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Use of laughing gas linked to brain damage, yet sold across US: Report
Deaths in the US attributed to abuse of nitrous oxide jumped more than 100% between 2019 and 2023; over a five-year period, emergency department visits rose 32%
The Conversation
The US Food and Drug Administration is warning Americans about the ever-increasing and potentially deadly recreational use of nitrous oxide products, particularly among young people.
Marketed with names like 'Galaxy Gas' and 'Miami Magic,' and often sold in steel cartridges known as 'whippets,' these products are cheap and readily available at gas stations, convenience stores, smoke shops and major retail outlets, including Walmart. They're also sold online.
As an assistant professor of public health who studies these products, I'm aware of how dangerous they can be.
Recreational and continued use of nitrous oxide can cause a wide range of serious health problems, and in some cases, death. A long list of potential harms
The list of serious side effects from frequent use is long. It includes: cognitive impairment, memory problems, hallucinations, headaches, lightheadedness, mood disturbances, blood clots, limb weakness, trouble walking, peripheral neuropathy, impaired bowel or bladder function, spinal cord degeneration and irreversible brain damage. Vitamin B-12 deficiency is common and can lead to nerve and brain damage.
Deaths in the US attributed to abuse of nitrous oxide jumped more than 100 per cent between 2019 and 2023; over a five-year period, emergency department visits rose 32 per cent.
All told, more than 13 million Americans have misused nitrous oxide at least once during their lifetimes. This includes children: In 2024, just over 4 per cent of eighth graders and about 2 per cent of 12th graders said they've tried inhalants. Nitrous oxide is among the most abused of these inhalants due to its low cost, easy availability and commercial appeal – one flavor of the gas is named 'pink bubble gum.' Laughing gas parties
Because of legal loopholes in the Food and Drug Administration Act, nitrous oxide remains unregulated. What's more, US scientists have done relatively little research on its abuse, partly because the public still perceives the substance as benign, particularly when compared with alcohol.
The few studies on the use of nitrous oxide are limited mainly to case reports – that is, a report on a single patient. Although limited in scope, they're alarming.
More thorough studies are available in the United Kingdom and Europe, where there's even more demand for the product. One example: Over a 20-year period, 56 people died in England and Wales after recreational use. Typically, deaths occur from hypoxia, which is the lack of oxygen to the brain, or accidents occurring while intoxicated by the gas, such as car wrecks or falls.
Americans have known about the effects of nitrous oxide for centuries. Before becoming a medicinal aid, nitrous oxide was popular at 'laughing gas' parties during the late 1700s.
Physicians began using it in the US around the mid-19th century after Horace Wells, a dentist, attended a stage show – called 'Laughing Gas Entertainment' – and saw the numbing effect that nitrous oxide had on audience volunteers. By coincidence, Wells was having a wisdom tooth removed the next day, so he tried the gas during his procedure. The nitrous oxide worked; Wells said he felt no pain. Thereafter, medicinal use of the gas was gradually accepted.
Today, nitrous oxide is often used in dentist offices. It's safe under a doctor's supervision as a mild sedative that serves as a pain reliever and numbing agent. Nitrous oxide also benefits some patients with severe psychiatric disorders, including treatment-resistant depression and bipolar depression. It may also help with anxiety and pain management. Bans and restrictions
No federal age restrictions exist for purchasing nitrous oxide products, although a few states have passed age limits.
As of May 2025, four US states – Louisiana, Michigan, Alabama and California – have banned the recreational use of nitrous oxide, and more than 30 states are working on legislation to ban or at least restrict sale of the products. In addition, numerous lawsuits filed against the manufacturers are in court.
Research shows school prevention programs help keep kids from using these products. So does early screening of patients by primary care and mental health physicians. The sooner they can intervene, the more likely that ongoing therapy will work.
Through appropriate legislation, regulation, education and intervention, nitrous oxide abuse can be slowed or stopped. Otherwise, these products – with their sleek packaging and attractive social media campaigns that obscure their dangers – remain a growing threat to our children.
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