To answer your question "is there a downside?", yes, there are downsides and there are upsides to using global scope... despite the ubiquitous warnings about global scope, you can use it effectively under some circumstances in some languages in some contexts if you plan accordingly, have enough information about your application and the various components that make it up, etc etc etc...
In my experience, node doesn't provide any compelling reasons to use global scope, so you're opening yourself up to the dangers without experiencing any of the potential benefits. You have to be mindful about passing your variables around, but that's the "node way", it's designed specifically to work that way and javascript in particular is very good about allowing you to do that in ridiculously powerful ways.
The short answer is that, if this is a module for inclusion in other projects, then you're courting disaster by introducing your variable into the global scope of projects where you couldn't hope to understand how that could effect things. If this is a standalone application, so long as it remains trivial and will not grow and evolve over time, you're probably OK using the global scope as a shortcut. The more your application grows and changes, the more likely you are to run into problems by not properly limiting scope.