Recreational use of nitrous oxide
Recreational use of nitrous oxide
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Recreational use of nitrous oxide

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Recreational use of nitrous oxide

Nitrous oxide (N2O), commonly referred to as laughing gas, along with various street names, is an inert gas which can induce euphoria, dissociation, hallucinogenic states of mind, and relaxation when inhaled. Nitrous oxide has no acute biochemical or cellular toxicity and is not metabolized in humans or other mammals. Rare deaths and injuries associated with use are due to asphyxia or accidents related to alcohol, or vitamin B12 deficiency. Excessive use can lead to long-term and significant neurological and haematological toxicity, such as subacute combined degeneration of spinal cord.

First recorded in the 18th century at upper-class "laughing gas parties", the experience was largely limited to medical students until the late 20th century when laws limiting access to the gas were loosened to supply dentists and hospitals. By the 2010s, nitrous oxide had become more popular as a recreational drug in the Western world and other nations.

Increasing recreational use has become a public health concern internationally due to the potential for long-term neurological damage caused by habitual use. Recreational users are often unaware of the risks. Owing to the chemical's numerous legitimate uses, the sale and possession of nitrous oxide is legal in many countries, although some have criminalised supplying it for recreational purposes.

When used recreationally, nitrous oxide can induce euphoria, relaxation and a hallucinogenic state. Long-term or habitual use can lead to severe neurological damage.

Nitrous oxide is said to enhance the effects of psychedelics.

Since nitrous oxide can cause dizziness, dissociation, and temporary loss of motor control, it is unsafe to inhale while standing up. Safer use can involve inhalation while seated to decrease risks of injury by falling. Inhalation directly from a tank poses serious health risks, as it can cause frostbite since the gas is very cold when released. For those reasons, most recreational users will discharge the gas into a balloon or whipped cream dispenser before inhaling.

Death can result if it is inhaled in such a way that not enough oxygen is breathed in. While the pure gas is not acutely toxic, it inactivates vitamin B12, with continued use causing neurological damage due to peripheral and central demyelination. Symptoms are similar to B12 deficiency: anemia due to reduced hemopoiesis, neuropathy, tinnitus, and numbness in extremities. Subacute combined degeneration of spinal cord can ensue.

A two-week course of vitamin B12 injection (not oral supplementation) is recommended as a first-line treatment, combined with abstinence; oral supplementation may be phased-in later. Recovery is often protracted and incomplete.

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