The potential risks are nothing to laugh at.
According to the latest Global Drug Survey, nitrous oxide – or laughing gas – is now the seventh most popular drug in the 50 countries surveyed. Just over half the UK respondents said they had tried the drug at some point, and 38% said they had used it in the last year, making it more popular in the UK than any other country.
Nitrous oxide is a colourless, sweet tasting gas that has been used recreationally since the late 18th century, most notably by Sir Humphry Davy, former president of the Royal Society. Medical use was established in the early 20th century and nitrous oxide remains an important anaesthetic, tranquilliser and painkiller, used by dentists, obstetricians and sports doctors. Indeed, many members of the public will have experienced the effects of nitrous oxide themselves without realising it.
The popularity of recreational use of nitrous oxide is unsurprising. It’s legal in many parts of the world, it’s cheap and it reliably produces a short-lasting euphoria as well as heightened senses and a slight feeling of disconnect from the body and is often used as a drug at concerts, nightclubs and festivals.
And it can be combined with other drugs to alter the effects. Availability is affected by national laws but, generally, where the drug is available it is either dispensed from large canisters or small bulbs (“whippets”), into balloons, which is then used to inhale.
Because nitrous oxide has legitimate uses in the food industry (to make whipped cream or in home brewing), it can easily be bought from online retailers such as catering companies. However, according to the Global Drug Survey, people are increasingly using the darknet to buy it.
Not a high risk drug
Nitrous oxide is considered to have relatively low toxicity. However, it can cause dizziness, so there’s a risk of harm from falling. There are also case reports of dependence in people – often medical professionals – who have access to large quantities of the drug.
Risks can vary, depending on how the drug is administered. Inhaling nitrous oxide directly from a pressurised canister can damage the lungs. And, although rare, a few people have died from asphyxiation after passing out while their mouth and nose are connected to a tube or surgical mask, or where a bag containing nitrous oxide has been placed over the head.
Most users inhale the drug from balloons or small bulbs, and the dose administered is low, so the risk of asphyxiation is almost nonexistent.
% of reported drug use in last 12 months Global Drug Survey
Top up on B12
Long-term and heavy-use of nitrous oxide can lead to vitamin deficiency and anaemia as a result of the inactivation of vitamin B12 in the body, although the incidence of this is unknown. Vitamin B deficiency can cause tingling in the fingers, toes and extremities which can last for hours or days. More severe cases can lead to numbness and difficulty walking, and the risks are heightened in people who are already B12 deficient.
The recent drug survey asked people who had used nitrous oxide to report whether they had experienced such symptoms, and 4% said they had, although it is not possible through a self-report survey to assess if this was actually related to nitrous oxide use. People who use nitrous oxide regularly, sometimes take B12 supplements to avoid these symptoms.
We don’t really know why use of this drug has risen. All we do know is that like fashion, drug use changes over time. What is popular today is likely to change in the future. Making the cat and mouse game of prohibiting substances deemed harmful so impotent.
The Psychoactive Substances Act, which came into force in the UK in May 2016 is intended to burst the ballooning use of nitrous oxide in Britain. But will suppliers and users have the last laugh? Next years global survey of drug use might provide the answer.