• Nitrous oxide (N2O) aka “laughing gas”, used clinically for its psychotropic properties as an inhalational anesthetic, is one of the most abused inhalants for decades due to its unregulated wide availability and public perception that it is a safe high. Social media trends have popularized use by teens and young adults.
• Easily purchased online, in groceries stores, gas stations,  smoke and vape shops it is used as a food processing  propellant in steel aerosol containers like whipped cream and available in small canisters marketed as whipped cream chargers called “whippets”.
• Between January 1, 2014 - Dec 31, 2023, nitrous oxide nearly doubled in exposure rate with a total of 2,322 exposures reported to U.S Poison Centers.  From 2010-2023,  1240 US deaths were reported between the ages of 15-74 attributable to nitrous oxide poisoning.
• Similar to Ketamine and phencyclidine, nitrous oxide causes antagonism at the NMDA receptor resulting in short lived reversible euphoria and sedation and analgesic effects through the K-opioid receptor.
• Nitrous oxide fatalities occur primarily due to asphyxiation and oxygen deprivation causing neurologic sequela, hypotension, arrythmias, and death. N2O depresses the sensation of shortness of breath so users may not seek fresh air.
•  Chronic recreational N2O exposure impedes vitamin B12 function and causes a distinct neurological syndrome manifested by numbness, gait disturbances, loss of coordination, changes in mentation, and loss of bowel and bladder control, and hematologic abnormalities.
• On June 6, 2025, the FDA issued a public advisory warning consumers not to inhale nitrous oxide products due to potential for severe adverse events if used for recreational nonfood purposes.

Additional Information

References

Vohra V, Matthews H, Stroh-steiner G. Notes from the field: Recreational Nitrous Oxide Use-Michigan, 2019-2023. MMWR Morb Mort Wkly Rep 2025;74:210-212. DOI: http://dx.doi.org/10.15585/mmwr.mm7412a3.

 Gummin D,  Mowry J, Beuhler MC,  et.al  (17 Dec 2024): 2023 Annual Report of the National Poison Data System® (NPDS) from America’s Poison Centers®: 41st Annual Report, Clinical Toxicology, DOI: 10.1080/15563650.2024.2412423

Yockey RA, Hoopsick RA. US Nitrous Oxide Mortality. JAMA Netw Open. 2025;8(7):e2522164. doi:10.1001/jamanetworkopen.2025.22164.

https://www.fda.gov/food/alerts-advisories-safety-information/fda-advises-consumers-not-inhale-nitrous-oxide-products.  FDA Advises Consumers Not to Inhale Nitrous Oxide Products 6/4/2025