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How dangerous is laughing gas? The history of the drug and its risks, explained

Nitrous Oxide has been used recreationally since the late 18th century, and out of all the countries in the world is the most popular in the UK

Ian Hamilton,Harry Summall

Friday 17 June 2016 18:11 BST

Dozens of protesters stage a mass inhalation of Nitrous Oxide, commonly known as laughing gas, outside the Houses of Parliament on August 1, 2015. The group of demonstrators inhaled the gas from balloons and chanted in protest at the government's proposed Psychoactive Substances Bill. (Jack Taylor/AFP/Getty Images)

According to the latest Global Drug Survey, nitrous oxide – or laughing gas – is now the seventh most popular drug in the 50 countries surveyed. Just over half the UK respondents said they had tried the drug at some point, and 38 per cent said they had used it in the last year, making it more popular in the UK than any other country.

Nitrous oxide is a colourless, sweet tasting gas that has been used recreationally since the late 18th century, most notably by Sir Humphry Davy, former president of the Royal Society. Medical use was established in the early 20th century and nitrous oxide remains an important anaesthetic, tranquilliser and painkiller, used by dentists, obstetricians and sports doctors. Indeed, many members of the public will have experienced the effects of nitrous oxide themselves without realising it.

The popularity of recreational use of nitrous oxide is unsurprising. It’s legal in many parts of the world, it’s cheap and it reliably produces a short-lasting euphoria as well as heightened senses and a slight feeling of disconnect from the body and is often used as a drug at concerts, nightclubs and festivals.

Footage of some of the people in Newcastle city centre under the influence of legal highs

And it can be combined with other drugs to alter the effects. Availability is affected by national laws but, generally, where the drug is available it is either dispensed from large canisters or small bulbs (“whippets”), into balloons, which is then used to inhale.

Because nitrous oxide has legitimate uses in the food industry (to make whipped cream or in home brewing), it can easily be bought from online retailers such as catering companies. However, according to the Global Drug Survey, people are increasingly using the darknet to buy it.

Not a high risk drug

Nitrous oxide is considered to have relatively low toxicity. However, it can cause dizziness, so there’s a risk of harm from falling. There are also case reports of dependence in people – often medical professionals – who have access to large quantities of the drug.

Risks can vary, depending on how the drug is administered. Inhaling nitrous oxide directly from a pressurised canister can damage the lungs. And, although rare, a few people have died from asphyxiation after passing out while their mouth and nose are connected to a tube or surgical mask, or where a bag containing nitrous oxide has been placed over the head.

Most users inhale the drug from balloons or small bulbs, and the dose administered is low, so the risk of asphyxiation is almost nonexistent.

% of reported drug use in last 12 months Global Drug Survey

Top up on B12

Long-term and heavy-use of nitrous oxide can lead to vitamin deficiency and anaemia as a result of the inactivation of vitamin B12 in the body, although the incidence of this is unknown. Vitamin B deficiency can cause tingling in the fingers, toes and extremities which can last for hours or days. More severe cases can lead to numbness and difficulty walking, and the risks are heightened in people who are already B12 deficient.

World's 10 deadliest street drugs

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1/10World's 10 deadliest street drugs

World's 10 deadliest street drugs

Whoonga

Whoonga is a combination of antiretroviral drugs, used to treat HIV, and various cutting agents such as detergents and poisons. The drug is widely available in South Africa due to South Africa’s high rate of HIV sufferers, and is believed to be popular due to how cheap it is when compared to prescribed antiretrovirals. The drug is highly addictive and can cause major health issues such as internal bleeding, stomach ulcers and ultimately death

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Scopolamine

Scopolamine is a derivative from the nightshade plant found in the Northern Indian region of South America (Ecuador, Colombia and Venezuela). It is generally found in a refined powder form, but can also be found as a tea. The drug is more often used by criminals due its high toxicity level (one gram is believed to be able to kill up to 20 people) making it a strong poison. However, it is also believed that the drug is blown into the faces of unexpecting victims, later causing them to lose all sense of self-control and becoming incapable of forming memories during the time they are under the influence of the drug. This tactic has reportedly been used by gangs in Colombia where there have been reports of people using scopolamine as way to convince victims to rob their own homes

World's 10 deadliest street drugs

Heroin

Founded in 1874 by C. R. Alder Wright, heroin is one of the world’s oldest drugs. Originally it was prescribed as a strong painkiller used to treat chronic pain and physical trauma. However in 1971 it was made illegal under the Misuse of Drugs Act. Since then it has become one of the most destructive substances in the world, tearing apart communities and destroying families. The side effects of heroin include inflammation of the gums, cold sweats, a weak immune system, muscular weakness and insomnia. It can also damage blood vessels which can later cause gangrene if left untreated

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Crack cocaine

Crack cocaine first came about in the 1980’s when cocaine became a widespread commodity within the drug trafficking world. Originally cocaine would have attracted a high price tag due to its rarity and difficulty to produce, but once it became more widespread the price dropped significantly. This resulted in drug dealers forming their cocaine into rock like shapes by using baking soda as a way of distilling the powder down into rock form. People were doing this because it allowed for them to sell cocaine at a lower quantity and to a higher number of people. The side effects of crack cocaine include liver, kidney and lung damage, as well as permanent damage to blood vessels, which can often lead to heart attacks, strokes, and ultimately death

World's 10 deadliest street drugs

Crystal meth

Not just famous because of a certain Walter H White, but also because it is one of the most destructive drugs in the world. First developed in 1887, it became widely used during the Second World War when both sides would give it to their troops to keep them awake. It is also believed that the Japanese gave it to their Kamikaze pilots before their suicide missions. After the war crystal meth was prescribed as a diet aid and remained legal until the 1970s. Since then it has fallen into the hands of Mexican gangs and has become a worldwide phenomenon, spreading throughout Europe and Asia. The effects of crystal meth are devastating. In the short-term users will become sleep depraved and anxious, and in the long-term it will cause their flesh to sink, as well as brain damage and damage of the blood vessels

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AH-7921

AH-7921 is a synthetic opioid that was previously available to legally purchase online from vendors until it became a Class A in January 2015. The drug is believed to have 80% of the potency of morphine, and became known as the ‘legal heroin’. While there has only been one death related to AH-7921 in the UK, it is believed to be highly dangerous and capable of causing respiratory arrest and gangrene

World's 10 deadliest street drugs

Flakka

Flakka is a stimulant with a similar chemical make-up to the amphetamine-like drug found in bath salts. While the drug was originally marketed as a legal high alternative to ecstasy, the effects are significantly different. The user will feel an elevated heart rate, enhanced emotions, and, if enough is digested, strong hallucinations. The drug can cause permanent psychological damage due to it affecting the mood regulating neurons that keep the mind’s serotonin and dopamine in check, as well as possibly causing heart failure

World's 10 deadliest street drugs

Bath salts

Bath salts are a synthetic crystalline drug that is prevalent in the US. While they may sound harmless, they certainly aren’t the sort of salts you drop into a warm bath when having a relaxing night in, they are most similar to mephedrone, and have recently been featured throughout social media due to the ‘zombification’ of its. The name comes from the fact that the drug was originally sold online, and widely disguised as bath salts. The side effects include unusual psychiatric behaviour, psychosis, panic attacks and violent behaviour, as well as the possibility of a heart attack and an elevated body temperature

World's 10 deadliest street drugs

Purple Drank

One of the more unusual drugs around at the moment, purple drank was popularised in 90s hip hop culture, with the likes of Jay Z and Big Moe all mentioning it in their songs. It is a concoction of soda water, sweets and cold medicine, and is drunk due to cold medicines high codeine content, which gives the user a woozy feeling. However it can also cause respiratory issues and heart failure

World's 10 deadliest street drugs

Krokodil

Krokodil is Russia’s secret addiction. It is believed that over one million Russians are addicted to the drug. Users of krokodil are attracted to the drug due to its low price; it is sold at £20 a gram while heroin is sold for £60. However, krokodil is considered more dangerous than heroin because it is often homemade, with ingredients including painkillers, iodine, lighter fluid and industrial cleaning agents. This chemical make-up makes the drug highly dangerous and likely to cause gangrene, and eventually rotting of the flesh

The recent drug survey asked people who had used nitrous oxide to report whether they had experienced such symptoms, and 4 per cent said they had, although it is not possible through a self-report survey to assess if this was actually related to nitrous oxide use. People who use nitrous oxide regularly, sometimes take B12 supplements to avoid these symptoms.

We don’t really know why use of this drug has risen. All we do know is that like fashion, drug use changes over time. What is popular today is likely to change in the future, making the cat and mouse game of prohibiting substances deemed harmful so impotent.

The Psychoactive Substances Act, which came into force in the UK in May 2016 is intended to burst the ballooning use of nitrous oxide in Britain. But will suppliers and users have the last laugh? Next years global survey of drug use might provide the answer.

Ian Hamilton is Lecturer in Mental Health, University of York and Harry Sumnall is Professor, Liverpool John Moores University

This article was originally published on The Conversation. Read the original article.

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