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Despite a recent advisory from the Food and Drug Administration concerning the inhalation of nitrous oxide, often referred to as laughing gas, incidents of fatalities linked to its misuse are increasingly prevalent in the United States.
Researchers Andrew Yockey from the University of Mississippi and Rachel Hoopsick from the University of Illinois at Urbana-Champaign are examining the growing trend of nitrous oxide abuse.
“Nitrous oxide is typically used as a sedative or anesthetic, but there is a noticeable increase in its recreational use,” Yockey explained. “Unfortunately, this trend is accompanied by a rise in hospital visits, poisonings, and fatalities.”
According to the 2023 National Survey on Drug Use and Health, over 13 million Americans have misused nitrous oxide at some point in their lives. The Centers for Disease Control and Prevention reports that deaths due to nitrous oxide poisonings surged by over 110% from 2019 to 2023.
“Early findings from our research indicate that while the absolute number of deaths remains relatively low compared to other hazardous substances, there has been an alarming exponential increase in these cases over the past few years,” Hoopsick noted. “If this trend continues, we could face a much more significant issue.”
Though nitrous oxide—often called whippets—has been misused for a long time for its short-lived euphoric effects, the long-term consequences of its abuse can be fatal. Recently, the FDA alerted consumers that repeated inhalation can result in serious health risks such as asphyxiation, blood clots, frostbite, numbness, paralysis, and even brain damage.
Contrary to many controlled substances, nitrous oxide remains largely unregulated. A simple online search reveals a strong market presence, with options presented in a variety of vibrant flavors and eye-catching packaging.
“This is reminiscent of the strategies employed by large tobacco companies, which specifically appealed to young consumers with cartoonish designs and enticing flavors,” Hoopsick remarked. “We can draw a similar parallel with the marketing of nitrous oxide.”
The substance is frequently advertised for its use in culinary applications, such as whipping cream. The FDA has highlighted that nitrous oxide can be purchased through major retailers like Amazon, Walmart, and eBay, as well as countless smoke and vape shops nationwide, often with little to no regulation.
“It’s hard to believe that anyone is actually using flavored nitrous oxide to create a blueberry mango whipped cream,” Yockey pointed out, referencing one of the flavors available on the market. “Yet, I can have it shipped directly to my home within days.”
In a manner akin to tactics employed by the tobacco industry, vendors of nitrous oxide downplay the potential hazards of misusing the gas, Hoopsick added. “There’s substantial evidence indicating that nitrous oxide poisoning poses serious risks, but this concern is frequently overlooked or minimized by sellers, leading the public to perceive it merely as a party drug.”
Yockey and Hoopsick are also exploring the influence of social media on the use of nitrous oxide among young adults, noting that videos depicting adolescents inhaling the substance are widespread on various platforms.
“Research shows that viewing others engage in this behavior increases the likelihood that someone will try it themselves,” Yockey stated. “I am particularly concerned about high school and college students who encounter such content online and feel encouraged to purchase a fruit punch-flavored tank since, at present, that is entirely legal.”
Further investigation is necessary to gain a deeper understanding of the extent of nitrous oxide misuse, but the researchers emphasize the need for regulatory measures to mitigate potential harm.
“At this point, we lack policy-level interventions,” Hoopsick asserted. “Implementing regulations on who can sell nitrous oxide, who can buy it, and how it is marketed could help us preemptively address the issue.”
In the meantime, the accessibility of nitrous oxide continues to expand.
“Some of these brands didn’t even exist just a week ago,” Yockey remarked while browsing listings online. With rapid delivery options, any number of these products could arrive on consumers’ doorsteps within a matter of days.
“Their marketing approach is incredibly strategic, but the implications for public safety are deeply concerning,” he concluded.
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