Teen and Young Adult Abuse of Nitrous Oxide

Rising inhalant abuse among teens may signal unavailability of psychiatric care.

Reviewed by Hara Estroff Marano

Key points

• Tobacco, alcohol, cannabis, and other drug use has decreased in teens.
• Recreational hallucinogen use is increasing dramatically.
• Increaseing use of nitrous oxide by teens may be a maladaptive response to mental health issues.
• Researchers are exploring nitrous oxide as a fast-acting treatment for treatment-resistant depression.

In September 2024, CNN reported that misuse of laughing gas (nitrous oxide, N₂O) is a popular method for some young people to obtain a quick high. A popular method is the use of "whippets," small metal canisters (also called chargers) containing pressurized nitrous oxide used to charge whipped cream dispensers.

Users typically puncture the canister, release the gas into a balloon or similar object, and inhale the drug. Whipped cream chargers containing nitrous oxide can be purchased from retail outlets and online sources. They can also be purchased at gas stations, smoke shops, or head shops.

The annual University of Michigan's Monitoring the Future (MTF) study highlights key trends in substance use among teens and young adults in the United States. According to the 2023 MTF study, inhalant use has remained relatively stable. While nitrous oxide is not a focus of MTF reports, the drug remains a concern due to its easy availability.

Nitrous Oxide and Galaxy Gas

Misuse of the stainless steel nitrous oxide cartridges is promoted on social media platforms such as TikTok. The manufacturer, Galaxy Gas, has responded to reports of abuse by pausing its sales of nitrous oxide products and emphasizing that its products are intended strictly for culinary use. They have also expressed concern over misuse of their products and provided resources for substance abuse help.

Teens are drawn to the short-term euphoria induced by nitrous oxide. Nevertheless, abuse can cause long-term neurological damage, cardiovascular issues, and vitamin B12 deficiency. Alarmingly, emergency room visits due to nitrous oxide misuse are on the rise, particularly among teens and young adults.

Sometimes Drug Abuse Is Self-Medication by Teens

The increasing use of ketamine, nitrous oxide, and hallucinogens such as psilocybin may be a way of medicating mental health issues in some teens, says Sarah Vinson, M.D., chair of child and adolescent psychiatry at Morehouse University Medical School. “It’s more likely to be an issue of lack of access to mental health care, extreme anxiety, depression, and trauma. Youths need mental health treatment and are not getting it." Vinson notes that "the suicide rate among young people ages 10‒24 increased 62% from 2007 through 2021. The most alarming trend in recent years has been a sharp rise in suicide among Black youth ages 10 to 24. They are not coming to us (mental health practitioners). We need academic and safety-net providers of pediatric, child, and adolescent care to go to the kids rather than wait for them to come to us.”

Looking at the Past

Nitrous oxide was first synthesized by English chemist Joseph Priestley in 1772. In 1799, Humphry Davy, a British chemist, self-experimented with it, noting its euphoric and analgesic effects. He coined the term "laughing gas" after noticing that the gas made people laugh uncontrollably. Davy suggested that nitrous oxide might be helpful for pain relief in surgery, although it would take decades before the idea was explored further. In the early 1800s, nitrous oxide became a recreational drug, and Davy and others held laughing-gas parties.

After experimenting with nitrous oxide and ether, Connecticut dentist Horace Wells realized the potential for painless dentistry in 1844. Unfortunately, Wells became addicted to chloroform, another anesthetic. His struggle with addiction led to his suicide in 1848. His case highlights the dangers of anesthetic misuse among medical professionals.

By the mid-1900s, nitrous oxide had become a standard tool in dental practice; however, its euphoric properties led to some cases of recreational abuse by dentists. Some instances still surface today, but professional abuse is far less common due to regulations, oversight, and a growing emphasis on substance use disorder education. Such abuse is usually detected through discrepancies in gas-usage records or unusual individual behavior. Those caught abusing nitrous oxide face disciplinary action, including loss of their license to practice.

Consequences of Abuse

When abused, nitrous oxide produces short-lived euphoric high and mild dissociative effects, which can make it appealing for recreational use.

Abuse can lead to neuropathy, memory loss, and motor dysfunction. When used without adequate oxygen, nitrous oxide can cause oxygen deprivation (hypoxia), which can result in dizziness, unconsciousness, cognitive impairment, paranoia, or even death in severe cases.

The drug can also cause nausea and vomiting, which may lead to choking if the user is lying down. One surprising side effect is frostbite; directly inhaling the gas from the canister can cause cold burns. Dependence, cravings, and compulsive use of nitrous oxide may result from regular use of the drug.

Some Experts Have Used Nitrous Oxide for Treating Severe Depression

As with ketamine, not all the nitrous oxide news is about abuse. For example, studies conducted by Washington University School of Medicine's Charles Conway, M.D,, and University of Chicago's Peter Nagele, M.D., have pioneered the use of nitrous oxide (N2O) for treating depression, particularly in patients with treatment-resistant depression (TRD). Their studies indicate that low doses of nitrous oxide have potential as a fast-acting treatment for depression. In comparison to traditional antidepressants, which can take weeks to show results (and still might not be effective), nitrous oxide has been observed to induce improvements in mood within hours.

A 2021 study led by Conway and Nagele found that a single one-hour session of inhaling low-dose nitrous oxide produced antidepressant effects lasting up to several weeks in patients with TRD. Nitrous oxide is widely available, has a shorter duration of action, and may have a more favorable side effect profile than drugs such as ketamine when used at low doses for those not responding to traditional antidepressant therapies.

Summary

While use if alcohol, tobacco, and cannabis has decreased in teens, according to the MTF survey, there is increasing use of hallucinogens (psilocybin), ketamine, and, according to the CNN report, nitrous oxide. Inhalant abuse, although not widespread, appears to be an increasing problem among adolescents and young adults in the U.S.

Kids learn about this form of drug abuse on social media sites. Experts need to make young people aware that nitrous oxide and other inhalants have severe health risks.

We must provide education and prevention while we follow the data. This is a trend that may reflect an epidemic of teenage depression and anxiety and a lack of access to behavioral health care, combined with an adolescent propensity to self-administer treatments associated with celebrities.

Suicide remains the second leading cause of death among adolescents, behind accidents. Unintentional overdoses are often classified as accidents, but adolescent mortality from drug overdoses is now the third leading cause of death in children under the age of 19.