Nitrous Oxide Overdose: How Much is Too Much?

Nitrous Oxide: How it Works

Nitrous Oxide was isolated as a gas in its own right by Joseph Priestly in 1772. Interestingly, the gas was used for “entertainment” purposes for years before scientists realized its pain-killing and anesthetic potential. In the late 1800s, dentists started to use this gas as a sedative during extractions and other treatments. That use of nitrous oxide continues to this day.Because nitrous oxide is a gas, it’s delivered via a mask directly to the lungs. This means it can take effect much quicker than injected forms of anesthetic. A mix of nitrous oxide and oxygen comes through the mask. The oxygen keeps the patient breathing normally, while the nitrous oxide triggers a release of endorphins and dopamine, the body’s natural painkillers and “feel good” chemicals.It’s this release of dopamine and other “positive” chemicals that recreational nitrous oxide users seek–that’s what provides the happy feelings that give laughing gas its name. If you’re unsure whether someone you know is taking nitrous oxide, or if you’ve been offered nitrous oxide, listen out for the following common names:

• Whippets or whippits, named for whipped cream canisters that use nitrous oxide as an aerosol
• Nos
• Noz
• Nox–usually combined with other substances such as MDMA
• Hippy crack
• Sweet air
• Buzz bomb
• Shoot the breeze or shooting the breeze
• Giggling gas
• Laughing gas

Nitrous Oxide Effects: How Long does Nitrous Oxide Last?

Nitrous oxide is popular among recreational substance users for the feelings the gas provides, including:

• Intense euphoria and a “rush”
• Feelings of happiness–which can lead to addiction where general happiness is low in a person’s life
• Philosophical periods of deep thought, which may present as being introverted or quiet
• Increased feelings of energy or motivation
• Lowered inhibitions or the courage to take risks

It’s important to note that no matter how tempting these feelings may be to the user, all these sensations are extremely short-lived. As soon as the gas is removed and the user starts to breathe normal air again, the body metabolizes and expels the laughing gas, returning the user’s state of mind and physical feelings to normal. In contrast to the euphoria they were feeling before, they may feel low, let down, or even depressed. This is what leads the user to seek another “hit,” and how addictions develop.

Nitrous Oxide: The Risks

A 2021 study¹https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7891713/ showed that the recreational use of nitrous oxide was on the rise in several countries. When you consider the risks associated with repeated use of laughing gas, that raises many concerns. The immediate risks of inhaling nitrous oxide recreationally include:

• Dizziness leading to falls
• Losing consciousness due to lack of oxygen to the brain
• Nausea or vomiting
• Lack of judgment and poor choice making
• Feelings of disassociation or a sense of unreality

In extreme cases, the lack of oxygen can cause the user to fall into a coma. Nitrous oxide also affects blood pressure and heart rate²https://www.bjanaesthesia.org.uk/article/S0007-0912%2817%2943010-8/pdf, making it dangerous for anyone, but especially those with even minor heart conditions. Another related issue is that the gas from the canisters is often extremely cold. This can lead to burns on the lips or fingers for those inexperienced at dealing with high-pressure compressed gas.Other problematic issues come from social and environmental factors. The risks highlighted above can be worsened due to:

• A lack of ventilation, often common in small rooms where users may gather together to partake in their recreational nitrous oxide use
• Users taking the gas on their own are prone to falls or passing out with no one to help them or offer medical assistance
• Users who slip into a coma may be left with other people who are too “high” or have had their judgment impaired so much that they don’t follow the correct emergency procedures such as calling for an ambulance

If you know someone who you think is using nitrous oxide recreationally, contact our compassionate team at (855) 491-7694 for a 15-minute chat. We can offer you advice on the next steps, potential treatment options, and how to approach the subject with your friend or family member.

Signs of Nitrous Oxide Overdose

As you can see from the risks above, overusing laughing gas comes with a variety of problems. This is made worse by the fact that, because it’s a gas, it’s impossible to dose correctly. Users may take the gas directly from a canister, usually by filling a balloon or other flexible vessel. They breathe directly from the balloon, taking a little or a lot at one time. There is no accurate way to determine how much N2O someone has inhaled, or how long it has been in their system. That’s why it’s critical to get medical help if you notice any of the following symptoms:

• Extremely irritated nose, throat, or eyes with no other explanation
• Shortness of breath
• Coughing, especially a cough that just keeps getting worse
• Wheezing
• Gasping for air
• Choking
• Tight feelings in the chest, or you may see them clutching at their chest
• A blue tinge to the lips or fingers
• Heart rate changes, particularly an extremely rapid heart rate
• Any symptoms associated with a heart attack such as arm pain, unexplained back pain, or sudden nausea
• Any symptoms associated with strokes, such as muscle weakness or dizziness
• Seizures
• Hallucinations or psychotic episodes

Of course, many of these symptoms can be linked to other causes including underlying medical conditions. But if you take nitrous oxide, or know someone who does, all these symptoms could indicate a nitrous oxide overdose.It’s important not to assume that there is one “type” of person who takes nitrous oxide. There’s a prevailing image of young people at music festivals passing balloons around; whilst these stereotypes certainly have their roots in reality, it’s far from the complete story. Many professionals with access to nitrous oxide may turn to the gas for stress relief from their high-pressure jobs. Ontario’s Royal College of Dental Surgeons³https://www.rcdso.org/en-ca/rcdso-members/dispatch-magazine/articles/2046 describes nitrous oxide use as a “silent addiction,” leaving dentists who use it feeling isolated, confined to their offices, and prone to further self-destructive behavior.

Nitrous Oxide Overdose: What to do in an Emergency

If you or someone you know has a nitrous oxide overdose, you must get medical help immediately. Most of the problematic symptoms are caused by a lack of oxygen to the brain. That means the individual may need to be given oxygen in a medical setting. They may also need extended treatment, depending upon the severity of the laughing gas overdose. If you think you’ve overdosed or are with someone who has, you must:

• Call for an ambulance immediately, do not transport the patient yourself, the emergency response team will know what to check for and can administer oxygen immediately if required.
• Be honest about what substances the individual has taken–tell medical staff as quickly and clearly as possible to avoid misdiagnosis or incorrect treatment.
• Follow all advice from medical professionals.

If the individual can move, try to sit them up and keep them calm. Ventilate the room or take them outside if they can move safely. If they are disoriented or dizzy, don’t risk moving them. Don’t allow them to take another inhalation of nitrous oxide, even if they feel better. Remove temptation by hiding the canisters or means of inhalation. Don’t let them take any medicine such as painkillers without consulting with medical staff or the ambulance team.

Side Effects of Nitrous Oxide Overdose or Overuse

As with many substances, long-term use or short-term intense use can cause debilitating side effects. Knowing about potential side effects can be the first step to overcoming substance addiction, with the right support. Repeated nitrous oxide use can lead to:

• Severe vitamin B12 deficiency
• Fatigue
• Digestive issues
• Loss of appetite
• Issues with vision
• Breathing problems
• Anemia
• Issues with the nervous system which can lead to paresthesia: prickling, tingling, or numb sensations on the skin with no external cause
• Bone marrow suppression which severely impacts the body’s immune system
• Lung damage
• Brain damage
• Coma
• Death

In a medical setting, staff may look out for muscle weakness or a lack of response to nerve impulses. They may also check for ataxia, which means a lack of coordination that can affect speech, eye movements, and even how you walk. It’s important to remember that every time you inhale nitrous oxide, you’re depriving your body of oxygen.Every cell in your body requires oxygen, which is transferred from your lungs into your blood with each breath you take. If you replace even a few of those breaths with nitrous oxide, you’re missing out on oxygen that your body and brain need to keep functioning. If you do this over and over, your body suffers, and you may experience some of the long-term side effects listed above. That’s why it’s critical to get support if you feel you’re not coping, in over your head, or too overwhelmed to face your addiction alone.

Treating Nitrous Oxide Addiction

Addiction doesn’t mean the same as physical dependence on a substance. You can’t become physically dependent on nitrous oxide. Your body doesn’t get “hooked” on the gas in the same way as it can with opiates. However, you can become addicted, as your brain craves the pleasurable feelings the gas provides. As we touched on above, there’s no single “type” of person who is prone to N2O addiction. However, the following factors can be linked to nitrous oxide addiction:

• Depression
• Anxiety
• Low self-esteem
• Desire to fit in
• Peer pressure
• Stress
• Trauma
• Periods of dissatisfaction with life
• The misconception that nitrous oxide is a “safe” high
• Grief or unhappiness
• Poverty or other socioeconomic factors

Laughing gas addiction can be challenging thanks to the short-lived effects of nitrous oxide. Individuals who enjoy the feeling seek it again and again. They take hit after hit. And, as we’ve seen, that can lead to nitrous oxide overdose or long-term ill health. There has to be a point at which support is offered to break the cycle of addiction.Talk to a professional about the best way forward. Extreme or long-term addiction may require medical intervention. In most cases, a combination of behavioral therapy, compassionate support, and removal from the source of the substance should have a positive impact. Because most people view laughing gas as “fun” or less addictive than other substances, they may not look for treatment until damage has been done. We encourage anyone who wants any advice about the dangers of nitrous oxide use to seek help now, to prevent future health problems or long-term addiction.Don’t suffer in silence. If you’ve decided you need help with your nitrous oxide usage, or you know someone who does, call us at (855) 491-7694 or contact us online today. We can talk you through what options are available, without judgment. Most importantly, we’ll help you decide what your next move is, and help you take that step on the road to recovery and good health.