Nitrous Oxide (Laughing Gas) Causes Laughter
Nitrous oxide, commonly known as "laughing gas," is the medication that causes laughter and euphoria. This effect is the basis for its colloquial name and has been recognized for over 200 years. 1, 2
Clinical and Recreational Effects
- Nitrous oxide produces a rapid euphoric, pleasant, joyful effect within 10 seconds of inhalation, which is why it earned the name "laughing gas." 1
- The drug has both analgesic and anxiolytic properties, making it useful clinically in dentistry, ambulance care, and childbirth settings. 1, 3
- Beyond laughter and euphoria, nitrous oxide can produce empathogenic and sometimes hallucinogenic effects that disappear within minutes. 1
Mechanism and Clinical Use
- Nitrous oxide is clinically used as a safe anesthetic due to its ease of use, rapid onset, dose titration capability, and lack of prolonged effects. 3
- The drug has been used clinically for more than 150 years as an anesthetic component. 2
- Its anti-anxiety effect is particularly appreciated in medical settings where patient comfort is important. 1
Important Safety Considerations
Acute Side Effects
- Transient dizziness, dissociation, disorientation, loss of balance, impaired memory and cognition, and leg weakness are common immediate side effects. 1
- Fatal accidents due to asphyxia (hypoxia) have been reported, particularly when used improperly. 1
- Accidents like tripping and falling may occur when intoxicated. 1
Chronic Toxicity with Heavy Use
- Heavy or sustained use inactivates vitamin B12, resulting in functional vitamin B12 deficiency. 1, 3, 4
- This deficiency initially causes numbness in fingers, which may progress to peripheral neuropathy and megaloblastic anemia. 1, 4
- Long-term abuse without timely treatment leads to irreversible neurological damage. 4
- Discontinuation of nitrous oxide and timely vitamin B12 supplementation are essential for good prognosis. 4
Occupational Hazards
- Occupational exposure has been associated with infertility, spontaneous abortion, blood dyscrasias, and neurologic deficits. 3
- Scavenger systems are recommended to minimize exposure in healthcare settings. 3
Recreational Use Patterns
- Nitrous oxide is the second most popular recreational drug after cannabis in the UK. 1
- Recreational use is rapidly increasing, especially in the dance and festival scene, with last-month prevalence among clubbers ranging between 40-80%. 1
- Most recreational users demonstrate moderate use patterns: less than 10 balloons per episode and fewer than 10 episodes per year in approximately 80% of users. 1
- Nitrous oxide does not appear to result in dependence. 1