The Dazed guide to laughing gas

The government is facing renewed calls to tackle the use of nitrous oxide in the UK. Nitrous oxide, or nos (also known as laughing gas, balloons or ‘hippy crack’ to boomers), is a colourless gas sold in canisters and often inhaled through balloons, giving users a short buzz – and experts consider it to be relatively safe. However, when asked whether she would consider taking tougher action on the sale and possession of nitrous oxide in the UK last week, home secretary Suella Braverman said that the government would be “announcing new measures soon”.

The government freakout isn’t unprecedented (or surprising). In recent months, there has been a rise in media reports of adverse health effects relating to nos, including nerve damage and even paralysis caused by vitamin B12 inactivation, all of which are very real risks. In some extremely rare cases, nos abuse can be fatal, but the number of nos-related deaths per year are fairly low (there have been 62 since 2001).

Back in January, the Home Office said it was “actively considering a ban on the sale and use of this harmful drug”. However, the UK’s independent Advisory Council on the Misuse of Drugs (ACMD) recently advised against banning the substance under the Misuse of Drugs Act, arguing that legal sanctions placed on users would be disproportionate to the level of harm associated with the drug. 

Currently, nitrous oxide is banned for recreational use under the Psychoactive Substances Act, but it’s legal to buy and possess, as long as you’re purchasing it for a legitimate reason. For example, nitrous oxide is perfectly legal to use in hospitals, dentistry and the catering industry. This makes canisters nos readily available and easy to buy online and from corner shops.

This is perhaps why use is so high, particularly among young people. The most recent government figures show that 1.3 per cent of adults aged 16 to 59 years admitted to using nitrous oxide in the year ending June 2022, rising to 3.9 per cent for those aged 16 to 24 years. That’s about 240,000 young people. However, more reliable drug use data from before the pandemic shows that laughing gas use was much higher: in 2019, 8.7 per cent of 16- to 24-year-olds admitted to using nos recreationally – around 796,000 young people. 

But is the media and government frenzy warranted? For the most part, those in the harm reduction field consider nos to be relatively safe. Despite reports that it is “more dangerous than cocaine,” nos has accounted for an average of 4.5 drug deaths a year since 2012, according to the latest available figures. By contrast, in 2021 alone, cocaine accounted for 840 reported drug deaths. 

That being said, 999 calls and hospitalisations due to nos are on the rise, and it’s impossible to know the long-term effects of excessive use. Some people start by feeling pins and needles and numbness in their feet and hands, coupled with clumsiness. This can, if use continues, become full-blown paralysis. While some cases have fully recovered, others haven’t, and it’s too early to know the long-term effects. Deaths, however rare, do occur, often due to suffocation or accidents, like falling over. So, here’s everything you need to know about doing it safely. 

DON’T OVERDO IT

According to harm reduction expert Dr Russell Newcombe, nos-related hospitalisations are likely increasing due to an unprecedented rise in “severe use of 50 to 100 balloons a day, which was virtually unheard of 10 years ago”.  While medical journals regarding the issue are yet to be published, it’s these excessive amounts that are more likely to lead to this problem of paralysis and damage to the nervous system, he adds. This is especially true if people consistently take high doses of nos.

The majority of people only use a moderate amount of nos over the course of the evening, once or twice a month. “That way of doing it isn’t harmful, as long as it’s done occasionally,” he says. However, there have even been media reports of young people using 150 canisters a day. Don’t do this. As Dr Newcombe says: “there’s always a price to pay for overdoing drugs”. 

If you do notice mild effects, like pins and needles, be sure to halt your nos usage before things escalate. 

TAKE SMALL DOSES (AND DON’T FORGET TO BREATHE!) 

The above advice only works if you’re taking small doses of nos. Most people use one canister of nos at a time, but if you use more than this, especially over and over again, you’re at risk of suffocating. “If you use a tank, or multiple canisters at once, you can get knocked unconscious due to the oxygen supply to your brain being cut off,” says Dr Newcombe. If you do this repeatedly, without breathing in enough oxygen, you can suffocate and die.

TAKE VITAMIN B12 SUPPLEMENTS

Nitrous oxide depletes vitamin B12, a lack of which can cause neurological problems including vision problems, memory loss, pins and needles, clumsiness, and nerve damage. This, therefore, is the main reason for paralysis and nerve damage in long-term and excessive nos users and those deficient in B12 are more at risk.

But even a small vitamin B12 deficiency can cause health problems. “If you’re not using nos excessively, [adverse effects] can simply be avoided by taking vitamin B12 supplements,” says Dr Newcombe.

WATCH THE WOBBLE

Finally, a number of nos-related deaths are actually caused by accidents, like people falling over while intoxicated and hitting their head or drowning. With something like nos, which can make you pretty wobbly, it’s important to follow basic harm reduction advice. 

“Make sure you're sitting down and not standing up, because you might fall,” says Dr Newcombe. “Don’t chew gum or eat while you’re doing nos because you might choke. And, finally, don’t take nos – or any drugs – next to water, because you might drown”.

Join Dazed Club and be part of our world! You get exclusive access to events, parties, festivals and our editors, as well as a free subscription to Dazed for a year. Join for £5/month today.