What is Nitrous Oxide? Effects, Risks & Use

Nitrous oxide, commonly known as laughing gas or nangs, is classified as a depressant, which means it slows down the functioning of the brain and the body. Nitrous oxide is a colourless, odourless gas used in medical and dental settings for anaesthesia, as a propellant for whipped cream and in the automotive industry to enhance engine performance. It is considered an inhalant.

According to the Australian Institute of Health and Welfare, use of inhalants in the previous 12 months has been gradually increasing from 0.4% in 2001 to 1.0% in 2016 and 1.7% in 2019. One third of those who reported using inhalants, use at least monthly. The most common form of inhalants used in 2019 was nitrous oxide, amyl nitrite and other nitrates.

After nitrous is inhaled, it is absorbed quickly into the bloodstream through the lungs, then travels to the brain and the rest of the body. The effects typically last a few minutes.

The effects of nitrous oxide depend on a range of factors including but not limited to how much is used, how it is used and whether other drugs are used around the same time.

Short term effects include

• Initial ‘rush’ or ‘high’
• Euphoria
• Giggling and laughing
• Altered mood
• Numbness and tingling sensation
• Dizziness and/or light headedness
• Drowsiness/sedation
• Reduced inhibitions
• Impaired judgment
• Headaches
• Blurred vision
• Confusion
• Sweating
• Muscular weakness
• Nausea
• Drop in blood pressure
• Fainting

Effects associated with high volume and/or high frequency use include:

• Numbness and tingling in the hands or feet when not using ,
• Memory loss
• Brain and spinal cord damage (reversible if identified and treated early)
• Poor balance and coordination
• Weakened immune system
• Incontinence
• Limb spasms
• Disruption to reproductive systems
• Potential birth defects (if consumed during pregnancy)
• Psychological disturbances

Inhaling nitrous oxide affects your body and can have damaging effects such as:

Your Brain

• Vitamin B12 depletion which can cause damage to the nervous system and to the brain.
• Impaired memory and cognition1
• Depression
• Psychosis

Your Lungs

• Ruptures in lung tissue.

Your Heart

• Vitamin B12 depletion can lead to increased amino acid (homocysteine) levels in the body which can cause clots and hardening of the arteries and may lead to a heart attack.

Your Nose, Lips and Throat

• When inhaling directly from cannisters (bulb, cylinder or tank), the gas is extremely cold and can cause frostbite to the nose, lips and throat.

Your Hands and Feet

• Numbness in hands and feet can occur.

Skin

• When inhaling directly from cannisters (bulb, cylinder or tank), the cannister can become extremely cold and can burn skin on the face, hands or body.

Use of nitrous oxide with other drugs should be avoided as it increases the risk of harm. Combining nitrous oxide with stimulants increases blood pressure and may disrupt heart rate.

Mixing nitrous oxide with alcohol can cause confusion, a heavy or sluggish feeling, reduced concentration and loss of body control.

Anecdotal evidence suggests that combining nitrous oxide with hallucinogenic drugs and /or cannabis, can cause intense dissociation.

Canisters of nitrous oxide contain 100% nitrous oxide, which means during inhalation you don’t breathe in any oxygen. This can starve the brain of oxygen (hypoxia) and be fatal.
Signs of overdose include:

• Asphyxia (when the body is deprived of oxygen)
• Headache
• Dizziness
• Confusion
• Temporary loss of consciousness caused by a fall in blood pressure
• Irregular heartbeat
• Seizures

If someone is experiencing any of the above symptoms, do not leave them on their own. If someone is experiencing confusion, chest pain, breathlessness, or blackouts when using nitrous oxide, call an ambulance immediately – dial Triple Zero (000). If they have stopped breathing commence CPR.

There is little evidence of dependence or withdrawal associated with the use of nitrous oxide, aside from cravings to use more nitrous oxide. Regular high volume use increases the risk of long-term harm. If you need help to reduce or cut back on use, see ‘getting help’ section below.

Use of nitrous oxide, can be particularly damaging for young brains that are still developing.

People with heart and lung issues are at a greater risk of health-related harm and should avoid inhaling nitrous oxide.

If you are pregnant or breastfeeding, it is recommended that you do not use nitrous oxide unless under medical supervision.

People with a predisposition to vitamin B12 deficiency (such as vegans and vegetarians) and people with pre-existing low vitamin B12 levels from other causes (e.g. pernicious anaemia, coeliac disease, Crohn’s disease etc) are at a greater risk of health-related harm. Nitrous oxide causes the inactivation of vitamin B12 which is where the body is unable to use vitamin B12. This can cause clots and hardening of the arteries and may lead to a heart attack. It is important to note that this is not prevented by oral vitamin B12 supplementation.

The relationship between drug use and mental health is complex. Individuals may experience co-occurring mental health and substance use problems. A mental health condition may make a person more likely to use drugs, for short-term relief from their symptoms, while for others with a predisposition to mental health conditions, drug use can trigger initial symptoms. The use of drugs can interact with mental health conditions in ways that create serious adverse effects.

Non-medical use of nitrous oxide is regulated under the Medicines and Poisons Act 2014, which means that wholesale and retail suppliers only able to legally sell nitrous oxide if:

• the purchaser is aged 16 years or older;
• products are labelled and packaged as a ‘poison’ with warning statements, “Do not intentionally inhale contents” and “WARNING – May cause irreversible nerve damage if inhaled”.

Western Australia will be introducing further regulatory supply controls. For more information, visit the Nitrous oxide supply restrictions webpage on the Department of Health website.

The most effective way to reduce the risk of harm is to not use nitrous oxide. If you do choose to use nitrous oxide, it’s important to know ways to reduce the risk of harm.

Avoid direct contact with skin
When nitrous oxide releases from its cannister (a bulb, cylinder or tank), the cannister is freezing cold and can burn the skin. As nitrous oxide intoxication may cause numbness in the body, the cold burn may not be felt immediately, which may result in a more severe burn.

Avoid direct inhalation from cannister
Nitrous oxide is stored under extreme pressure in canisters. When released, the gas is freezing cold. Inhaling directly into the mouth can cause frostbite to the mouth, nose, lips and throat (including vocal cords), and can cause a rupture in lung tissue due to the pressure. Additionally, canisters may also release grease and metal fragments which could be inhaled.

Avoid repeated or prolonged use
Because the effects do not last long you may be tempted to repeat use. Frequent use increases your risk of harm as nitrous oxide can cause the inactivation of vitamin B12 which is where the body is unable to use vitamin B12. This can cause clots and hardening of the arteries and may lead to a heart attack. It is important to note that this is not prevented by oral vitamin B12 supplements.

Have a friend with you
Nitrous oxide intoxication can cause disorientation and a lack of awareness of surroundings, and even unconsciousness, making you more vulnerable to your environment. Avoid using alone or inform someone you are going to use and where you will be in case you have a negative experience or need medical assistance.

Ensure someone who is not using knows what signs to look for regarding overdose e.g., blue lips, pale skin, no response, shallow breathing or no breathing, seizures, chest pain.

Ensure this person knows how to respond with DRSABCD – Danger, Response, Send for help, Airways, Breathing, CPR, Defibrillator.

Avoid spraying near flammable substances and naked flames (including cigarettes)
Nitrous oxide is not considered flammable; however, it can act as an oxidizer and can make a fire burn hotter, faster and more intensely. Throwing nitrous oxide canisters in fire can also cause explosions.

Don’t mix with alcohol and other drugs
Using with alcohol or other drugs can increase risk of harmful effects.

Avoid risky methods of use

• Do not put plastic bags over the head or obstruct breathing in any way.
• Do not drive or operate machinery if intoxicated.

Avoid using in high-risk environments

• Avoid using in enclosed spaces, near water, traffic or at heights.

Alcohol and Drug Support Line (24/7)
Metro (08) 9442 5000 or Country 1800 198 024
A free 24-hour, state-wide confidential, non-judgemental telephone counselling, information and referral service for anyone seeking help for their own or another person’s alcohol or drug use.