{
  "abstract": "Background Recreational use of nitrous oxide (N 2O) has risen markedly over the past decade; typically, users are young adults, often from ethnic minority backgrounds and not in full-time employment. Prolonged or intense N2O use can inactivate vitamin B12, leading to subacute combined degeneration of the spinal cord, which may result in significant neurological disability. Understanding N2O-related health and social harms remains challenging due to limited patient engagement with research and healthcare.Methods Drawing on our experience of conducting a longitudinal study and existing literature, we offer practical recommendations for researchers and clinicians.Results Inclusive research practices that incorporate lived experience perspectives are essential to enhance relevance and accessibility. Offering compensation, psychological support resources and flexible delivery models may improve recruitment and retention. Confidentiality limits must be clearly communicated, particularly when illegal activity may be disclosed.Conclusions Strengthening engagement in research will inform evidence-based practice within healthcare systems. Additionally, we advocate for better training on N 2O-related harms and multidisciplinary collaboration to enhance healthcare provision.Trial registration numberNCT05714917.",
  "authors": [
    {
      "affiliations": [
        "Mental Health and Clinical Neurosciences Academic Unit, School of Medicine, University of Nottingham, Nottingham, UK",
        "Clinical Neurology, Queens Medical Centre, Nottingham University Hospitals, Nottingham, UK"
      ],
      "name": "Aimee Hibbert"
    },
    {
      "affiliations": [
        "Centre for Preventive Neurology, Wolfson Institute of Population Health, Queen Mary University of London, London, UK",
        "Department of Neurology, The Royal London Hospital, Barts Health NHS Trust, London, UK"
      ],
      "name": "Mohamoud Hashi"
    },
    {
      "affiliations": [
        "Centre for Preventive Neurology, Wolfson Institute of Population Health, Queen Mary University of London, London, UK"
      ],
      "name": "Isabelle Symes"
    },
    {
      "affiliations": [
        "Department of Neurology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"
      ],
      "name": "Tom Hayton"
    },
    {
      "affiliations": [
        "Manchester Centre for Clinical Neurosciences, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, UK"
      ],
      "name": "James B Lilleker"
    },
    {
      "affiliations": [
        "Manchester Centre for Clinical Neurosciences, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, UK"
      ],
      "name": "Katherine Dodd"
    },
    {
      "affiliations": [
        "Mental Health and Clinical Neurosciences Academic Unit, School of Medicine, University of Nottingham, Nottingham, UK",
        "Clinical Neurology, Queens Medical Centre, Nottingham University Hospitals, Nottingham, UK"
      ],
      "name": "Nikos Evangelou"
    },
    {
      "affiliations": [
        "Centre for Preventive Neurology, Wolfson Institute of Population Health, Queen Mary University of London, London, UK",
        "Department of Neurology, The Royal London Hospital, Barts Health NHS Trust, London, UK"
      ],
      "name": "Alastair J Noyce"
    },
    {
      "affiliations": [
        "Centre for Preventive Neurology, Wolfson Institute of Population Health, Queen Mary University of London, London, UK"
      ],
      "name": "Laura J Smith"
    }
  ],
  "title": "Inclusive approaches to research and healthcare for nitrous oxide users: lessons from a longitudinal study",
  "uid": "a95f05e3-47d1-5f7b-8cf5-e285a2350e95"
}