The Impact of Recreational Nitrous Oxide Use on Health

Tuesday - October 17 2023, 02:57 UTC - 1 year ago

Nitrous oxide, commonly known as "laughing gas," is popular recreational drug particularly among the youth. Chronic use of nitrous oxide can cause functional vitamin B12 deficiency, which can result in long-term health effects, especially neurological consequences. Respiratory depression is a potential side effect of nitrous oxide, particularly when mixed with alcohol. Clinicians must be aware of the signs of nitrous oxide toxicity.

Nitrous oxide, commonly known as "laughing gas," is not just a popular recreational drug, particularly among the youth, but also an anesthetic frequently utilized in pediatric and dental procedures. Due to its affordability and easy online accessibility, many are resorting to its use for a quick high. In the 2021 Global Drug Survey, 10% of all respondents, and 15% of Canadian respondents, indicated having used the drug in the previous year.

"The low cost of and ease of access to nitrous oxide make it a popular recreational drug, especially among younger people," writes Dr. Cyrille De Halleux, a specialist in internal medicine, critical care, and resident at The Hospital for Sick Children (SickKids) and chief fellow in the Division of Clinical Pharmacology and Toxicology at the University of Toronto, Toronto, Ontario.

Chronic use of nitrous oxide can cause functional vitamin B12 deficiency, which can result in long-term health effects, especially neurological consequences. The three most common presentations of toxicity are damage to the spinal cord (myelopathy), nerve damage affecting strength and sensation (neuropathy), and behavioral abnormalities (encephalopathy). Treatment includes stopping the use of the substance, vitamin B12 supplementation, and methionine.

"Clinicians should enquire about nitrous oxide use in patients with unexplained findings suggestive of vitamin B12 deficiency or other compatible neurologic symptoms," the authors conclude.

Nitrous oxide use may lead to more immediate effects, such as nausea, dizziness, lightheadedness, headache, and disorientation. In some cases, individuals may experience an intense thrill or euphoria; however, this is more common in those with a higher tolerance. In terms of risks, respiratory depression is a potential side effect of nitrous oxide, particularly when mixed with alcohol. Nitrous oxide use is also associated with disinhibition and may make individuals vulnerable to exploitation by individuals supplying the drug.

The allure of nitrous oxide lies in its faster and more powerful highs compared to other recreational drugs. Studies have shown that its effects can be felt within one minute, and can last for 10 to 15 minutes. However, users of nitrous oxide should be wary of its potential for long-term health risks. Those who seek to use nitrous oxide for its recreational purposes must be aware of the risks, and clinicians must be able to recognize the signs of nitrous oxide toxicity.

Reference: "Diagnosis and management of toxicity associated with the recreational use of nitrous oxide" by Cyrille De Halleux and David N. Juurlink, 21 August 2023, Canadian Medical Association Journal.DOI: 10.1503/cmaj.230196 .