Definition (Encyclopedia of Global Warming)
A colorless gas with a sweet odor, nitrous oxide is one of the many oxides of nitrogen. Sometimes called laughing gas, funny gas, nitrogen suboxide, or dinitrogen monoxide, it was first manufactured by Joseph Priestley, an English chemist, in 1775. It can be used to render a person insensible to pain in short surgical procedures; if inhaled for too long a period, it will cause death. It is also used as a propellant in aerosals and as an oxidizer to increase a racing-car engine’s power output.
(The entire section is 86 words.)
Significance for Climate Change (Encyclopedia of Global Warming)
Nitrous oxide is a trace gas produced by human industrial activity that affects the environment as do the other greenhouse gases (GHGs) and, as such, is limited by the Kyoto Protocol. (The other nitrogen oxides are not considered to be GHGs.) Another source of nitrous oxide is nitrogen fertilizers. Nitrous oxide also occurs naturally as a by-product of the bacteria in soil and water, particularly in tropical forest areas, and in animal waste products. Nitrous oxide may have slightly less effect than the halocarbons, as nitrous oxide reacts naturally with soil and water, so is less likely to make its way into the atmosphere. However, one molecule of N2O in the atmosphere has two to three hundred times the warming effect of one molecule of CO2.
As light from the Sun enters the atmosphere, some of that light gets scattered by molecules in the air or gets reflected from clouds back into space. Some of the light that reaches Earth is reflected back into space, such as light that bounces off snow or ice. Much of the light that reaches Earth is absorbed into the Earth and retained as heat. The Earth’s surface warms and emits infrared photons, which make several passes between the Earth and the atmosphere, warming the atmosphere and the Earth as they go back and forth. Eventually, these infrared photons return to space.
The GHGs, including nitrous oxide, all have three or more atoms. They are able to absorb...
(The entire section is 552 words.)
Further Reading (Encyclopedia of Global Warming)
Cowie, J. Climate Change: Biological and Human Aspects. New York: Cambridge University Press, 2007. Reviews past and projects future climate changes due to GHG release.
Emanuel, Kerry. What We Know About Climate Change. Cambridge, Mass.: MIT Press, 2007. Discusses how GHGs, including nitrous oxide, have increased in the atmosphere and the climate changes they may cause.
Fagan, B. M. The Little Ice Age: How Climate Made History, 1300-1850. New York: Basic Books, 2001. Reviews the history of climate change over time, discussing whether the current changes are part of a natural cycle.
Flannery, Tim. We Are the Weather Makers: The Story of Global Warming. Rev. ed. London: Penguin, 2007. Argues that global warming is real, providing definitions and models.
Hoffman, Jennifer, Tina Tin, and George Ochoa. Climate: The Force That Shapes Our World and the Future of Life on Earth. London: Rodale Books, 2005. Explains how human actions have caused a shift in the climate; includes photos, graphs, diagrams, and maps.
Marshall, John, and R. Alan Plumb. Atmosphere, Ocean, and Climate Dynamics. Boston: Elsevier Academic Press, 2008. Discusses changes in the atmosphere and how those changes affect the oceans.
(The entire section is 183 words.)
Nitrous Oxide (Encyclopedia of Nursing & Allied Health)
Nitrous oxide is a colorless, sweet-smelling gas used as an anesthetic, most commonly during dental procedures.
Nitrous oxide, also called laughing gas, is the weakest form of sedation to aid in the relaxation of the anxious dental patient. When inhaled, nitrous is absorbed by the body and has a quick-acting calming effect on the patient.
The nitrous gas used in dental offices is actually a blend of two gases: oxygen and nitrous oxide. Mixed together it has a sweet-smelling aroma that gives a sense of well-being and aids in relaxation of the entire body. It causes light, conscious sedation, while the patient still retains the ability to respond to verbal commands.
Nitrous oxide has three kinds of sedative characteristics, including:
- Conscious sedation: Being awake and able to interact vocally with the dental staff, but feeling completely relaxed.
- Inhalation sedation: Becoming sedated through inhalation with the nose or mouth with a sedative agent such as nitrous oxide.
- Psychosedation: Nitrous oxide acts on the psyche or the central nervous system in such a way that pain impulses are not relayed to the cerebral cortex or their interpretation is altered.
According to the American Academy of Pediatric Dentistry, nitrous oxide/oxygen is the safest sedative in dentistry. It is non-addictive, mild, and easily administered to the patient. It is a safe, effective technique for calming patient fears of the dental office and procedures to be performed.
The concentration of nitrous oxide in the oxygen mixture varies, allowing for a range from light to deep sedation, depending on the apprehension, anxiety, fear, and pain the patient is experiencing. Consideration of the patient risks due to health issues or age may determine the amount of gas used during the dental procedure. Commonly used first in the dental office as a calming agent before an injection of a local anesthetic, nitrous oxide is inhaled through a nosepiece attached to the patient's face. From two separate tanks, two tubes carry the oxygen and the nitrous oxide gases to the nosepiece, where they are combined into one gas. Each tank has separate controls that indicate how much oxygen and nitrous are being used at any given time. The minimum number of people involved in the administration of the gas should be two, the dentist or other licensed professional and an assistant trained to monitor the patient during the procedure to make certain the amount of gas flowing through both tubes is correct. The effectiveness of all procedures using nitrous oxide is greatly enhanced by a quiet environment. Near the end of the dental procedure the flow of nitrous oxide is shut off and the patient is allowed to inhale 100% oxygen. The body quickly dissipates the nitrous oxide, and the patient begins to come out of the conscious sedated state.
Pregnant women should not use or handle nitrous oxide, because studies of pregnant mice and rats exposed to nitrous oxide have linked the use of the gas with birth defects.
Monitoring the control panels from each tank of oxygen and nitrous oxide at the beginning of each day is essential for safe practice. Daily checking of the tubes and nosepiece is vital to make certain they are free of blockages and small tears.
The tanks of oxygen and nitrous oxide should have an oxygen fail-safe system that is calibrated weekly. All emergency equipment should be functional and within reach.
Health care team roles
The dental office staff, including the dentist, dental hygienist, and dental assistant working as team, help create a calm environment. To ensure an adequate supply, the supervising dental assistant should monitor the amount of gas in each tank of oxygen and nitrous oxide, and schedule tank replacements as necessary. At least one back-up tank of each gas should be on hand, in addition to the ones being actively used with patients.
The front office staff maintains a current health history on each patient seen in the office. This health history has all known allergies or medical problems kept up to date for the dentist to refer to when deciding if nitrous oxide is safe for a particular patient.
The dental assistant in charge of the patient during the conscious sedation needs to document the heart rate, blood pressure, respiratory rate, and responsiveness of the patient periodically during the procedure, including the few minutes of recovery period when the patient is inhaling 100% oxygen.
Many state laws require dental offices to have a license for housing a nitrous oxide unit and administering the gas. Dentists and dental hygienists receive training for using the gas in their degree courses. Continuing education courses on how to administer nitrous oxide are offered for the dental assistant. However, the dental assistant can only monitor the patient under the guidance of a licensed general dentist or licensed dental hygienist. A separate test is required to become fully licensed for use without supervision.
Anesthesia complete or partial loss of sensation.
Conscious sedationeing awake during a procedure, able to respond to questioning, but completely relaxed.
General sedationeing completely asleep during the procedure.
Inhaled sedationeaching a sedated state through inhalation of the nose or mouth with a sedating agent, such as nitrous oxide.
Sedativen agent having a calming, relaxing effect.
Nitrous Oxide. Brochure. American Academy of Pediatric Dentistry (AAPD) Brochure. 2001. <<a href="http://aapd.org/publications/brochures/nitrous.html">http://aapd.org/publications/brochures/nitrous.html>.
Academy of General Dentistry (AGD). 211 East Chicago Ave., Chicago, IL 60611. (312) 440-4300. <<a href="http://www.agd.org">http://www.agd.org>.
American Academy of Pediatric Dentistry. 211 East Chicago Avenue, Suite 700. Chicago, IL 60611-2663. <<a href="http://aapd.org">http://aapd.org>.
Anesthesia. Academy of General Dentistry. <<a href="http://www.agd.org/consumer/factsheets/anesthesia.html">http://www.agd.org/consumer/factsheets/anesthesia.html>.
Cindy F. Ovard, RDA
Nitrous Oxide (Encyclopedia of Drugs and Addictive Substances)
- What Is It Made Of?
- Are There Any Medical Reasons for Taking This Substance?
- Usage Trends
- Effects on the Body
- Treatment for Habitual Users
- The Law
What Kind of Drug Is It?
Nitrous oxide is a type of anesthetic, a substance used to deaden pain. It can alleviate pain without causing a loss of consciousness. Best known by the nickname "laughing gas," nitrous oxide is used primarily by dentists to keep patients comfortable during painful procedures. It can also be used in combination with other drugs as a . When administered by trained medical professionals, the gas is considered a safe and effective form of anesthesia.
As a recreational drug drug used solely to get high, not to treat a medical conditionitrous oxide is classified as an inhalant. (An entry on inhalants is available in this encyclopedia.) Inhalants contain dangerous vapors, which are gases or fumes that can be irritating or physically harmful when breathed in. Vapors from inhalants produce psychoactive, or mind-altering, effects when breathed in through the mouth or nose.
More than 1,000 different household and industrial productsll readily accessible to consumers of any agere sniffed or huffedInhaling through the mouth, often from an inhalant-soaked cloth. for their intoxicating effects. Glues, paints, markers, nail polish, correction fluid, and shoe polish are among the most commonly abused inhalants.
Among young teens, nitrous oxide is typically obtained from canned whipped cream available at grocery stores. Nitrous oxide gas is used to propel, or to drive out, the whipped cream from the can. Sales of nitrous oxide to older teens and adults usually occur at dance clubs and all-night dance parties called or through Internet transactions.
In the 1700s and the 1800s, chemists, doctors, and dentists in Europe and the United States experimented with three different anesthetic gases: nitrous oxide, ether (EETH-uhr), and chloroform (KLOR-uh-form). These compounds revolutionized surgical and dental procedures. While under the influence of an anesthetic gas, a patient's perception of pain is altered. Nitrous oxide, ether, and chloroform all dull or block painful sensations. They also produce a rather intense high.
The intoxicating side effects of the gases, however, led to their use and abuse as recreational drugs. A research report titled "Inhalant Abuse," prepared by the National Institute on Drug Abuse (NIDA) and updated in 2005, noted that "nitrous oxide is the most abused of these [three] gases."
Nitrous oxide is a gas with both anesthetic and analgesic (pain relieving) properties. It was first discovered in 1772 by British scientist, theologian, and philosopher Joseph Priestley (1733804). Earlier, Priestley had identified oxygen, which he termed "phlogisticated (floh-JISS-tih-kay-ted) air." The term "phlo-gis-tic" comes from a Greek word meaning "flammable."
Nitrous Demonstrations: An Unusual Form of Entertainment
Although Priestley is credited with discovering nitrous oxide, another scientist recognized the potential value of its numbing and intoxicating effects. This man was Sir Humphry Davy (1778829), a British chemist who experimented with the gas on himself and his friends. In a book Davy wrote on the subject in 1800, he suggested that nitrous oxide's ability to dull pain might make it a useful anesthetic in surgeries. But, as Julie M. Fenster noted in Ether Day: The Strange Tale of America's Greatest Medical Discovery and the Haunted Men Who Made It, "no one took his suggestion."
And so, despite Davy's writings on the subject, nitrous oxide was not put to use in the medical field for another four decades. Apparently, according to historical sources, pain was such an accepted part of medical intervention during the early nineteenth century that neither scientists nor doctors seriously considered trying to ease it. Instead, nitrous oxide, which had earned the nickname "laughing gas," enjoyed popularity as a way for the British upper classes to entertain themselves at social gatherings. "The gas was soon offered at dinner parties instead of wine," wrote Fenster. It was even demonstrated in theaters and at festivals. In 1824, crowds in London were amazed by a show called "M. Henry's Mechanical and Chemical Demonstrations." The highly successful performances showed the uninhibiting effects of nitrous oxide on audience volunteers eager to try the gas.
"A New Era in Tooth-Pulling!"
Meanwhile in the United States, laughing gas was featured in traveling medicine shows and carnivals. Gardner Q. Colton (1814898), a former medical student, made a good living by giving public demonstrations of nitrous oxide. In New York City in 1844, he organized the "Grand Exhibition of Nitrous Oxide" on Broadway, charging the then-outrageous price of twenty-five cents per ticket. Colton moved his act to Hartford, Connecticut, later that year. Dr. Horace Wells (1815848), a dentist in Hartford, attended the nitrous exhibition with his wife. The evening's entertainment changed Wells' life forever.
Both Wells and his wife were among the volunteers from the audience who tried the laughing gas. The couple apparently engaged in some silly antics after sampling the nitrous oxide, but Wells was actually more interested in the effects of the gas on another member of the audience. A local man named Sam Cooley had seriously gashed his legs on a piece of furniture while stumbling around the stage on his nitrous high. His knees were bleeding badly, but he felt no pain. In fact, he didn't even realize he had been hurt. Wells was stunned by the effect of the gas and concluded that nitrous oxide might be useful as a medical anesthetic. In Wells' own often-quoted words, it was the beginning of "a new era in tooth-pulling!"
In keeping with the tradition of scientific experimentation in the nineteenth century, Wells used himself as a test subject. He devised a test case involving his dental colleague and friend Dr. John Riggs, who agreed to extract a tooth from Wells' mouth. The experiment took place on December 11, 1844. Wells asked Colton to set up his nitrous oxide equipment at the office Wells shared with Riggs. Wells administered the gas himself and soon nodded off from its effects. Riggs immediately pulled a sore wisdom tooth from Wells' mouth. The nitrous oxide had worked. Wells woke up shortly after the procedure and reported feeling no pain.
Considering his test a success, Wells began using nitrous oxideuite successfullys an anesthetic in his dental practice. When people heard about the new dental procedure, Wells' business increased. He was confident that painful dentistry would soon become a thing of the past.
A Demonstration Gone Bad
In January of 1845, before an audience of experts from the Harvard Medical School and Massachusetts General Hospital, Wells attempted to demonstrate the anesthetizing effects of nitrous oxide. He used a bag of the gas to sedate a patient before removing a tooth. However, the bag was withdrawn too soon, and the patient awoke before the procedure was complete. The experiment was considered a failure, and Wells was devastated. He never fully recovered from the disastrous demonstration and committed suicide in 1848. More than a decade later, in the early 1860s, the medical community came to understand and accept nitrous oxide as a valuable tool. It was finally being used not as a prop in a traveling sideshow, but as the anesthetic that Wells had suggested.
By 1871, companies in both the United States and Great Britain were producing compressed nitrous oxide in cylinders. As of 2003, according to the Compressed Gas Association (CGA), nearly 90 percent of the nitrous oxide manufactured in the United States is intended for medical and dental applications. Another 5 to 8 percent is used in the food industry. Other legitimate uses for nitrous oxide include the manufacture of airbags, semiconductors, and fuels that boost horsepower in race car engines.
However, the laughing gas parties and public demonstrations of the early 1800s evolved into a serious problem of abuse that has persisted into the twenty-first century. The gas is often sold at dance clubs and raves in balloons. Whipped cream cartridges, nicknamed "whippets," also contain nitrous oxide. These cartridges are sold through restaurant supply companies but are frequently purchased for illegal use.
What Is It Made Of?
Nitrous oxide is a compound made from nitrogen and oxygen. Its chemical formula is N2o The gas itself is clear and colorless, with a slightly sweet odor and taste. Nitrous oxide should not be confused with the potentially toxic gas known as nitric oxide (NO). Nitric oxide is found in the atmosphere as an air pollutant. It is also found in very small amounts in the human body, where it helps to move oxygen to the tissues and transmit nerve impulses.
Nitrous oxide is best described as a liquefied gas. It is from a compound found in fertilizers and explosives. This compound, ammonium nitrate (NH4NO3), forms steam and nitrous oxide when heated. The nitrous oxide is then processed and turned into a liquid form for storage in tanks, cylinders, or cartridges.
Pure nitrous oxide is deadly. The gas must be mixed with oxygen to be used safely as an anesthetic.
How Is It Taken?
N2O is used as an propellant in cans of whipped cream and some other food and beverage products. These products are a primary source of nitrous oxide for some abusers.
Depending on its intended use, nitrous oxide can be purchased in varying "grades," or degrees of purity. A food-grade version of the gas is sold to restaurants and caterers in small, bullet-shaped, metal cartridges. These cartridges are perfectly legal for use in the food preparation industry. Nitrous abusers refer to them as "whippets." One whippet delivers enough nitrous oxide to produce a three- to five-minute high. To release the nitrous oxide from a whippet, the high-pressure seal on the canister is pierced with a device called a "cracker." The resulting hole then emits a stream of nitrous oxide gas, which users inhale directly or use to inflate a balloon. Mishandling the cracker or piercing the wrong part of the canister can result in explosions and serious injuries.
Dealers often sell nitrous oxide to users at concerts, clubs, and raves. Instead of using small food-grade canisters, however, they use huge medical-grade nitrous tanks to dispense the gas into balloons. (Medical grade nitrous oxide is considered a prescription drug. These tanks can only be purchased legally by qualified medical personnel.) Nitrous-filled balloons sell for $3 to $5 apiece. One large cylinder of nitrous oxide can fill enough balloons to generate $20,000 to $30,000 in sales.
Sometimes, users fill plastic bags with nitrous oxide gas and then place the bags over their mouths or heads. This method of use carries a particularly high risk for serious injury and possible death. The user can easily lose consciousness and suffocateUnable to breathe; death caused by a blockage of air to the lungs. on the bag. Suffocation can also occur when nitrous oxide is consumed in large quantities in poorly ventilated spaces, such as closed-up cars or closets.
Are There Any Medical Reasons for Taking This Substance?
As an anesthetic, nitrous oxide has many legitimate uses. Its ability to reduce anxiety, restlessness, and fear makes it especially useful in the field of dentistry. Adults and children over the age of six have been shown to experience less discomfort and mental distress when given nitrous oxide during short but painful medical or dental procedures.
American obstetricianshysicians specializing in the birthing processsed nitrous oxide as a common pain management tool for women in labor until the early 1970s. By the early twenty-first century, however, the anesthetic had been replaced by newer drugs in the United States. However, a half-and-half mixture of nitrous oxide and oxygen was still being used in the United Kingdom to ease the pain of childbirth.
In a 2005 article for The Age, Julie Robotham reported on a group of Australian doctors who believed that nitrous oxide should no longer be used as a base for general anesthetics. According to an international study involving more than 2,000 patients, the use of nitrous oxide "doubles the rate of serious vomiting and after surgery," explained Robotham. Both of these side effects can result in a patient's death.
Nitrous oxide is among the substances of abuse categorized as inhalants. It gained popularity on the dance club circuit because of its supposed effects. It is also preferred over other inhalants such as spray paints, shoe polish, markers, and glue because it does not leave stains on skin and clothes.
Food-grade nitrous oxide chargers, better known as "whippets," are available by the box or the case and are sold on the Internet. David Holthouse commented in a Phoenix New Times article, "The cardboard boxes [of whipped cream chargers] are decorated with images of fancy desserts and fresh berries, next to warnings not to directly inhale the contents." Whippets were blamed for the death of a twenty-year-old Virginia Polytechnic Institute student in 1999. The student suffocated after inhaling nitrous oxide from whipped cream cartridges he had purchased through an online merchant.
Patterns of Inhalant Abuse
The Office of National Drug Control Policy (ONDCP) Web site notes in its "Inhalants: Drug Facts" publication that "typically, first use of inhalants occurs between late childhood and early adolescence." According to the "2003 National Survey on Drug Use and Health (NSDUH)"he latest survey data available in 2005ore youths age twelve and thirteen used inhalants than marijuana between 2002 and 2003. (An entry on marijuana is available in this encyclopedia.)
But general statistics on the broad category of inhalant abuse do not necessarily reflect the rate of nitrous oxide abuse. The 2003 NSDUH reports that less than one third of 1 percent of U.S. twelve and thirteen year olds reported using nitrous oxide as a recreational drug in their lifetimes. However, the rate of glue and/or shoe polish inhalation among youths in the same age group was nearly fifteen times higher than that, at about 4.3 percent.
Heavy nitrous abusers tend to be eighteen years of age or older. This may be due to N2O's growing status as a club drug. According to NIDA, nitrous oxide use occurs frequently at raves, where it is often mixed with other club drugs such as ketamine, ecstasy (MDMA), GHB, and LSD (lysergic acid diethylamide). (Separate entries on each of these drugs are available in this encyclopedia.) By the early 2000s, nitrous oxide had gained popularity as a drug that enhanced sexual pleasure. It was even featured in a 2004 episode of the television series CSI: Miami as the cause of death in an otherwise healthy young woman.
Abuse in the Medical and Dental Fields
There have also been cases of nitrous oxide abuse among healthcare professionals. Dentists and anesthesiologistsMedical doctors trained to use medications to sedate a surgery patient. with easy access to the drug seem to be at a higher risk than the general public of developing nitrous-related dependence problems. Dependence is the belief that a person needs to take a certain substance in order to function.
Substance abuse is also especially high among healthcare professionals who administer anesthesia in a hospital setting. According to the American Association of Nurse Anesthetists (AANA), about 15 percent of anesthesia providers are substance abusers. "Nurse anesthetists are dying from accidental overdose or from suicide," reported Carlos "Rusty" Ratliff in "Anesthetists in Recovery: Chemical Dependency in the Profession." Like dentists, certified registered nurse anesthetists have large supplies of nitrous oxide readily available to them. Consequently, nitrous oxide is one of the drugs these professionals may end up abusing.
"Chemical Dependence in Anesthesiologists," a document developed by the ASA TaskForce on Chemical Dependence, addresses the problem of drug abuse among anesthesiologists. Although addicted medical doctors typically become hooked on such as fentanyl, nitrous oxide was mentioned by the ASA as another potential drug of abuse. (An entry on fentanyl is available in this encyclopedia.)
Calling Attention to a Serious Problem
NIDA began an intensive campaign against inhalant abuse in 2005. This action was prompted by the results of the 2004 Monitoring the Future (MTF) study, an annual survey of drug use among young people in the United States. The MTF survey is conducted by the University of Michigan with funding from NIDA. Findings for 2002 through 2004 indicate that inhalant abuse among eighth-grade students was on the rise during that period. As of 2004, approximately 17.3 percent of eighth graders in the United States had abused an inhalant at some time in their lives. That represents an increase over the 2003 figure of 15.8 percent. This "upward trend in use," according to the MTF report, was accompanied by a "decline among eighth graders in the perceived risk of using inhalants."
Effects on the Body
Nitrous oxide acts as a on the human body. Once inhaled, the gas enters the bloodstream through the lungs. The blood then carries it throughout the rest of the body. It reaches the brain quickly, affecting vital functions such as breathing and heart rate. It also alters other mechanisms of the nervous system, such as the activity of neurotransmittersA substance that helps spread nerve impulses from one nerve cell to another. that regulate thought processes, behavior, and emotions.
A single balloon filled with nitrous oxide can bring on a shortlived but intense high. The overall effects of the gas depend largely on the user's frame of mind. It can further stimulate an already excited user, or it can sedate a more relaxed user. Symptoms of a nitrous oxide high include giddiness, a loss of balance, slurred speech, twitching, mental confusion, and an inability to feel pain. After the effects of the gas wear off, users may experience side effects such as nausea (upset stomach), restlessness, tiredness, difficulty concentrating, and the appearance of spots before their eyes.
How Nitrous Oxide Works
Nitrous oxide alters the user's perception of time. Because the effects of a single "hit" last only three minutes or so, some abusers inhale the gas many times over the course of a few hours. Such attempts to maintain a nitrous high can be fatal, since continued
breathing of the gas causes . In addition, the possibility of brain damage increases when the brain does not receive sufficient amounts of oxygen.
Abusers also run the risk of vomiting and losing consciousness while intoxicated by nitrous oxide. Unconscious individuals are not able to clear their own airways of vomit. This increases the possibility of death by choking. Even if vomiting does not occur, an individual who loses consciousness from an overdose of nitrous oxide is likely to stop breathing. In addition, pure nitrous oxide takes the place of oxygen in the lungs. This process could result in asphyxiationeath or unconsciousness caused by the inability to breathenless the unconscious person is quickly moved to an area with fresh air. According to the CGA, death frequently occurs when abusers of the gas "attempt to achieve a higher state of euphoria [happiness and well-being]" by breathing "pure N2O in a confined spacen a small room, inside an automobile or other vehicle cab, or by placing their head inside a plastic bag."
Death by overdose of nitrous oxide is very difficult to recognize. It leaves no telltale signs for a coroner or medical examiner to identify. Under normal circumstances, blood carries oxygen to the tissues and organs of the body. But nitrous oxide pushes oxygen out of the blood. Without a sufficient supply of oxygen in the bloodstream, the tissues and organs of the body cannot function properly. Damage to the brain and other organs may result. Long-term abuse of nitrous oxide can also interfere with the production of blood cells in the bone marrowSoft tissue in the center of bones where blood cell formation occurs..
As nitrous oxide takes the place of oxygen in the lungs, a deficiency in vitamin B12 may result. This sparks a series of negative effects within the body. The user's red blood cell count decreases, leading to anemia (uh-NEE-mee-uh), a condition in which the blood is lacking in oxygen-carrying red blood cells. Nerve damage may also occur, leading to difficulty walking as well as tingling, numbness, or pain in the arms and legs. These side effects are usually reversible if nitrous use is stopped.
People who have a genetic disorder called phenylketonuria (fenn-uhl-kee-tuh-NORR-ee-yuh) should be particularly careful about nitrous oxide use. Phenylketonuria (PKU) is an inherited disorder that interferes with the breakdown of a certain protein called phenylalanine (fenn-uhl-AL-uh-neen). The protein is found in milk, eggs, and other foods. Individuals with PKU require a special diet that can cause a vitamin B12 deficiency. Because nitrous oxide can remove even more B12 from the bloodstream, the possibility of nerve and brain damage is especially high under these circumstances.
Nitrous users who inhale the gas while standing risk falling down and possibly breaking a limb or suffering a head injury. In addition, injury to the face, mouth, throat, and hands may occur because of the extremely low temperature of nitrous oxide. In an article for the Phoenix New Times, David Holthouse warned, "When N20 is released from a whippit, it's cold enough to flash-freeze spittle." Sometimes, users who get hurt while high on nitrous oxide are completely unaware of their injuries because of the numbing effect of the gas.
Improper handling of any compressed gas tank or cylinder can also cause injuries. Attempting to inhale a gas like nitrous oxide directly from a large gas cylinder can damage the lungs beyond repair. The force of the gas entering the lungs is so powerful that the air sacs in the lungs actually burst. Victims die in a matter of seconds due to internal bleeding. Inhaling any compressed gas is especially risky for people with ear problems, as the pressure of the gas may damage the inner ear.
N2O Plus Pre-Existing Conditions Can Equal Death
Individuals with certain medical conditions may also suffer severe and potentially fatal side effects from the use of nitrous oxide. For example, anyone with a history of , asthma, airway obstruction, head injury, or chest infection should not take nitrous oxide under any circumstances.
Nitrous oxide should not be given to pregnant women in the early or middle stages of pregnancy. The gas can interfere with the baby's development and may cause the mother to lose the baby before it is born. Heavy, ongoing nitrous oxide exposure during pregnancy has been shown to cause birth defects in animals.
Reactions with Other Drugs or Substances
Nitrous oxide produces effects on the body similar to those of alcohol, which is a depressant. When used along with other depressants, nitrous oxide can slow the user's breathing rate to a dangerously lownd sometimes even deadlyevel.
The increasing use of nitrous oxide in combination with other club drugs poses serious risks to users. In the event of a multiple-drug overdose, emergency medical personnel may not be able to identify the mix of drugs the patient has consumed. This further complicates emergency treatment and could delay lifesaving measures.
Treatment for Habitual Users
Abuse of nitrous oxide alone has not been shown to cause withdrawal symptomshe physiological effects of terminating use of an addicting drug. Because of this, it is not considered an addictive or habit-forming substance. At the very least, however, the gas does appear to cause . "Supposedly, nitrous is nonaddictive," wrote Holthouse, but "habitual users have a [tendency] to sit around doing whippit after whippit until all the whippits are gone, then go buy more whippits."
Nitrous oxide is eliminated from the body rapidly. However, if the patient has been abusing other drugs as well, the detoxification period, in which one rids the body of the drugs' toxins, could take up to forty days, depending on the chemicals involved. After detox, the primary goal of treatment is avoiding future drug use.
Substance abusers need to identify the underlying causes of their drug use. To curb drug abuse, they may need to alter their lifestyles substantially. This may include not going to the same clubs or hanging out with the same circle of friends if they are continuing to use drugs illegally. It may mean finding a new supportive, drugfree network of friends. Nitrous oxide abusers, like other substance abusers, typically benefit from individual therapy that focuses on changing unhealthy patterns of behavior and developing better coping skills. Group therapy and self-help organizations can also assist in the recovery process. Discussing addiction in a group setting can help drug abusers gain insight into their own thoughts and behaviors through the eyes and experiences of others.
There are few studies that focus specifically on the illicit use of nitrous oxide. Rather, the abuse of this gas is usually lumped into the general category of inhalant use. According to the 2003 NSDUH report, young adolescents who use inhalants tend to have more academic, social, and behavioral problems than those who do not. High school dropout rates and involvement in serious fights, thefts, and illicit drug use were especially high among inhalant abusers. These statistics reflect patterns seen among users of all inhalants, not just nitrous oxide.
Specifically, nitrous oxide abuse may cause mood swings and personality changes in heavy users. Users report that the gas decreases their . People with lowered inhibitions tend to take more chances and engage in riskier behavior than they would if they were not high. Nitrous oxide is also viewed as an aphrodisiac (sex enhancer) in some social circles. Some users might engage in unsafe sex, thereby increasing their risk for contracting sexually transmitted diseases, including HIV (the human immunodeficiency virus), which can lead to AIDS (acquired immunodeficiency syndrome).
Nitrous oxide is regulated by the U.S. Food and Drug Administration (FDA) as a food-grade propellant, medical-grade gas, and prescription drug. In 1971, the state of Maryland began controlling its sale and distribution. In the 1990s, in an attempt to curb the growing abuse of the gas, a number of other states followed suit. Connecticut, Arizona, Texas, Michigan, and Wisconsin were among the states that passed laws placing strong safeguards and stricter penalties on the illicit use of nitrous oxide.
Selling nitrous oxide for use as a drug carries stiff penalties. Distributors face up to 15 years in prison and fines of up to $1.5 million. In 2001, an Arizona man was sentenced to a 15-month jail term and fined $40,000 for a nitrous oxide sale that resulted in the death of a Virginia college student.
Until federal legislation is passed to prohibit the possession, inhalation, and distribution of nitrous oxide for purposes of intoxication, the CGA has proposed a list of recommendations regarding its use. The main goal of these recommendations is to keep the gas from falling into the wrong hands. Among the guidelines proposed by the CGA are:
- restricting the sale of nitrous oxide to those who can prove they have a "legitimate use" for it
- encouraging legitimate users to store containers of the gas and other equipment in a secured area
- requiring medical and restaurant personnel to keep a careful count of used and unused cylinders
- reporting any thefts to the police immediately.
For More Information
Brecher, Edward M., and others. The Consumers Union Report on Licit and Illicit Drugs. Boston: Little Brown & Co., 1972.
Fenster, Julie M. Ether Day: The Strange Tale of America's Greatest Medical Discovery and the Haunted Men Who Made It. New York: HarperCollins, 2001.
Lobo, Ingrid A. Inhalants. Philadelphia: Chelsea House Publishers, 2004.
Menhard, Francha Roffe. The Facts about Inhalants. Tarrytown, NY: Benchmark Books, 2005.
Holthouse, David. "Softly into That Good Nitrous." Phoenix New Times (September 29, 1999).
Robotham, Julie. "Laughing Gas Unsafe, Say Doctors." The Age (May 5, 2005).
White, Josh. "Virginia Student's Death Leads to Drug Conviction." Washington Post (October 21, 2000).
"2003 National Survey on Drug Use and Health (NSDUH)." U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http://www.oas.samhsa.gov/nhsda.htm (accessed July 31, 2005).
"About Inhalants." National Inhalant Prevention Coalition. http://www.inhalants.com/about.htm (accessed July 31, 2005).
ASA Taskforce on Chemical Dependence. "Chemical Dependence in Anesthesiologists." American Society of Anesthesiologists. 1999. http://www.asahq.org/publicationsAndServices/chemical.html (accessed July 31, 2005).
"CGA/NWSA Nitrous Oxide Fact Sheet" (November 3, 2003). Compressed Gas Association. (accessed July 31, 2005).
"Drugs of Abuse: 2005 Edition." U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea/pubs/abuse/index.htm (accessed July 31, 2005).
"Drugs of Abuse: Uses and Effects Chart" (June, 2004). U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea/pubs/abuse/chart.htm (accessed July 31, 2005).
Haynes, Thomas L. "Escaping Addiction: The Door to Freedom" (November, 2004). American Dental Association. (accessed July 31, 2005).
"Inhalant Abuse: NIDA Research Report Series" (2005). National Institutes of Health, National Institute on Drug Abuse. http://www.nida.nih.gov/researchreports/inhalants (accessed July 31, 2005).
"Inhalant Use Is Associated with Other Substance Use and Delinquency" (March 17, 2005). U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov/news/newsreleases/050317nr_inhalants.... (accessed July 31, 2005).
"Inhalants: Drug Facts" (February, 2003). Office of National Drug Control Policy. http://www.whitehousedrugpolicy.gov/publications/factsht/inhalants/index.htm (accessed July 31, 2005).
"INHALANTS.DRUGABUSE.GOV." National Institutes of Health, National Institute on Drug Abuse. http://www.inhalants.drugabuse.gov/ (accessed July 31, 2005).
Johnston, Lloyd, et. al. "Overall Teen Drug Use Continues Gradual Decline, but Use of Inhalants Rises" (December 21, 2004). Monitoring the Future. http://www.monitoringthefuture.org/ and http://www.nida.nih.gov/Newsroom/04/2004MTFDrug.pdf (both accessed July 31, 2005).
"NIPC Inhalant Update Alert." National Inhalant Prevention Coalition. http://www.inhalants.com/alert_update.pdf (accessed July 31, 2005).
"Nitrous Oxide Issues and Incidence of Abuse" (November 3, 2003). Compressed Gas Association. (accessed July 31, 2005).
"Nitrous Oxide (Laughing Gas)." MedicineNet.com, December 13, 1998. http://www.medterms.com/script/main/art.asp?articlekey=7793 (accessed July 31, 2005).
"The NSDUH Report: Inhalant Use and Delinquent Behaviors among Young Adolescents" (March 17, 2005). Office of Applied Studies, Substance Abuse and Mental Health Services Administration. http://www.oas.samhsa.gov/2k5/inhale/inhale.htm (accessed July 31, 2005).
Poremba, Sue Marquette. "Sucking the Life from Your Child: The Danger of Inhalants." Preteenagers Today. http://preteenagerstoday.com/resources/articles/inhalents.h... (accessed July 31, 2005).
Ratliff, Carlos "Rusty." "Anesthetists in Recovery: Chemical Dependency in the Profession" (January, 1996). American Association of Nurse Anesthetists. (accessed July 31, 2005).
"Spring 2005 NIPC Inhalant Prevention Update." National Inhalant Prevention Coalition. http://www.inhalants.com/SPRING_UPDATEMAY_2005.pdf (accessed July 31, 2005).
"After the Fall." CSI: Miami (television series), CBS, November 29, 2004.
See also: Amyl Nitrite; Inhalants