The visible dangers all over our streets

As I walk around our Southbank neighbourhood caches of discarded large nitrous oxide gas bottles in our nature strips and laneways have piqued my interest.

When I enquired about nitrous oxide and its uses, I discovered that, while legal and relatively safe when professionally administered, it can have devastating and permanent effects on human health when breathed and misused as a “party drug”. Such use is sometimes referred to as “nanging”.

I am motivated to write this article because I care about people’s wellbeing and safety and not to dampen anyone’s fun. As with any drugs of choice I am encouraging healthy, personal inquiry that might prompt good conversations leading to informed decisions which identify and consider the serious risks associated with inhaling nitrous oxide.

I also need to state that this article reflects the limitations of my own understanding and should not in any way be viewed as medical advice. Always consult qualified and accredited medical practitioners for the advice and treatment that you need.

A quick Google search reveals that nitrous oxide has many beneficial industrial and medical uses. It can be used to froth whipped cream, and as an additive to motor racing fuels. In medicine it is used to manage some pain.

Its “quick high” leads to its recreational enjoyment, which many users assume is harmless. I have, however, learned that when nitrous oxide is used as a “party drug” its volume is likely to be delivered to the human body at industrial and not medical levels. This can lead to permanent, irreversible neurological damage.

To better understand the risks of the recreational use of nitrous oxide, I asked a neurological registrar who works at one of our major hospitals. He informed me of:

Effects on the body and risks of prolonged use

Inhaling nitrous oxide can cause significant damage to the nervous system – particularly the peripheral nerves that control movement and sensation, and the spinal cord itself.

One serious condition it can cause is called subacute combined degeneration of the spinal cord, which affects both balance and strength. The result can be life-altering: some people lose the ability to walk, a particularly devastating outcome given that nitrous oxide misuse is most common among younger individuals.

With continued use, the damage can extend further – potentially leading to acquired brain injuries, cognitive problems, and even vision loss if the optic nerves are affected. Alarmingly, neurological harm can occur after just a few weeks of regular use, although the exact threshold varies from person to person.

Treatment limitations

The harm from nitrous oxide arises because it interferes with the body’s ability to use vitamin B12, which is essential for nerve health. Treatment involves stopping nitrous oxide use and starting high-dose B12 supplementation and a related supplement called Methionine.

Unfortunately, even with prompt treatment, full recovery occurs in only about half of cases. For those who do improve, recovery often takes many months.

Some users attempt to prevent damage by taking B12 supplements while continuing to use nitrous oxide. However, research shows that this strategy does not protect against the neurological effects.

It seems clear that the recreational use of nitrous oxide carries considerable risk and that some people are irreversibly harmed. It’s important that we talk about this with each other in informed and respectful ways.

I am confident that the conversations which happen within trusted relationships can motivate people to at least consider the risks associated with their choices and to seek appropriate help. Help is available through:

Medical emergencies: Dial 000.

National Alcohol & Other Drug Hotline: 1800 250 015 or health.gov.au/contacts/national-alcohol-and-other-drug-hotline

Alcohol and Drug Foundation: adf.org.au/drug-facts/ •