Nitrous Oxide

Desired Effects:

Side Effects:

• If you get nitrous oxide on your skin rinse it in cold water. If you get an ice burn, seek medical attention from a doctor or at a hospital.

• Do not inhale directly from the tank, ‘cracker’ or whipped cream dispenser, it’s so cold that it could seriously damage the throat and lungs. Always inhale nitrous oxide through a balloon.
• Do not use nitrous oxide with a bag over your head or with a mask attached to cylinders.
• Do not continuously breath nitrous oxide in a confined space like a car. Nitrous oxide displaces air in a confined spaces depriving the body of oxygen. Several deaths have been associated with these methods of use.

• Driving under the influence of nitrous oxide is an offence and has resulted in a number of fatal car crashes.
• When using nitrous oxide, use in a safe location (e.g., sitting on a sofa or the floor) so that any lack of coordination or temporary unconsciousness does not result in falling or other accidents. Do not smoke or hold drinks or anything sharp when inhaling nitrous oxide. The more nitrous oxide you use, the higher the risk of falls or accidents.

• People with heart conditions or abnormal blood pressure may be at higher risk as the drop in oxygen levels caused by inhaling nitrous oxide raises the heart rate, which could cause problems in these individuals.
• Avoid mixing nitrous oxide with other drugs, especially stimulants, as effects on blood pressure and   heart rate could be unpredictable.

• Use of nitrous oxide may induce psychotic symptoms in people with underlying mental ill health.

• If pregnant, breast-feeding or planning on becoming pregnant then you should avoid nitrous oxide as this can harm the baby.

• Using large amounts of nitrous oxide on a regular basis can lead to vitamin B12 deficiency, which can cause serious damage to the nerves and spine, resulting in some people being unable to walk. In some cases, this can last for months or years, or may even be permanent.
• Taking B12 supplements, will not prevent B12 deficiency as a result of heavy prolonged nitrous oxide use. You may be treated with B12 supplements at hospital or your GP, but this is given by injection, and you have to stop using nitrous oxide for this treatment to be effective.
• The earliest symptoms of B12 deficiency are usually the persistence of tingling, skin crawling or itching, numbness in hands and legs and later a staggering uncoordinated walk, lower limb weakness, muscle stiffness or twitching.
• If you have been using large amounts of nitrous oxide and are experiencing any of these symptoms, please see your doctor or go to the A&E department of the hospital as soon as possible.

• Because they are both gases used to fill balloons, nitrous oxide is sometimes confused with helium.  Helium causes a high ‘silly’ voice, whereas nitrous oxide causes a deep ‘silly’ voice. The two gases are not related.
• Nitrous oxide is not the same as nitric oxide. Nitric oxide is a poisonous gas.
• If there are serious adverse effects call 999 and tell emergency services what has been taken.

Long term risks:

• Regular or heavy use can cause vitamin B12 deficiency which may lead to nerve damage. This may be irreversible.
• Prolonged or heavy use of nitrous oxide may also cause anaemia.
• There has been an increase in the use of larger 600g+ tanks and extra-large balloons. This has led to some people using very large amounts on a regular basis. Because of the increased use of larger tanks and extra-large balloons, there has been a significant increase in people being seen at hospitals.
• Some people are using compulsively and may have become dependent on nitrous oxide.

Short term risks:

• Nitrous oxide tanks can become freezing cold when the gas is released and there has been a rise in ice burns when people hold the large tanks between their legs.
• Nitrous oxide released directly from the tank can cause ice burns, sometimes these ice burns are not noticed due to the anaesthetic effect of nitrous oxide. Some of the burns are very deep and require multiple surgeries and result in scars. Burns can look superficial but can rapidly develop into third- degree burn wounds.
• It is dangerous to inhale directly from the canister, because when under high pressure the gas is very cold and can cause throat spasm and lung damage.
• If used with a bag over the head or in an enclosed space or if too much is used in one go, cause a lack of oxygen to the brain. This may cause suffocation, heart problems and unconsciousness which may be fatal. It is thought up to 5 people a year die from using nitrous oxide in this way.
• Effects on the brain such as lack of coordination, dizziness or fainting, may lead to accidental injury for example from a fall or acting in a harmful way, especially if taken with other substances such as alcohol.
• Driving a car while using nitrous oxide has been responsible for a number of accidents some of them fatal. Freeze burn may occur if the gas canister is not opened properly.