No Laughing Matter. The Huge Increase in Recreational Use of Nitrous Oxide Among the Young Is Causing Concern.

Nitrous Oxide (laughing gas) abuse is on the rise among young people and doctors are concerned about life-threatening harm it can do to the body. 

Laughing Gas / Nitrous Oxide 

You may have noticed lots of little silver canisters lying around pathways and street corners. Perhaps you’ve also heard your teens talking about Nos or Whippits and wondered what they meant. That’s laughing gas – the official name nitrous oxide. It’s available legally because caterers commonly use it to power cream whipping machines (hence the nickname). You can probably buy the canisters at your local grocers for around 25p each. 

It Has Been Around a Long Time

Since its formulation in 1772, the gas has been known to offer short-term highs that were commonly seen as harmless. Doctors and dentists have used it for years to generally calm and alleviate pain. Charlie Chaplin’s 1914 film ‘Laughing Gas’ is an example of how it was regarded by the wider public for a long time – just a little bit of fun. 

NOS Growing in Popularity

Recently, things have changed dramatically, perhaps influenced by lockdown restrictions. The Office For National Statistics reported in 2021 that nitrous oxide is now the second most common drug (after cannabis) used by people aged 16 to 24. It is now hugely popular at festivals and other recreational gatherings as well as being a cheap quick high for bored teenagers around the world. This year’s recent Notting Hill Carnival was one venue where use was heavy. 

A recent article in The Guardian has highlighted the dangerous consequences that can come from heavy use of Nos. The amount of hospitalisations and deaths has increased recently too, though it remains relatively small. 

Reasons for the Increase in NOS Abuse

This increase has been put down partly to lockdown when people’s recreational habits changed, and partly to changes in the way the drug is dispensed. Instead of small single use canisters (‘bulbs’) the gas is now widely available in much larger containers. Big cylinders of Nos are often seen at festivals where they can fill hundreds of balloons that are then sold individually.  

Mixing With Other Drugs

It is very much a young person’s drug and though relatively un-addictive physically on its own, people can become psychologically dependent. In addition, because it is viewed as mostly harmless by users, they often combine it with other dangerous substances as a way of enhancing the experience. The outcome of doing so is always to greatly increase the potential for harm – suffocation, heart problems or hallucination being the most common.  

The Main Dangers of Nitrous Oxide Abuse

The effect of repeated use of NOS on its own can lead to three potentially life-threatening situations:  

  • Firstly, users often lose balance and orientation causing them to stagger, fall and injure themselves. 
  • Secondly, and more seriously, they can develop peripheral neuropathy (damage to nerve ends) resulting in loss of some bodily functions and even paralysis and death. Nos does this by deactivating the vitamin known as B12. The body does not produce this vitamin naturally but relies on its food intake for replenishment, so any diminution can have serious consequences. When the spinal cord becomes damaged, this can have long-lasting consequences. Symptoms of vitamin B12 deficiency should always be addressed promptly. The main ones are: 
    • tiredness 
    • heart arrythmia 
    • breathing difficulties 
    • loss of appetite and digestion problems 
    • numbness or tingling in fingers and toes 
    • mobility problems 
    • impaired vision 
  • Thirdly, taking NOS without added oxygen increases the dangers. In a normal clinical setting, it would be administered with at least 20 percent oxygen. But taken straight from the canister, as some people do, without adding oxygen, can lead to hypoxia (low blood oxygen) in the body and possibly, irreversible brain damage. 

Effects of Nitrous is Similar to Alcohol Abuse

Taken in large quantities (up to 700 canisters a day has been reported), Nos can cause symptoms similar in some ways to alcohol abuse, such as: 

  • Increased tolerance 
  • Taking larger amounts to get the same effect 
  • Obsessive thinking about using the substance 
  • Inability to relax unless using 
  • Withdrawal symptoms of nausea, vomiting, sweating and anxiety.

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Extreme Cases of Nitrous Abuse

In extreme cases, excessive use of Nos can result in death. It seems that people vulnerable to depression and anxiety may develop a habit of using Nos to give themselves repeated small shots of euphoria although the feeling may last less than a minute. When times are particularly difficult, such as during a Covid lockdown or economic crisis, more and more people are turning to this type of quick fix. 

Cross Addiction 

Any kind of recreational drug use carries the huge additional danger that it becomes a gateway to the use of more damaging substances. The subculture of peer pressure, dealing and risk taking that surrounds all drug use is often not noticed at first by youngsters who start by seeking just a thrill or two. There are signs that dealers in street drugs are starting to add Nos to their wares, despite its relative cheapness.  

Parental Guidance 

Drug use of any kind should never be ignored. Over-reacting can have negative results and parents should remember that its possession is not illegal. They would be wise however to discuss Nos in the context of the dangers of drug taking generally with their children and to make sure that they understand the possible dangers.  

The Law   

As of 2016, nitrous oxide is covered by the Psychoactive Substances Act 2016 and to supply it purely for its psychoactive effect is illegal. In addition: 

  • it is illegal to sell nitrous oxide to anyone under the age of 18. 
  • It is illegal to supply for human consumption (penalty is 7 years in prison or unlimited fine) 
  • It is not illegal to simply possess nitrous oxide. 

A psychoactive substance is one that produces one or more of the following effects: 

  • hallucinations 
  • changes in alertness 
  • altered perception of time and space 
  • affecting empathy with others 
  • drowsiness 

People so affected may not be charged with possession but if they were to attempt certain actions such as driving or operating machinery while under the influence, they would certainly risk criminal prosecution. 

A Reluctance to Criminalise Nitrous Oxide

The Government is considering what further steps might be appropriate but are reluctant to criminalise possession for fear of a negative result by driving its use underground. 

Danger Should Not Be Minimised

Although the deaths and hospitalisations are relatively small compared to other drug abuse, the fact that they have appeared at all is a warning sign that medical experts say should not be ignored.  At the very least, they call for more education on the matter. 


Any form of addictive behaviour where negative consequences are evident, needs to be addressed. Community drugs teams are well aware of the dangers of nitrous oxide as just one of many problematic substances. It is the nature of addiction that it gets progressively worse and action should be taken sooner rather than later. 

If you have a problem 

If you think you have a problem or know somebody who might, the best course is to seek professional help and advice. Your GP may be the first person to approach. 

At Castle Craig Hospital, we are used to treating all kinds of addictions leading to successful outcomes. Our support team are available 24/7 to offer help and advice in complete confidence. 

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