[top]Short-term dangers of nitrous oxide
Nitrous oxide can produce acute adverse effects in some users, and some of its dissociative effects may represent dangers to the user. Possible adverse effects of nitrous oxide include: nausea (especially when used repeatedly, after a meal, or in combination with
alcohol) which can lead to vomiting (can be dangerous to the user, because he/she can fall unconscious on nitrous oxide and choke on his/her vomit) and headaches, during or after the experience. Because nitrous oxide can cause loss of motor control, inhaling it when standing can be dangerous. Nitrous oxide should not be used in any situation in which sudden unconsciousness may be dangerous (standing, driving, operating machinery, etc.). Users should be in a comfortable and safe setting to avoid accidentally inuring themselves. Serious injury and death has resulted from nitrous oxide being inhaled while driving or standing in front of an open window.
[top]Long-term dangers of nitrous oxide
Nitrous oxide interacts with vitamin B12 synthesis in the human body by interfering with the enzyme methionine synthase, depleting the body of vitamin B12. Also, in a scientific study, it was shown that 24 hours of exposure to nitrous oxide caused interferences with DNA synthesis.
When nitrous oxide is used heavily and over an extended period of time, vitamin B12 depletion will probably become a major problem, as it can cause brain and nerve damage. Physical symptoms of vitamin B12 deficiency include: tingling sensation in extremities, paresthesias (no sense of touch and pain), difficulties with motor control (can lead to inability to walk), etc. If a frequent user of nitrous oxide experiences one or more of the above symptoms, it is vital to cease the use immediately and consume healthy amounts of vitamin B12 and other vitamins (especially folic acid). If symptoms persist or get worse, a physician has to be consulted. There are some reported cases of chronic nitrous oxide use resulting in the symptoms mentioned above. However, virtually all of the patients used nitrous oxide excessively, up to 400 whippets each week, over the period of several months.
If nitrous oxide is used frequently (although this is not recommended), consuming supplements containing vitamin B12 and folic acid may reduce the long-term risks of chronic nitrous oxide use.
Heavy use of nitrous oxide can result in lower amounts of lymphocytes of the blood (results in a weakened immune system), reproductive disturbances and hyperhomocysteinemia (a risk factor in vascular disease).
As the effects caused by nitrous oxide are pleasant and very short-lasting, many users desire another dose. Sometimes, this continues until no more nitrous oxide is available to the user. This compulsive use of nitrous oxide can lead to psychological
addiction in some users, which can lead to excessive use (dangerous for the reasons stated above) and deterioration of personality.
Prolonged exposure to nitrous oxide has been shown to cause Olney’s Lesions, although the alveolization of certain parts of the brain does not result in further damage as it happens with most other dissociative drugs.
[top]Who should not use nitrous oxide
Nitrous oxide should be avoided by pregnant women. High doses of nitrous oxide have been proven to be teratogenic in rodents, and also other conditions caused by chronic use of nitrous oxide (vitamin B12 depletion, hyperhomocysteinemia) can result in a malformed child if the user is pregnant.
Because nitrous oxide tends to diffuse into air-filled spaces in the body (intestines, middle ear, etc.), it may be dangerous when used by persons with middle ear disease, bowel obstruction, pneumothorax, etc. In the case of nitrous oxide in the intestines, it will probably only result in mild gastrointestinal discomfort. Nitrous oxide in the middle ear may cause temporary or permanent hearing loss, which is why nitrous oxide should not be used when one has an ear infection or any other disease in this region. Pneumothorax (collapsed lung, accumulation of air in the pleural cavity) is a medical emergency. Nitrous oxide should not be used for analgesia in such cases, but medical personnel will (hopefully) be aware of the dangers of administering nitrous oxide in these circumstances.
[top]Dangerous or negative interactions with nitrous oxide
Alcohol can increase the likelihood of nausea when combined with nitrous oxide.
Although most other hallucinogens combine well with nitrous oxide, the resulting experience may be too intense for many users, especially those inexperienced with hallucinogens.
[top]Indirect dangers of nitrous oxide
The dangers not directly related to nitrous oxide are mostly present because nitrous oxide is often administered from pressurized containers, without constant oxygen supply, or from sources that may contain contaminants. Also, other compounds like carbon dioxide and nitric oxide may be mistaken for nitrous oxide.
Nitrous oxide is commonly used from tanks or whippets, which contain liquefied nitrous oxide which is under pressure. If nitrous oxide is administered directly from a whippet or tank, the expanding gas will be very cold and is capable of freezing the nose, lips and throat (including vocal cords) of the user. The gas is also under constant pressure and can cause ruptures in lung tissue. Both dangers can be prevented by releasing the nitrous oxide into a balloon before inhalation, so it will warm up and have normal pressure when inhaled.
If nitrous oxide is administered in it's pure form, without supplemental oxygen, it can cause hypoxia (low levels of oxygen in the blood). Hypoxia can cause headache, brain damage, and finally death through suffocation. A few breaths of pure nitrous oxide are unlikely to be a problem, but if nitrous oxide is administered through a mask or equivalent, 20% oxygen (by volume) has to be added (2l oxygen for each 8l nitrous oxide). Note that it is not possible to the user to determine whether he/she has enough oxygen, because nitrous oxide does not cause shortness of breath. Hypoxia can also happen if pure nitrous oxide is administered through a garbage bag (can fall over the face) or in a closed room (closet, car or other sealed space).
Different sources of nitrous oxide may contain harmful contaminants. Automotive grade nitrous oxide (NOS, NX) is contamined with sulphur dioxide and should not be inhaled. Food grade nitrous oxide from whippets may contain oily residues, which may be harmful if inhaled. Medical grade nitrous oxide is the highest purity of nitrous oxide available, as it is specifically produced for human consumption.
Nitric acid (NO) should not be confused with nitrous oxide. Nitric oxide is an industrial gas which decomposes lung tissue if inhaled. This can cause irreversible lung damage and death. Containers containing carbon dioxide may be mistaken for whippets containing nitrous oxide, but this is usually quickly noticed by the user, because high concentrations of carbon dioxide rapidly produce shortness of breath, which doesn’t appear with nitrous oxide. Nitrous oxide is colourless and has a slightly sweet taste. Anything that smells strong or has an unusual taste is either contaminated nitrous oxide or not nitrous oxide at all.