woman laughing
dentist working on a mouth

Nitrous oxide is commonly known as “laughing gas.” It has various uses, including medical and dental applications. In fact, dentists and surgeons have used nitrous oxide since 1844. The gas is usually called “laughing gas” because of the side effects. While nitrous oxide helps relieve anxiety, it also has a euphoric effect. People abuse nitrous oxide because they like the high it gives. Nitrous oxide abuse isn’t new. Since 1799, people have used this gas recreationally. However, nitrous oxide abuse is dangerous. That’s why doctors and other experts are trying to raise awareness about nitrous oxide abuse and treatment options.

What Is Nitrous Oxide?

Nitrous oxide is a gas that is also known as N2O, whippet, balloons, buzz bomb, hippy crack, NOS, nangs or nitro. Some of these terms are street names. It’s most commonly referred to as “laughing gas” due to its effects.

The gas is colorless. It has many uses, including:

  • Sedation and pain relief
  • Food additive
  • Engine performance (for automobiles and racing)
  • Treatment for alcohol dependence

Nitrous oxide is officially classified as a dissociative anesthetic. This means it creates feelings of dissociation (aka “out of body” experiences). When you inhale nitrous oxide, you may feel like you are floating. You may see things that aren’t there, and your senses may be impaired. You may perceive the world to be different than it really is.

Medical Use of Nitrous Oxide

Most people experience some level of anxiety before and during surgery. This includes both medical and dental procedures. Most clinics and dental offices use nitrous oxide for anxiety relief during certain procedures. Nitrous oxide helps calm patients and also provides some pain relief.

Is Nitrous Oxide Harmful?

In most situations, nitrous oxide is completely harmless. It works quickly and wears off quickly. Usually, side effects are rare after the gas leaves the body. Sometimes, though, the brain may continue experiencing the effects of nitrous oxide.

How Do People Become Addicted to Nitrous Oxide?

If you experience nitrous oxide for surgery, you probably won’t remember how you felt during your procedure. However, if the effects don’t wear off once the gas leaves your body, you may continue to notice its antidepressant and euphoric effects. Some patients enjoy the feeling so much that they are eager to experience nitrous oxide effects again. This, of course, can lead to nitrous oxide abuse.

The History of Nitrous Oxide

Nitrous oxide is not a new treatment, and nitrous oxide abuse is even older than its medical use. Nitrous oxide was created in 1772, but it wasn’t regularly used in medical settings until 1844. However, nitrous oxide parties started around 1799, and the drug was used recreationally well before these parties started.

In fact, medical professionals misused nitrous oxide in its early days. Many doctors and dentists had access to nitrous oxide, though it wasn’t an approved treatment. They used it for various medical purposes (including anesthesia) well before it was standard practice.

Today, nitrous oxide abuse is a growing concern. It is often used at concerts, festivals, parties and other social gatherings, usually by teenagers and young adults.

Long-Term Effects of Nitrous Oxide Abuse

While isolated exposure to nitrous oxide is almost always harmless, repeat exposure can create significant problems. The brain is most affected. Nitrous oxide specifically affects B12, which may cause neurological issues.

The Effect of Nitrous Oxide on Vitamin B12 and the Brain

The body can not produce B12 naturally. Most of our B12 comes from animal food products and vitamin supplements. We need B12 to create DNA and maintain red blood cell production as well as other important functions. B12 does not stay in the body for long, though. That’s why we need to get B12 from food and supplements to maintain adequate levels of the vitamin.

Vitamin B12 performs the following functions:

  • Helps the brain and nervous system function properly
  • Helps the body create red blood cells
  • Helps create and regulate DNA
  • Helps synthesize fatty acids and create energy
  • Helps the body release energy
  • Helps the body absorb folic acid
  • Helps cells in the body metabolize

Your body creates millions of new red blood cells every minute. Without B12, you can’t create these cells. Eventually, this can lead to anemia, which has severe symptoms.

Symptoms of Vitamin B12 Deficiency

Sometimes, B12 deficiency does not produce any symptoms. These situations are usually mild B12 deficiency. When the deficiency continues without treatment, though, your symptoms may be severe.

They can include:

  • Breathing difficulties
  • Confusion
  • Depression
  • Loss of memory
  • Fatigue or tiredness
  • Rapid or slow heartbeat
  • Loss of appetite
  • Nausea, vomiting, constipation or diarrhea
  • Numb fingers or toes
  • Tingling sensation in fingers or toes
  • Blurry vision
  • Weight loss
  • Problems with balance
  • High risk for developing dementia, mania or psychosis

Severe B12 deficiency may lead to anemia, which includes the symptoms above as well as:

  • Sore mouth or tongue
  • Additional weight loss
  • Menstrual irregularities
  • Pale or yellow skin

As you may have guessed, nitrous oxide can create a B12 deficiency. According to research1, nitrous oxide can make B12 completely ineffective. Once a patient stops producing B12 from animal-based foods and supplements, they’ll quickly feel the effects.

The research shows that patients with B12 deficiency may not do well with nitrous oxide treatment. It also notes that the neurological effects may be irreversible. Sometimes they may be fatal.

Recreational Use of Nitrous Oxide

People gain access to nitrous oxide in a variety of ways. Whippits (aka whip-its, whippets or whipits) are sold to whipped cream manufacturers to use in dispensers. Canned whipped cream comes with one of these devices, which have a small amount of nitrous oxide. People can use the can to get a pure dose of nitrous oxide. It’s important to note that pure nitrous oxide is more dangerous than the kind you will experience in a medical setting. Most laughing gas includes oxygen, too. Because the oxygen is not included in whippets, low oxygen can be an immediate side effect. This is called “hypoxia” in the medical community.

People either inhale nitrous oxide directly from the whippet or discharge the cartridge into a balloon. Because whippets contain pure nitrous oxide, the effects are immediate, though short. The person may immediately feel like they are floating or excited. They may feel euphoria or out-of-body effects. In addition, side effects include slurred speech, trouble walking or balancing, slow response to questions and inability to respond to an outside stimulus (e.g. pain, talking or loud noises). Some people may become unconscious.

If a person repeatedly inhales nitrous oxide without oxygen, they may experience irreversible brain damage.

If you currently use nitrous oxide recreationally, please contact Windward Way Recovery for help. We can perform an assessment through a series of questions. This assessment helps determine your risk and the Level of Care you may need for recovery.

Other Uses for Nitrous Oxide

Nitrous oxide has other uses, too. It’s sometimes used to inflate balloons (similar to helium). Besides medical and dental anesthesia, food additives and balloon inflation, it’s also used to manufacture semiconductors, chemical manufacturing, analytical chemistry and auto racing engine injection.

Nitrous Oxide Case Studies

People can suck the gas out of the balloons or canisters to experience the euphoric effects. In one case study, the people who attempted this experienced nerve damage. Even after medical treatment, the patients were “significantly disabled2”

Other case studies include a 20-year-old male who used nitrous oxide recreationally. He had brain damage similar to an alcoholic who had drank significantly for 40 years. Another college student inhaled 360 cans of nitrous oxide in one week. She had severe nerve damage to her spinal cord. She may never use her feet again.

As you can see, laughing gas abuse isn’t as harmless as people think. While the gas itself rarely causes severe effects with occasional use in a doctor or dentist’s office, repetitive use is a major concern.

If you misuse nitrous oxide and are worried about the long-term effects, please call Windward Way Recovery. We can help you recover from nitrous oxide addiction so you can resume your normal life.

Current Nitrous Oxide Abuse

While nitrous oxide abuse is not new, it is currently a widespread problem affecting most developed countries across the world. The current trend started at concerts, music festivals and parties. In a 2012 survey, nearly half of all respondents said they used nitrous oxide recreationally at least once. The study was conducted in the United Kingdom.

How Do People Abuse Nitrous Oxide?

It’s a widespread problem because it is easy to get and inexpensive. Whippets are especially popular for this reason. Because the drug is so easy to get and not as regulated as other drugs, people mistakenly think it isn’t harmful. Some people may not even realize nitrous oxide abuse is illegal.

Young people are especially susceptible. In 2011, the Substance Abuse and Mental Health Service Administration reported that 719,000 people ages 12 and older had used inhalants recently. Most people said they first used whippets as teenagers; the average age was 16. In fact, many people get high in convenience or grocery stores because the cans are so easy to find there.

While law enforcement agencies attempt to stop nitrous oxide misuse, it is a difficult task. It isn’t illegal to purchase cans of whipped cream even in bulk. That makes it hard to police the way they’re used.

Nitrous oxide abuse is illegal, and the distribution and use of nitrous oxide on the streets is a misdemeanor offense. It isn’t a controlled substance, so punishment is a maximum of six months in jail. That does not mean nitrous oxide isn’t dangerous, though. Besides the long-term effects mentioned above, nitrous oxide has been linked to numerous high-level crimes, including rape and reckless driving. Sometimes, these crimes have fatal consequences.

Still, law enforcement attempts to keep nitrous oxide abuse under control. Police departments routinely shut down nitrous oxide parties and stop suppliers from illegally selling nitrous oxide in bulk.

Is Nitrous Oxide Abuse Fatal?

Sometimes, yes. Nitrous oxide misuse can cause death. Usually, the person becomes unconscious first. This requires immediate medical attention. If you become unconscious from nitrous oxide inhalation, your brain may slowly shut down. You may lose access to air, which can kill you quickly.

Even more concerning: You can die from one exposure to nitrous oxide. If you accidentally inhale a high level of nitrous oxide (either all at once or through several inhalations), you may become unconscious and die within seconds. Many users die after inhaling nitrous oxide several times within a short time frame. The “high” doesn’t last long, so this type of inhalation is pretty common and often leads to tragedy.

The Effects of Nitrous Oxide Abuse

Like most drugs, nitrous oxide users quickly adjust to the lowest dosage. With repeated use, they may need more and more nitrous oxide to experience the same effects. A 1994 research study showed that rats who were exposed to nitrous oxide did the same thing. With repeat exposure, the rats adjusted to the effects of nitrous oxide. They needed higher doses of the drug to feel the same effects.

This, of course, is one of the primary reasons people become addicted to drugs. They seek the high of drugs like nitrous oxide, so they take it more often. Eventually, they can’t feel the effects they seek from the same dose. So they take more, hoping to feel that same high. This creates more tolerance, so they have to take even higher doses for the same effects. Their dependence grows. At some point, they can not function without the drug. They use nitrous oxide to relieve anxiety, and they feel depressed or anxious when they aren’t high.

For many users, the drug becomes their only goal. They forget about the long-term side effects and other consequences of illegal drug use. They need the drug to feel normal, so they take more and more nitrous oxide.

With nitrous oxide abuse, it is easy to become physically dependent. If your body experiences withdrawals, you may have severe physical reactions. Researchers3 say the withdrawals from inhalants “resemble the nature and severity of alcohol withdrawal symptoms.”

Mild symptoms may include:

  • Anxiety
  • Headache
  • Insomnia
  • Nausea
  • Sweating
  • Vomiting

Withdrawals may progress to include more serious symptoms such as:

  • Fever
  • High blood pressure
  • Increased or decreased heart rate
  • Abnormal heart beat
  • Mental confusion or disorientation

While people sometimes think that nitrous oxide abuse is not a significant drug problem, the opposite is true. In fact, some research shows4 that inhalant dependence is a lot like other drug dependence. One young man used nitrous oxide recreationally for several years, but he never used any other drugs. He reported5 severe agitation and anxiety. He couldn’t focus without the inhalants. Eventually, the young man went through treatment for his drug abuse, and the results were successful.

Another young boy of just 14 years old said he had intense cravings for inhalants each day. These cravings affected his daily routine at school and at home. The boy was hospitalized for these issues, but all of his withdrawal symptoms continued during hospitalization.

Treatment Options for Nitrous Oxide Abuse

Nitrous oxide is a relatively new problem, though it has a long history of abuse. It really was not a widespread problem until the recent past. Still, there are effective treatment options available.

First, many doctors use lamotrigine to help patients work through nitrous oxide withdrawals. This medication is an anticonvulsant, and it is usually used for seizures and bipolar disorder. Some of the case studies mentioned above received lamotrigine treatment in addition to other services.

In some cases, therapy was unsuccessful, but lamotrigine helped patients reduce withdrawal symptoms and cravings.

Public opinion is one of the biggest challenges when it comes to nitrous oxide abuse. Due to its medical uses, some people think nitrous oxide abuse isn’t concerning. It’s not a highly publicized drug, and you rarely hear warnings about the side effects of nitrous oxide.

People who struggle with nitrous oxide abuse may feel embarrassed. Research also shows that people who use inhalants may already struggle with social anxiety and other issues. They may be unlikely to seek treatment because of these two factors. It is difficult to reach out for your help when you feel like a social outcast and don’t recognize your drug abuse as an actual problem.

Besides these issues, there simply are not enough recovery programs for nitrous oxide abuse. Few programs have treatment programs that have specific services for inhalant addictions.

Even more concerning: Doctors sometimes aren’t aware that nitrous oxide abuse is such a widespread concern. We do not have enough research or studies that are dedicated to nitrous oxide abuse. Many of the signs, risk factors and effects are still unknown.

For recovery from nitrous oxide abuse, a few things remain certain: Immediate treatment is crucial, and a strong support system is often the difference between successful recovery or relapse.

Windward Way Recovery Nitrous Oxide Abuse Treatment Programs

If you are struggling with nitrous oxide abuse yourself or suspect that a loved one has this disorder, please contact Windward Way Recovery for assistance. We provide programs that help patients recover from nitrous oxide addiction. We work with insurance plans to provide low out-of-pocket payment options, and we perform an initial assessment to find the best program for your needs. Call (855) 491-7694 to speak with one of our treatment experts.

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