Cases of nitrous oxide poisoning still on the rise
Since 2020, reports of poisoning related to the misuse of nitrous oxide, or ‘laughing gas’, have been steadily increasing. This gas can lead to dependence and to severe, sometimes irreversible complications affecting the nervous and cardiovascular (heart and blood vessels) systems if taken repeatedly and/or in large quantities. Nitrous oxide is mainly consumed by teenagers and young adults: according to data from a Santé publique France survey, in 2022, 14% of 18-24-year olds had already tried it and more than 3% reported having consumed it within the last year. Not all of these young users are aware that it can be dangerous. In response to this public health issue, the ANSM, ANSES and Santé publique France are reiterating the measures that should be taken to prevent and manage the risks associated with nitrous oxide consumption.
Between 2019 and 2020, ANSES highlighted a worrying increase in cases of poisoning caused by the misuse of nitrous oxide cartridges among young people. Its data gave rise to the French Act of 2021 to prevent the misuse of nitrous oxide.
Since 2013, the ANSM has been monitoring this misuse of non-medical nitrous oxide through an addiction monitoring survey. Conducted by centres for evaluation and information on drug dependence and addiction monitoring (CEIP-As), this survey is supplemented by an analysis of data from poison control and toxicovigilance centres (CAP-TVs).
In 2023, 472 reports involving the consumption of nitrous oxide were recorded by CEIP-As, i.e. 30% more than in 2022. CAP-TVs received 305 reports, i.e. 20% more than in 2022. These figures confirm the increase in the number of reported cases of complications associated with nitrous oxide observed in recent years. We note that the percentage of reports involving women is also increasing.
These reports also show an increase in cases involving the repeated and prolonged (for more than one year) use of nitrous oxide. Among these reports of abuse, misuse and dependence, 92% mention the consumption of high doses and the use of large cylinders. Fifty percent of them describe daily consumption.
These cases of abuse, misuse and dependence seldom involve the consumption of other substances.
On 16 March 2023, the European Chemicals Agency (ECHA) classified this substance as toxic to reproduction, Category 1B, as recommended by ANSES, marking the first step towards European-level regulation.
In 2023, for the first time, the CEIP-As and CAP-TVs received reports of two newborns showing neurological disorders at birth after the mother had repeatedly misused nitrous oxide during pregnancy. We are therefore particularly drawing the attention of pregnant women and women of childbearing age to the potentially serious risks to the unborn child associated with significant exposure to nitrous oxide during pregnancy.
Health risks
When nitrous oxide is consumed repeatedly over a short period and/or in high doses, it can lead to serious complications, as confirmed by the latest data from the CEIP-A and CAP-TV networks:
- Substance misuse disorders (loss of control over consumption), including cases of dependence;
- Neurological complications: sensory and/or motor disorders with numbness, muscle weakness and even loss of the ability to walk. Intense nerve pain, coordination disorders and urinary disorders (difficulty controlling the bladder or even urinary incontinence) may also occur;
- Cardiovascular problems (heart and blood vessels): formation of blood clots (thrombosis), which can lead to death in the event of pulmonary embolism;
- Psychiatric symptoms: hallucinations, delusions, mood disorders.
Nitrous oxide alters sensory experiences and slows reflexes. Driving a car or riding a bicycle or scooter after consumption can cause serious or even fatal accidents.
Using vitamin B12 as an ‘antidote’ to nitrous oxide is not a good idea
Taking vitamin B12 supplements is not enough to counteract the harmful effects of nitrous oxide. If you continue to consume nitrous oxide, the vitamin B12 will be systematically neutralised and rendered ineffective.
To protect your health, the best solution is to not consume nitrous oxide.
Help is available if you need it.
Information and support for consumers of laughing gas and their loved ones
What should you do if you or someone else has been poisoned with nitrous oxide?
There are many health risks associated with nitrous oxide. If, after consuming it, you experience numbness in your arms and legs, a sensation of burning or electric shock, tingling, loss of feeling or difficulty walking or moving, consult a healthcare professional or contact your poison control centre (+33 (0)1 45 42 59 59).
If you or someone you know feels unwell, is having difficulty breathing or is unconscious, call an emergency number immediately (112 for medical emergencies, 15 for an ambulance, 17 for the fire brigade).
If you are pregnant or wish to become pregnant, do not consume laughing gas: this product could also pose risks to your unborn child.
What should you do in the event of dependence?
People who use laughing gas can become dependent. If you or someone close to you is having difficulty controlling and/or stopping consumption, talk to your doctor, an addiction management centre (CSAPA) or a centre for evaluation and information on drug dependence and addiction monitoring.
Young consumers’ consultation centres (CJCs) provide users under the age of 25 and their families with a free and confidential service involving support, listening, advice and, if necessary, referral.
In addition, Drogues Info Service is the national remote assistance service for drugs and dependence run by Santé publique France. Its mission is to provide information, advice, support and guidance to the public (www.drogues-info-service.fr or anonymous and free hotline at 0 800 23 13 13, available 7 days a week, from 8 am to 2 am).
Drogues Info Service:
> Promotes access to information tailored to each individual, addressing users as well as their families and friends through dedicated spaces;
> Invites users to speak openly by encouraging interaction and mutual support through interactive modules (Q&As, forums, testimonials, etc.) and an individual chat service (real-time dialogue between the user and a professional);
> Facilitates referral by providing a directory of over 3,000 organisations specialising in addiction management.
Information for healthcare and medical-social professionals
There are certain signs and behaviours that should alert you to potential nitrous oxide poisoning: Download this document that can help you diagnose and treat nitrous oxide poisoning (updated on 16/04/2025) (PDF in French).
Appropriate care should be offered to patients, with support provided wherever possible.
If you suspect significant consumption of nitrous oxide with dependence, you should refer the patient to an appropriate addiction management facility, in particular via the addiction liaison and treatment team (ELSA) if hospitalisation is needed.
Feel free to contact your centre for evaluation and information on drug dependence and addiction monitoring or your poison control centre (+33 (0)1 45 42 59 59).