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Nitrous oxide is [[neurotoxic]] and long-term or habitual use can cause severe neurological damage.<ref name=nangs>{{cite journal |vauthors=Evans EB, Evans MR |title=Nangs, balloons and crackers: Recreational nitrous oxide neurotoxicity |journal=Aust J Gen Pract |volume=50 |issue=11 |pages=834–838 |date=November 2021 |pmid=34713284 |doi=10.31128/AJGP-10-20-5668 |type=Review}}</ref>
Since nitrous oxide can cause dizziness, [[Dissociation (psychology)|dissociation]], and temporary loss of [[motor control]], it is unsafe to inhale while standing up. So part of safer use can be to inhale it while seated, because there is a decreased risk of injury from falling. Inhalation directly from a tank poses serious health risks, as it can cause [[frostbite]] since the gas is very cold when released. For those reasons, most recreational users will discharge the gas into a balloon or [[whipped cream]] dispenser before inhaling.<ref>{{Cite journal|last1=van Amsterdam|first1=Jan|last2=Nabben|first2=Ton|last3=van den Brink|first3=Wim|date=2015-10-22|title=Recreational nitrous oxide use: Prevalence and risks|journal=Regulatory Toxicology and Pharmacology |volume=73|issue=3|pages=790–796|doi=10.1016/j.yrtph.2015.10.017|issn=1096-0295|pmid=26496821}}</ref>▼
Nitrous oxide can be habit-forming, mainly because of its short-lived effect (generally from 1–5 minutes in recreational doses) and ease of access. Death can result if it is inhaled in such a way that not enough oxygen is breathed in. While the pure gas is not toxic, long-term use has been associated with [[vitamin B12]] deficiency and its symptoms: [[anemia]] due to reduced [[hemopoiesis]], [[neuropathy]], [[tinnitus]], and [[numbness]] in extremities. Pregnant women should not use nitrous oxide recreationally, because chronic use is also [[teratogen]]ic and [[fetus|foetotoxic]].▼
Inhaling industrial-grade nitrous oxide is also dangerous, as it contains many impurities and is not intended for use on humans. Food grade nitrous oxide is also not meant to be inhaled; the bulbs commonly have industrial lubricants from their manufacturing process on and in them. When the bulb is punctured, these solvents can aerosolize, introducing unknown particles into the gas. These lubricants commonly leave an oily residue on the bulb "cracker" or inside the whipped cream dispenser.<ref>Erowid F, Erowid E. "N2Oily: Nitrous Oxide Chargers—Residue and Usage Surveys." [https://erowid.org/chemicals/nitrous/nitrous_article2.shtml Erowid Extracts]. Nov 2009;17:12–14.</ref>▼
=== Nitrous oxide related deaths ===▼
From 1993 to 2016, only 30 death certificates in England and Wales mentioned nitrous oxide. Of those, 6 were in the 17-year period from 1993 through 2009, and 24 were in the 7-year period from 2010 through 2016.<ref>{{Cite web|url=https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/adhocs/007534drugrelateddeathsinvolvingnitrousoxide1993to2015|title=Drug-related deaths involving nitrous oxide, 1993 to 2016|date=28 September 2017|website=Office for National Statistics|access-date=14 February 2019}}</ref>▼
In 2018, an Ohio University freshman died of asphyxiation as a result of nitrous oxide ingestion from [[whipped-cream charger]]s, allegedly as part of a [[hazing]] ritual.<ref>{{cite news |author=Dakin Andone and Carma Hassan |title=Family files lawsuit in death of fraternity pledge at Ohio University |url=https://edition.cnn.com/2019/02/15/us/ohio-university-fraternity-death-lawsuit/index.html |access-date=10 November 2019 |work=CNN}}</ref>▼
In 2020, a fifteen-year-old Irish boy died after ingesting nitrous oxide,<ref>{{cite news |title='Just say no' - heartbroken father whose son died from laughing gas warns others to stay away from 'lethal' drug |url=https://www.independent.ie/irish-news/just-say-no-heartbroken-father-whose-son-died-from-laughing-gas-warns-others-to-stay-away-from-lethal-drug-39351032.html |access-date=10 July 2020 |work=independent |language=en}}</ref> leading to Ireland's [[Health Service Executive]] classing it as a [[dangerous drug]].<ref>{{cite news |last1=Gleeson |first1=Colin |title=Minister seeks report on use of laughing gas following death of a teenager |url=https://www.irishtimes.com/news/health/minister-seeks-report-on-use-of-laughing-gas-following-death-of-a-teenager-1.4299570 |access-date=10 July 2020 |work=The Irish Times |date=8 July 2020 |language=en}}</ref>▼
==Popularity==
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In Australia and New Zealand, nitrous oxide bulbs are known as "nangs", possibly derived from the sound distortion perceived by consumers.<ref>{{cite web|last1=Emory|first1=Sami|title=Will Nangs Kill You?|url=https://www.vice.com/en_au/article/78qpe9/will-nangs-kill-you|website=Vice|language=en-au|date=1 March 2017}}</ref><ref>{{cite web|url=http://www.smh.com.au/nsw/nanging-out-the-rise-of-nitrous-oxide-as-a-sydney-party-drug-20150820-gj4ai4.html|title='Nanging' out: the rise of nitrous oxide as a Sydney party drug|work=The Sydney Morning Herald|date=22 August 2015}}</ref>
▲Since nitrous oxide can cause dizziness, [[Dissociation (psychology)|dissociation]], and temporary loss of [[motor control]], it is unsafe to inhale while standing up. So part of safer use can be to inhale it while seated, because there is a decreased risk of injury from falling. Inhalation directly from a tank poses serious health risks, as it can cause [[frostbite]] since the gas is very cold when released. For those reasons, most recreational users will discharge the gas into a balloon or [[whipped cream]] dispenser before inhaling.<ref>{{Cite journal|last1=van Amsterdam|first1=Jan|last2=Nabben|first2=Ton|last3=van den Brink|first3=Wim|date=2015-10-22|title=Recreational nitrous oxide use: Prevalence and risks|journal=Regulatory Toxicology and Pharmacology |volume=73|issue=3|pages=790–796|doi=10.1016/j.yrtph.2015.10.017|issn=1096-0295|pmid=26496821}}</ref>
▲Nitrous oxide can be habit-forming, mainly because of its short-lived effect (generally from 1–5 minutes in recreational doses) and ease of access. Death can result if it is inhaled in such a way that not enough oxygen is breathed in. While the pure gas is not toxic, long-term use has been associated with [[vitamin B12]] deficiency and its symptoms: [[anemia]] due to reduced [[hemopoiesis]], [[neuropathy]], [[tinnitus]], and [[numbness]] in extremities. Pregnant women should not use nitrous oxide recreationally, because chronic use is also [[teratogen]]ic and [[fetus|foetotoxic]].
▲Inhaling industrial-grade nitrous oxide is also dangerous, as it contains many impurities and is not intended for use on humans. Food grade nitrous oxide is also not meant to be inhaled; the bulbs commonly have industrial lubricants from their manufacturing process on and in them. When the bulb is punctured, these solvents can aerosolize, introducing unknown particles into the gas. These lubricants commonly leave an oily residue on the bulb "cracker" or inside the whipped cream dispenser.<ref>Erowid F, Erowid E. "N2Oily: Nitrous Oxide Chargers—Residue and Usage Surveys." [https://erowid.org/chemicals/nitrous/nitrous_article2.shtml Erowid Extracts]. Nov 2009;17:12–14.</ref>
▲=== Nitrous oxide related deaths ===
▲From 1993 to 2016, only 30 death certificates in England and Wales mentioned nitrous oxide. Of those, 6 were in the 17-year period from 1993 through 2009, and 24 were in the 7-year period from 2010 through 2016.<ref>{{Cite web|url=https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/adhocs/007534drugrelateddeathsinvolvingnitrousoxide1993to2015|title=Drug-related deaths involving nitrous oxide, 1993 to 2016|date=28 September 2017|website=Office for National Statistics|access-date=14 February 2019}}</ref>
▲In 2018, an Ohio University freshman died of asphyxiation as a result of nitrous oxide ingestion from [[whipped-cream charger]]s, allegedly as part of a [[hazing]] ritual.<ref>{{cite news |author=Dakin Andone and Carma Hassan |title=Family files lawsuit in death of fraternity pledge at Ohio University |url=https://edition.cnn.com/2019/02/15/us/ohio-university-fraternity-death-lawsuit/index.html |access-date=10 November 2019 |work=CNN}}</ref>
▲In 2020, a fifteen-year-old Irish boy died after ingesting nitrous oxide,<ref>{{cite news |title='Just say no' - heartbroken father whose son died from laughing gas warns others to stay away from 'lethal' drug |url=https://www.independent.ie/irish-news/just-say-no-heartbroken-father-whose-son-died-from-laughing-gas-warns-others-to-stay-away-from-lethal-drug-39351032.html |access-date=10 July 2020 |work=independent |language=en}}</ref> leading to Ireland's [[Health Service Executive]] classing it as a [[dangerous drug]].<ref>{{cite news |last1=Gleeson |first1=Colin |title=Minister seeks report on use of laughing gas following death of a teenager |url=https://www.irishtimes.com/news/health/minister-seeks-report-on-use-of-laughing-gas-following-death-of-a-teenager-1.4299570 |access-date=10 July 2020 |work=The Irish Times |date=8 July 2020 |language=en}}</ref>
==Legality==
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