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Substance misuse

Nitrous Oxide: Understanding the risks

A group of young adults sit together on a bed in a cosy bedroom. One holds a glass in their hands. Overlaid is text that reads: "Drugs Awareness Poster Hub".

Substance misuse is an issue which cuts across our organisation and we have worked with frontline staff at our Young People’s Substance Misuse services to produce downloadable resources that anyone working with young people, or who would like to know more about emerging trends, can download, print off and share.

What is nitrous oxide?

Nitrous oxide is a colourless gas that people inhale, usually via a balloon. You may have seen these canisters lying around on the street, in fields or areas where young people gather. Nitrous oxide is a depressant drug: it slows down your brain and your body’s responses. In medical settings, it serves as an anaesthetic during various procedures.

Nitrous oxide may commonly be called: ‘Balloons’, ‘Noz’, ‘Nos’, ‘Laughing Gas’, or ‘Hippie Crack’

What are the effects?

The effects of nitrous oxide vary on how much you inhale. It can cause feelings of euphoria, relaxation, and calmness, fits of giggles and laughter (hence the term laughing gas), or sound distortions and hallucinations. It can also give you a severe headache, dizziness, and nausea, stop you thinking straight, and cause short-lived but intense feelings of paranoia

Heavy, regular use can lead to a deficiency of vitamin B12 which can cause nerve damage and some types of anaemia.

The law

  • As of November 8th 2023, nitrous oxide is a Class C drug.
  • Being in possession of nitrous oxide can result in an unlimited fin , visible community punishment, cautions and up to 2 years in prison.
  • Producing or supplying nitrous oxide, which includes giving or selling it to your friends, can result up to 14 years in prison.
  • A conviction for a drug-related offence may stop you from visiting certain countries, such as the United States, as well as making it harder to get a job.

Harm reduction

  • It can be extremely dangerous to inhale nitrous oxide directly from the canister – the high pressure can cause your throat to close.
  • Avoid taking nitrous oxide in an enclosed space and don’t take too big a breath – if you have too much you can end up fainting, falling unconscious or suffocating from a lack of oxygen. People have died this way.
  • Avoid using nitrous oxide in potentially dangerous places where falls could cause injury.
  • Don’t take nitrous oxide with other drugs – mixing nitrous oxide with alcohol is particularly dangerous as it increases risks associated with both substances
  • Be with people who you trust when taking nitrous oxide.

Ten things you need to know

  1. High doses of nitrous oxide can lead to health risks, including oxygen deprivation, which may result in convulsions, breathing difficulties , and, in severe cases, heart issues or loss of consciousness.
  2. If someone collapses after using nitrous oxide, turn them on to their side, call 999 and stay with them until an ambulance arrives.
  3. Nitrous oxide inactivates B12 reserves in the body. Users are reporting tingling in the limbs and prolonged use can cause anemia and a form of nerve damage called peripheral neuropathy.
  4. Nitrous oxide produces brief euphoric effects, and the “high” is short-lived, lasting only around up to 2 minutes typically.
  5. Inhaling nitrous oxide directly from canisters or using improper equipment can be dangerous and may lead to frostbite or other health issues.
  6. Nitrous oxide use can lead to feelings of dizziness, disorientation, and, in some cases, anxiety or panic attacks. It can also worsen pre-existing mental health conditions.
  7. Combining nitrous oxide with other substances, such as alcohol or drugs, can amplify the risks and negative effects associated with its use. This can lead to unpredictable and potentially dangerous outcomes.
  8. Not everyone has a positive experience with nitrous oxide, and some may experience discomfort, anxiety, or paranoia when using it.
  9. Nitrous oxide intoxication can impair coordination and cognitive function, increasing the risk of accidents, particularly when engaged in activities that require alertness, such as driving.
  10. Over time, regular nitrous oxide users
    may develop tolerance, which means they need increasingly larger amounts of the gas to achieve the same effects. This can increase the risk of overdose and health complications.

If you have used nitrous oxide and you’re feeling unwell or notice someone else is unwell whilst using, after using or after stopping using nitrous oxide, then seek medical attention urgently. Contact 111 for urgent medical advice or 999 in an emergency.

Symptoms of withdrawal include:

Knowledge about the dependance of nitrous oxide is limited. There are no properties that make nitrous oxide physically addictive; however, there is evidence to support its psychological impact.

Whilst a person may not experience the ‘typical’ symptoms such as nausea or abdominal cramping, the short ‘high’ that nitrous oxide provides causes people to frequently reuse, meaning people are often using more than they would with any other substances.

Constant use and binge use of the drug can cause many physical issues. A lack of B12 may cause fatigue, damaged muscles, paralysis and, in extreme cases, death.

Catch22 Young People’s Substance Misuse services offer free and confidential advice and support to young people aged between 11 and 25. We can provide you with information about the risks and effects of alcohol or drugs. We are here to listen and can work with you to achieve the changes you would like to make in your life.