases of intoxication in 2020 among a young audience”, with ” sometimes serious and lasting neurological consequences “, but also psychiatric and cardiovascular complications.
Last year, 388 cases were reported compared to 93 in 2019, with an increase in the proportion of minors. On the ground, the expansion seems to continue: “In 2020, I saw two, advance Thomas de Broucker. This year, we are at 20 or 25.” Since June, a law has regulated the sale of the product in open access and prohibited providing it to a minor.
To try to identify the phenomenon, an epidemiological study is underway in Île-de-France – one of the two regions most affected with Hauts-de-France. By collecting data from all internal medicine and neurology services in the Region between 2018 and 2021, Yachar Dawudi, medical intern at AP-HP, attempts to establish “a link between the explosion of these complications and the various confinements and curfews “, during which young people were able to increase the doses, alone at home. Second hypothesis: a territorial disparity between rich territories and disadvantaged territories. “Saint-Denis and Bobigny [Seine-Saint-Denis] report many cases, explains Yachar Dawudi, while the Cochin or Pompidou hospitals [Paris intra- muros] hardly declare any. “