Heartbeat: Dangers of “laughing gas” drug warn Trust’s clinicians

October 20, 2022

Two of the Trust’s clinicians have stepped into the media spotlight to raise awareness about the rise in cases of nerve damage linked to the use of nitrous oxide.

We’ve seen a marked rise in admissions – from six patients between 2015 to 2020, to now roughly one every two weeks.

Both neurologist Dr David Nicholl and toxicologist Dr Mark Pucci have been talking to the media about the serious harm the substance can have on users. Dr Pucci said: “Even when we had around one admission per year, that was felt to be frequent.”

“But in the past year or so there has been an exponential growth in hospital admissions. We’re now seeing one admission every two weeks or so.”

Like Dr Pucci, Dr Nicholl sees only the most severe cases, with one of his patients still relying on crutches to move 18 months on from admission, despite being young and otherwise healthy.

He fears there could be far more, less severe cases who need treatment elsewhere.

“This is something I rarely saw in the past ten years, but it has gone through the roof over the past two, and it’s getting worse,” he said.

“At the beginning of the pandemic, we were seeing around two admissions every two months and now it’s almost weekly. I’m seeing patients with life-changing neurological injuries.

“And there will be others who we don’t see in primary care of other emergency departments.”

Users typically inhale by filling a balloon with laughing gas.

The effects can be devastating, with both Dr Nicholl and Dr Pucci seeing patients with spinal cord damage and an inability to walk.

Nitrous oxide can inactivate vitamin B12, which is essential for healthy nerves, Dr Pucci explains.

“Patients have symptoms including pins and needles, numbness, electric-shocktype symptoms in their hands, arms, feet and legs, while the most severe cases have damage to the spinal cord, when they can’t walk,” he said.

“They tend to be young adults that are otherwise generally fit and healthy, they don’t tend to be hardened drug users on other drugs. The average age in the patients we have seen is 22.”

With the recent wave of nitrous oxide highs seemingly driven by young adults between 18 and 30, some suspect social media is one potential factor behind the increase.

Searching for terms such as ‘Smartwhip’ and ‘Goldwhip’ on TikTok or Twitter produces videos and pictures of users fainting or sustaining other injuries.

Dr Nicholl believes boredom that came about over several lockdowns led many to take up balloons, which then turned into a habit – so much so that he sees even patients who have lived the worst effects take it up again after leaving hospital.

On the other hand, a lack of awareness around the gas’ effects can lull users into a sense that they are taking up a safe drug, Dr Pucci said, which can become a “psychological addiction.”

But what many experts single out as the most significant factor is the apparent ease with which even teenagers can get hold of nitrous oxide cylinders.