Is nitrous oxide a controlled substance?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: April 23, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

Nitrous oxide is indeed controlled in many medical settings due to its potential for abuse and side effects, but its use is highly regulated and monitored to ensure patient safety. When considering the use of nitrous oxide for medical procedures, such as colonoscopy, the benefits of rapid onset, rapid recovery, and an excellent safety profile are notable, as highlighted in the study by Saunders 1. This study demonstrated that patients receiving nitrous oxide experienced less prolonged sedation and faster recovery compared to those receiving intravenous sedation. Additionally, Maslekar's study 1 showed that patients in the nitrous oxide arm had higher overall satisfaction and better pain assessment scores, with a significantly shorter time to discharge.

The major risks associated with nitrous oxide, such as hypoxia, hypertension, arrhythmias, nausea, vomiting, and headache, can be mitigated by coadministering it with 30% to 50% oxygen and proper monitoring 1. The use of nitrous oxide in medical settings requires proper equipment, trained personnel, and adherence to regulatory guidelines to minimize the risk of adverse effects. The control of nitrous oxide is also important due to its potential for recreational abuse, which can lead to serious health issues, such as vitamin B12 deficiency and neurological damage.

Some of the key benefits of using nitrous oxide in medical procedures include:

  • Rapid onset and recovery
  • Excellent safety profile
  • High patient satisfaction
  • Reduced risk of prolonged sedation and slower recovery compared to intravenous sedation
  • Shorter time to discharge

However, it is essential to weigh these benefits against the potential risks and take necessary precautions to ensure patient safety, as highlighted in the studies by Saunders and Maslekar 1. The use of nitrous oxide should be carefully controlled and monitored to minimize the risk of adverse effects and ensure optimal patient outcomes.

From the FDA Drug Label

NITROUS OXIDE USP UN1070 Rx only The FDA drug label does not answer the question.

From the Research

Nitrous Oxide Control

  • Nitrous oxide is a legal drug in most countries and is widely available and cheap 2.
  • There is no evidence to suggest that nitrous oxide is controlled in the same way as other recreational drugs, although its use is monitored by some organizations such as the French Monitoring Centre for Addiction 3.
  • The use of nitrous oxide for recreational purposes is not regulated, and it is often used in social settings such as parties and festivals 2, 4.

Medical Use and Regulation

  • Nitrous oxide is clinically used as a safe anesthetic and analgesic, and its use in medical settings is regulated and monitored 5, 6.
  • The medical use of nitrous oxide is subject to guidelines and protocols to minimize the risk of adverse effects, and its use is typically limited to trained medical professionals 5, 6.

Risks and Side Effects

  • The recreational use of nitrous oxide can have serious side effects, including vitamin B12 deficiency, numbness, and peripheral neuropathy 2, 4.
  • Heavy or sustained use of nitrous oxide can lead to irreversible neurological damage, and users should be informed of the risks associated with its use 2, 4.
  • The medical use of nitrous oxide can also have adverse effects, including pulmonary atelectasis, and its use should be carefully monitored and regulated 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.