Nitrous oxide use has continued to decline across England and Wales, according to the data from the Office for National Statistics (ONS).
However, while deaths remain low, charities and specialist healthcare professionals have not seen a reduction in the drug’s harm, painting a more complex picture of the issue.
Nitrous oxide (N₂O) – also known as laughing gas – is an inhaled pain reliever is known for causing instant, short-term sensations of euphoria, laughter, and auditory and visual hallucinations, and was reclassified as a Class C drug in 2023.
Peter (not his real name), told The Londoners his experience of doing nitrous oxide.
He said: “I hallucinated whilst doing a lot of balloons [nitrous oxide] once. As I was doing it, I felt someone tap me on my shoulder and looked to my left and I see myself, asking if I am alright.
“It just freaked me out. I didn’t tell anyone about it for two years because it made me feel so weird.”
Once one of the most commonly-used recreational drugs among young adults, the amount of 16-24 year olds consuming nitrous oxide was 85% lower in 2024/25 than the data’s peak in 2019/20, and 79% lower comparing the same period for all adults.
However, there is no data for 2020-2022 due to the suspension of the Crime Survey England and Wales during the Pandemic, so it is difficult to determine when the decline began and how sharply it fell.
Dr Laura Smith, health psychologist and lecturer at Queen Mary University, said the lack of data during the Covid-19 pandemic is a loss of critical insight, as other countries saw nitrous oxide consumption peak during those years.
Dan Gibbons, training and engagement lead at solvent and gas misuse charity Re-Solv, said: “What we experience here at Re-Solv – and this is the more complex, chronic side – it couldn’t be more opposite.”
Re-Solv has seen a 50-70% increase in nitrous oxide abuse support requests in the last two years.
Smith added: “For us, we haven’t seen this decline in people presenting to the hospital with harms.”
The risk of the drug is relatively low in comparison to other substances, with 62 fatalities reported in a 20-year period, but abuse of nitrous oxide can cause serious physical and mental harms and is impacting children.
Smith said: “We have seen nitrous oxide use recreationally in people aged 11 to 15.
“And in our sort of work – looking at people that come to hospital and need treatment for neurological harms – we have had someone as young as 14.”
Young people use nitrous oxide almost three times more (1.3%) than adults overall (0.5%), but both age groups show parallel downward trends.
However, this does not indicate which age group is more likely to encounter nitrous oxide-related harms, with Gibbons revealing the average age of Re-Solv service users is 25 years old.
Popularity in nitrous oxide consumption peaked in 2019/20 for 16-24-year-olds, at 9%, when it hit 2.4% in the wider adult population.
Despite laws on nitrous oxide possession, supply and production coming into effect in November 2023, the number of people recreationally consuming the gas had already dropped by more than half in 2022/23 compared to 2019/20 levels.
While policy may have played an important secondary role in the drug’s decline, the initial decline appears to have been driven by a cultural change, rather than a legislative one.
Smith acknowledged the limitations of the data as the Crime Survey England and Wales is a self-reporting study, and respondents might not be honest for fear of repercussions.
She also highlighted the data does not include people who are living in group residences such as student halls, where nitrous oxide consumption might be commonplace.
The data also fails to represent children who might be consuming nitrous oxide.
Year-on-year data on nitrous oxide consumers begins in 2016/17, where the drug was second-most popular among young people – twice as common as ecstasy and far more common than ketamine.
More recently, in 2024/25, it ranks sixth, and the gas’s decline is unique compared to other ‘party’ drugs, as shown on the above graphs.
Ecstasy’s popularity has also declined, but less so, while cannabis and cocaine use has remained relatively stable, and ketamine use has increased.
For some, nitrous oxide can become addictive.
Gibbons said: “Speaking to some of the people we support, nitrous oxide turns everything off – it turns the brain off.
“You can just sit there, you’ve got no worries, the stresses and strains of the world are no longer a concern.
“Naturally, once you stop, those stresses come knocking. So, the only way to keep those at bay is just to continue.”
Re-Solv encounters people who are consuming six to eight cylinders a day, with one cylinder containing around 500-700g of liquid nitrous oxide and costing £25 on average.
In comparison, a single use canister of nitrous oxide, often known as a ‘whippet’, contains 8g of nitrous oxide.
Sustained, heavy-consumption of nitrous oxide can cause serious physical and psychological harm.
Smith said: “The reports of health harms associated with nitrous oxide have continued to increase in more recent decades. The ones that are commonly reported are neurological harms.”
Nitrous oxide abuse can cause vitamin B12 deficiency because the gas inactivates it, damaging nerves throughout the body.
Physical side effects reported include peripheral neuropathy (nerve damage in extremities), myelopathy (spinal cord damage), a tingling sensation in hands and feet, physical immobility, bladder and bowel dysfunction, and thromboembolic issues such as blood clots.
Alongside physical harm, nitrous oxide can also cause psychological issues, particularly if a person has a history of psychiatric problems, said Smith.
Psychological side effects reported include anxiety, depression, paranoia, insomnia, delusions and hallucinations, and personality changes.
Treatment is dependent on the symptoms nitrous oxide users display, but it often involves administering intramuscular vitamin B12 injections, alongside other tailored therapies.
Smith said: “The good news is lots of people, particularly for the neurological symptoms, can make a good recovery and progress with treatment.”
If you are concerned about any of the issues raised in this article, contact your GP or speak to Re-Solv for judgement-free advice.
Feature image: Free to use from Pixabay/Alexas_Fotos
Join the discussion