Nitrous oxide

Also known as

Whippits, laughing gas, hippie crack, chargers, nitro, N2O, NOS, nangs, whippet, buzz bomb, balloons, nitrous, crackers, johnny gas, bulbs

Classification

Depressant

Overview

Nitrous oxide is a colourless gas that is commonly used for sedation and pain relief, but is also used by people to feel intoxicated or 'high' .

It is commonly used by dentists and medical professionals to sedate patients undergoing minor medical procedures. It is also a food additive when used as a propellant for whipped cream, and is used in the car industry to enhance engine performance. It is also increasingly being used to treat people withdrawing from alcohol dependence. Nitrous oxide is classified as a 'dissociative anaesthetic' and has been found to produce dissociation of the mind from the body (a sense of floating), distorted perceptions and in rare cases, visual hallucinations , .

Nitrous oxide is a gas with several legitimate uses, but when inhaled it can make people feel euphoric and relaxed. This happy feeling has led to it being nicknamed 'laughing gas'. Some people also experience hallucinations.

However, there is a risk of death as a lack of oxygen can occur when using nitrous oxide. This risk is likely to be greater if the gas is consumed in an enclosed space or if a substantial amount is rapidly used .

There are three main legitimate uses of nitrous oxide -

• To numb pain during medical procedures such as dental work.
• In engines to increase their power output.
• In catering, in whipped cream aerosol cans to prevent the cream going 'bad' and in food packaging to prevent the food from rotting .

Nitrous oxide is a colourless gas. Some people say that it has a slightly sweet smell and taste.

It is normally bought in pressured canisters, varying in size and depending on what it will be used for. The gas is commonly transferred to a container, e.g. a balloon, from which the gas is inhaled.

Nitrous oxide is most commonly inhaled through the mouth. Because nitrous oxide is a pressurised gas in the canister, there is a risk of harming yourself if you inhale nitrous oxide straight from the canister. This method can lead to sudden death due to a lack of oxygen and is one reason why nitrous oxide is sold to people in balloons .

Nitrous oxide is a gas that has a long history of use as an anaesthetic and, more recently, as a propellant in aerosol cans as a replacement for ozone-damaging CFCs.

It has a long history of use as a recreational substance, but due to the relative ease of obtaining it (being legal to purchase) and sharing it, it is particularly popular amongst teenagers and younger people, as well as festival goers. There has been a notable increase in reported use in recent years, and certain sections of the media have dubbed nitrous oxide ‘hippy crack’, though it has very little connection to either part of this term .

What does it look like?

Nitrous oxide is a colourless gas that is slightly sweet smelling and tasting .

Source

Nitrous oxide is also found in supermarket cans of whipped cream, although it is not as easily inhalable from this source.

Other sources of nitrous oxide include full sized gas cylinders, intended for medical or industrial use. Using these is high risk outside of the medical context. Breathing the pure gas directly from a tank using a mask on your face may be fatal because it can cause oxygen deprivation. Opening a tank in a car or small room could do the same. Filling a bag with the gas from a tank and putting it over your head can kill easily. Tanks of nitrous oxide intended for use in cars can contain other substances like sulphur dioxide which could cause harm .

Why take it?

Sought after effects

• relaxation,
• mild euphoria (often giggling),
• head rush/light headedness .

Undesired effects

• headaches,
• nausea.
• mood swings,
• excessive use can cause breathing difficulties and heart problems .
• it makes you clumsier than a drunk clown, lots of people fall over and hurt themselves,
• it can make you feel like you're going to vomit, especially if you mix it with alcohol,
• some people get an instant headache of epic proportions,
• too much can make you faint .

What are the different forms?

• canned whipped cream - These are found in any grocery store. They contain very minimal gas with one or two uses before the cream comes out,
• chargers - These are readily available and cheap to purchase online. They are small metal canisters which can be used by a nitrous cracker to fill a balloon full of gas which is then inhaled. Some varieties contain industrial residue and strength vary (as it is food grade),
• medical tanks - These are hard to find and dangerous without a professional. They are occasionally seen at music festivals being used to fill balloons for sale .

How long do its effects last?

Some individuals may experience a headache after extended use which can last several hours .

Onset of effects

0 - 1 minutes .

Come up

15 - 30 seconds .

Peak

15 - 30 seconds .

Offset

1 - 5 minutes .

Duration of effects

1 - 5 minutes .

Coming down

10 minutes .

After-effects

15 - 30 minutes .

Pharmacology

N₂0 is an inorganic molecule that works on the brain as a biological regulator. It has analgesic effects similar to opioids in nature, as well as anaesthetic and anxiolytic actions. Its anxiolytic effects are similar to benzodiazepines and act on the GABAA receptor. At high concentrations, N₂0 can displace oxygen, which can result in asphyxiation to the subject .

Although N2O affects quite a few receptors, its anaesthetic, hallucinogenic, and euphoriant effects are likely caused predominantly or fully via its effects as an NMDA receptor antagonist , . NMDA receptors allow for electrical signals to pass between neurons in the brain and spinal column; for the signals to pass, the receptor must be open. Dissociatives close the NMDA receptors by blocking them. This disconnection of neurons leads to loss of feeling, difficulty moving, and eventually the famous 'hole' .

Tolerance

Tolerance to many of the effects of nitrous oxide develops with prolonged and repeated use. This results in users having to administer increasingly large doses to achieve the same effects. After that, it takes about 3 - 7 days for the tolerance to be reduced to half and 1 - 2 weeks to be back at baseline (in the absence of further consumption). Nitrous oxide presents cross-tolerance with no other psychoactive substances, meaning that after the use of nitrous oxide other dissociatives will not have a reduced effect .

Mode of use

The gas is inhaled, typically by discharging nitrous gas cartridges (bulbs or whippets) into another object, such as a balloon, or directly into the mouth. Inhaling nitrous oxide produces a rapid rush of euphoria and feeling of 'floating' or excitement for a short period of time .

Recreational users normally get it from whipped-cream chargers, which are single-use, finger-length steel cartridges containing 8g of highly pressurised nitrous oxide. These are usually discharged into a balloon with a kind of whipped cream dispenser or a smaller widget called a 'cracker'. This balloon method seems to be relatively low risk .

Effects

Short-term effects

The following effects may be felt almost immediately and can last for a few minutes -

• euphoria,
• numbness of the body,
• sedation,
• giddiness,
• uncontrolled laughter,
• uncoordinated movements,
• blurred vision,
• confusion,
• dizziness and/or light-headedness,
• sweating,
• feeling unusually tired or weak,
• sudden death , , , .

Long-term effects

Prolonged exposure to nitrous oxide may result in -

• memory loss,
• vitamin B12 depletion (long-term depletion causes brain and nerve damage),
• ringing or buzzing in the ears,
• incontinence,
• numbness in the hands or feet,
• limb spasms,
• potential birth defects (if consumed during pregnancy),
• weakened immune system,
• disruption to reproductive systems,
• depression,
• psychological dependence,
• psychosis , , , , .

Inhaling nitrous oxide can be fatal if oxygen supplies fall, which is known as hypoxia , , , .

Physical effects

• changes in felt bodily form,
• physical euphoria,
• spontaneous tactile sensations,
• motor control loss,
• perception of decreased weight,
• tactile suppression,
• dizziness,
• headaches .

Cognitive effects

• cognitive euphoria,
• compulsive redosing,
• depersonalisation,
• derealisation,
• déjà vu,
• laughter,
• suggestibility enhancement,
• amnesia,
• information processing suppression,
• memory suppression,
• thought deceleration,
• unity and interconnectedness .

Visual effects

• acuity suppression,
• double vision,
• frame rate suppression,
• pattern recognition suppression,
• geometry,
• external hallucinations,
• internal hallucinations .

Auditory effects

• auditory distortion,
• auditory suppression .

Positive effects

• anxiolytic,
• euphoria,
• giggling and laughing,
• neuroprotection,
• dream-like state .

Neutral effects

• analgesia,
• sound distortion,
• minor to strong hallucinations,
• minor to strong visualisations .

Negative effects

• neurotoxicity,
• nausea,
• headaches,
• reduction of vitamin b12 levels in the body,
• numbness in extremities .

Risks

Nitrous oxide can cause dizziness or affect your judgement, which might make you act carelessly or dangerously and put you at risk of hurting yourself, particularly in an unsafe environment .

Other risks include -

• Unconsciousness or death from lack of oxygen. This occurs when the available oxygen for breathing is effectively pushed out by the nitrous oxide. The risk is greater if the gas is consumed in an enclosed space or if a plastic bag is used that covers both nose and mouth.
• It can be hard to judge the amount to use safely - just enough to get a high but not so much to end up fainting, having an accident or much worse.
• Severe vitamin B deficiency can develop with heavy, regular use of nitrous oxide. This can cause serious nerve damage, which leads to tingling and numbness in the fingers, toes and other extremities, and even to difficulties with walking, and to pains in the affected areas .
• Heavy regular use of nitrous oxide can lead to deficiency of vitamin B12 and to a form of anaemia. The severe B12 deficiency can lead to serious nerve damage in some cases, which causes tingling and numbness in the fingers and toes and other extremities, and even difficulties with walking and pains in affected areas. Regular use may also depress formation of white blood cells .

Purity

Sulphur dioxide, a poisonous gas, is added to the nitrous oxide used in engines to discourage people from using it to get 'high' .

Addiction

As with other NMDA receptor antagonists, the chronic use of nitrous oxide can be considered mildly addictive with a low potential for abuse .

Can you get addicted

It may be possible to become psychologically dependent on nitrous oxide, meaning that users develop an increased desire to keep using it despite any harms, but the evidence on this is limited. In anecdotal reports, some people have reported developing cravings or feelings that they want to continue using nitrous oxide .

Dangerous interactions

Caution

• Alcohol - Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.
• GHB/GBL - Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.
• Opioids - Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.
• Tramadol - Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely .

Legality

Although nitrous oxide has been legal in the past, since the Psychoactive Substances Act came into effect on 26 May 2016, it is now illegal to supply or import nitrous oxide for human consumption .

Did you know?

Like drinking and driving, it's illegal to drive if your driving has been impaired by taking drugs. With some drugs, you can even remain unfit to drive the next day. As well as this drug-impaired-driving offence, it's now illegal in England and Wales to drive over set levels for any of 17 named drugs (legal and illegal) in your body, whether or not you are impaired. Very low limits have been set for some common illegal drugs such as cannabis, cocaine and MDMA. You can get a heavy fine, be disqualified from driving or even go to prison.

Check out the Think! Website for more details .

Mixing with other drugs

Mixing nitrous oxide with alcohol is especially dangerous as it can increase the risks associated with both substances and can lead to an increased risk of accidents or death.

Sulphur dioxide, a poisonous gas, is added to the nitrous oxide used in engines to discourage people from using it to get 'high' .

There is no current evidence demonstrating that mixing nitrous oxide with other substances increases health risks. However, it is possible that combining the gas with stimulants and other drugs places additional pressure on the heart, increases blood pressure and may disrupt heart rate .

Anecdotal evidence suggests that combining nitrous oxide with other drugs such as cannabis, ketamine, LSD, 'magic mushrooms' and salvia can cause intense dissociation , .

Nitrous oxide can, allegedly, briefly multiply the effects of psychedelics like LSD, or bring the effects back strongly when the drug is wearing off, which could be very frightening if unexpected .

Mixing nitrous oxide and alcohol can cause -

• confusion,
• feeling heavy or sluggish,
• reduced concentration,
• loss of body control .

Harm reduction advice

Heart failure - gas or solvent use may stop the heart instantly or cause it to beat irregularly. Sudden exercise after inhaling solvents increases the risk of heart failure.

Suffocation and asphyxiation - when volatile substances are used in an enclosed space, there is a risk of suffocation due to lack of oxygen, especially if the user becomes unconscious. When users place their whole head in a bag containing a volatile substance, they incur a high risk of suffocation. If inhaling from a balloon, it is important not to take too big a breath in one go, as this can overwhelm you and make you lightheaded. Keep an eye on how much friends are taking too.

Choking on vomit, especially when unconscious, is another significant risk. Accumulating the amount you use, particularly if you are by yourself, increases the risk. In any peer group, particularly one where party drugs are regularly used, it is important to have people trained in basic first aid awareness .

• Accidental injuries - users may become confused and disorientated. This creates a risk of accidents such as falling or drowning, and loss of spatial awareness which can result in poor decision making in relation to tasks such as crossing the road. Young people may use volatile substances in dangerous environments such as car parks, construction sites, railway embankments or river sides. Such places are hazardous and may be inaccessible to emergency services.

• Burns - gases and solvents can usually be highly flammable and therefore carry a high risk of serious burn injuries, especially when used near cigarettes or candles. The canisters are also highly pressurised and therefore carry a risk of explosion near naked flames .

Nitrous oxide is not physically addictive, but it is easy to get caught up in using too much when with friends, such as over a weekend long festival. Users may also feel that they cannot do without them for a few hours after stopping use. These cravings will lessen with time .

When inhaling directly from tanks or whippets (bulbs), the gas is intensely cold (-40 degrees) and can cause frostbite to the nose, lips and throat (including vocal cords) . As the gas is also under constant pressure, it can cause ruptures in lung tissue when inhaled directly from these containers. Releasing the nitrous oxide into a balloon helps to warm the gas and normalise the pressure before inhaling , .

People can also harm themselves if they use faulty gas dispensers, which may explode. Dispensing several gas canisters consecutively with one cracker (a handheld device used to 'crack' a nitrous oxide bulb/whippet) can also cause cold burns to the hands .

Using a balloon

Using a balloon, with caution, is the least risky way to use nitrous oxide. Here the gas is dispensed into a balloon from which a user inhales and exhales repeatedly until they have had enough or the gas runs out. If the user overdoes it and oxygen levels in the body drop to the degree where they are close to passing out, they will be unable to hold the balloon to their lips and will automatically breathe air again. This safety mechanism minimises the risk of death by suffocation, but will not prevent a user overdoing it enough to suffer a headache or other unpleasant effects. Paying attention to any discomfort and not resisting the urge to breathe will minimise the chances of harm of any kind .

Choosing the right setting

The risks of hurting yourself if you fall or lose coordination and awareness when taking nitrous oxide can be minimised by sitting down away from hard edges and other hazards .

Never try to fill a space with the gas

If someone has got hold of a large canister of nitrous oxide they should never attempt to fill a room, car, bag over someone's head, or any enclosed space with the gas. This can lead to fatal oxygen starvation. It is much safer to use a balloon .

It is possible to reduce the risks associated with misusing nitrous oxide by not -

• using it alone or in dangerous or isolated places,
• putting plastic bags over the head or impeding breathing in any way,
• spraying near flammable substances, such as naked flames or cigarettes,
• drinking alcohol or taking other drugs,
• standing or dancing while inhaling, as the user may pass out , ,
• make sure you are sitting down and won't hurt yourself if you get dizzy
• very cold temperatures of the gas can freeze the lips and throat if taken directly from a tank or whippit. Releasing the gas into a balloon first allows the gas to warm before being administered.
• avoid driving.
• avoid walking or moving in general if possible .

History

Nitrous oxide was first identified in the late 18th century by the British scientist and theologian Joseph Priestley, who was also responsible for isolating oxygen. Sir Humphrey Davy, of the Pneumatic Institution in Bristol, introduced the gas to friends and colleagues and coined the term 'laughing gas' due to the reactions it provoked.

In the early 19th century a practice of piping the gas into sealed auditoria, whilst audiences were entertained by comic acts on stage, came into vogue. These 'laughing gas parties' were primarily the preserve of the upper classes, and were seen as more civilised entertainment than the debauched alternatives (mostly involving alcohol) of the poorer.

In the late 20th century, as the technology to compress the gas into portable canisters became more widely available, the use of nitrous oxide began to spread to a wider using group, becoming especially popular amongst teenagers who could purchase the canisters more easily than alcohol or other drugs. Nitrous oxide has become the focus of media attention after a number of cases linking it to deaths have come to light, and whilst (as with any substance) there are potential health risks associated with its excessive use, such as lack of oxygen to the brain, it is certainly not a new phenomenon or a more dangerous substance now than it has been in the past .

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