Dangers of Nitrous Oxide when used for recreational purposes.
The miss-use of nitrous oxide [N2O] can be viewed in two ways.
One, the public accessing N2O via stolen N2O cylinders, N2O whipped cream machine charges or N2O tanks for cars.
The second way is the miss-use of N2O in the Dental surgery via a Relative Analgesia machine by a Dentist or staff.
N2O when inhaled produces a euphoric state and also provides a certain amount of sedation and analgesia, also N2O in big enough doses can produce a disassociated anaesthetic state.
Since I don’t use N2O as a recreational drug I went to the media to discover the ways it was currently being abused by the public.
The Sydney Morning Herald had an online article dated August 2015 informing me that using the gas in whipped cream dispenses [N2O] you could fill a balloon and to deeply inhale the N2O from the filled balloon.
Some of the British newspapers such as the Guardian and Telegraph in articles about N2O abuse, explained how balloons of N2O were used to breathe in and out of to produce a euphoric state. These newspapers also eluded to the potential problems that N2O [laughing gas] is used because it is considered a very safe drug.
So I went on line to see how easy it would be to purchase N2O whipped cream charges. Sure enough 1 week later I had N2O charges delivered to my door at little cost.
N2O is a safe drug when used in Dentistry for its intended purpose because Relative Analgesia machines always deliver a minimum of 30% oxygen and N2O is used only for the duration of the appointment. In my opinion N2O is the safest form of sedation in Dentistry.
The abuse of N2O on the other hand can carry significant morbidity when used by the public or abused by health care providers.
The primary physiological dangers of N2O inhalational are:
1/ Oxygen deprivation
2/ Loss of motor control
3/ Vitamin B12 synthesis interference and Folic acid interference
1/ Oxygen Deprivation:
When 100% N2O is inhaled and exhaled into a balloon no oxygen is available. When N2O is used to fill a confined space such as a car or a small room then laboratory simulations have confirmed that N2O displaces oxygen in that confined space which can lead to hypoxia.
Forensic Science International 1995 reported on a case of an accidental asphyxia to N2O abuse. The deceased was a hospital worker who had access to the hospital supply of N2O, his death was due to hypoxia and asphyxiation, secondary to N2O in halation.
2/ Loss of motor control:
N2O rapidly leads to loss of motor control and as such a standing person may soon be on their backside at best. Serious injuries have resulted from people inhaling N2O while standing or frolicking under the effects of N2O, and due to the analgesic effects of N2O injuries may not be noticed till after the event.
3/ Vitamin B12 synthesis inhibition and folic acid interference:
Prolonged and repeated exposure to N2O can interfere with Vitamin B12 and Folic acid. Vitamin B12 and Folic acid deficiencies can lead to progressive demyelination and axonal lesions on peripheral nerves and the cervicothoracic spinal cord causing peripheral neuropathy.
Nausea besides being unpleasant can carry significant risk in combination with other drugs such as alcohol. There is an increased risk of inhaling vomitus if you are a bit confused or temporary unconscious, hence the use of using N2O with other drugs can lead to significant problems.
In summary N2O is a very safe drug when used in combination with oxygen but it is this concept of safety that gives a false sense that 100% N2O is safe and abuse doesn’t carry consequences.