Recreational use of nitrous oxide

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Food grade N 2O charger (bottom right), cracker (top right) and balloon NOS Cracker With Balloon And Charger.jpg
Food grade N
2O charger (bottom right), cracker (top right) and balloon
3 liter can of recreational nitrous oxide to fill up balloons. Recreational N2O 3L-1.jpg
3 liter can of recreational nitrous oxide to fill up balloons.

Nitrous oxide (street name nangs, hippy crack, whippets, whippits or cannies) is a gas which can induce euphoria, hallucinogenic states and relaxation when inhaled. [1] Nitrous oxide is a neurotoxin and excessive use can cause long-term neurological damage. [2] [3]

Contents

First recorded in the 18th century at upper-class "laughing gas parties", the experience was largely limited to medical students until the late 20th century when laws limiting access to the gas were loosened to supply dentists and hospitals. By the 2010s, nitrous oxide had become a moderately popular recreational drug in some countries. [4]

Increasing recreational use has become a public health concern internationally due to the potential for long-term neurological damage following excessive use. [1] [2] Recreational users are often unaware of the risks associated with excessive use. [5] Possession of nitrous oxide is legal in many countries, although some have criminalised supplying it for recreational purposes.

Effects

Nitrous oxide is used recreationally, as inhalation can induce euphoria, relaxation and a hallucinogenic state. [1] Long-term or habitual use can lead to severe neurological damage. [3]

Since nitrous oxide can cause dizziness, dissociation, and temporary loss of motor control, it is unsafe to inhale while standing up. Safer use can involve inhalation while seated to decrease risks of injury by falling. Inhalation directly from a tank poses serious health risks, as it can cause frostbite since the gas is very cold when released. For those reasons, most recreational users will discharge the gas into a balloon or whipped cream dispenser before inhaling. [6]

It is not known if nitrous oxide causes drug dependency but its use can be habit-forming. [1] Death can result if it is inhaled in such a way that not enough oxygen is breathed in. While the pure gas is not acutely toxic, it inactivates vitamin B12, with continued use causing neurological damage due to peripheral and central demyelination. [3] Symptoms are similar to B12 deficiency: anemia due to reduced hemopoiesis, neuropathy, tinnitus, and numbness in extremities. As such, a two week course of vitamin B12 injection (not oral supplementation) is recommended as a first-line treatment, combined with abstinence; [3] oral supplementation may be phased-in later. [7] Pregnant women should not use nitrous oxide recreationally, because chronic use is also teratogenic and foetotoxic.[ medical citation needed ]

Inhaling industrial-grade nitrous oxide is also dangerous, as it contains many impurities and is not intended for use on humans. Food grade nitrous oxide is also not meant to be inhaled; the bulbs commonly have industrial lubricants from their manufacturing process on and in them. When the bulb is punctured, these solvents can aerosolize, introducing unknown particles into the gas. These lubricants commonly leave an oily residue on the bulb "cracker" or inside the whipped cream dispenser. [8]

In 2022, a Portland, Oregon, couple became temporarily unable to walk due to spinal nerve damage caused by the recreational use of nitrous oxide, and still had difficulties walking a year later. [9]

From 1993 to 2016, only 30 death certificates in England and Wales mentioned nitrous oxide. Of those, 6 were in the 17-year period from 1993 through 2009, and 24 were in the 7-year period from 2010 through 2016. [10]

In 2018, an Ohio University freshman died of asphyxiation as a result of nitrous oxide ingestion from whipped-cream chargers, allegedly as part of a hazing ritual. [11]

In 2020, a fifteen-year-old Irish boy died after ingesting nitrous oxide, [12] leading to Ireland's Health Service Executive classing it as a dangerous drug. [13]

Culture and society

Discovery and early use

Aquatint depiction of a laughing gas party in the 19th century Doctor and Mrs Syntax, with a party of friends, experimentin Wellcome L0022227.jpg
Aquatint depiction of a laughing gas party in the 19th century

Inhalation of nitrous oxide for recreational use, with the purpose of causing euphoria or slight hallucinations, began as a phenomenon for the British upper class in 1799, known as "laughing gas parties". [14] English chemist Humphry Davy offered the gas to party guests in a silken bag, and documented its effects in his 1800 book Researches, Chemical and Philosophical which investigated "nitrous oxide, or diphlogisticated nitrous air, and its respiration". [15] Poet Samuel Taylor Coleridge described the effect as "like returning from a walk in the snow into a warm room". [14]

During the 19th century, William James and many contemporaries found that inhalation of nitrous oxide resulted in a powerful spiritual and mystical experience for the user. James claimed to experience the fusing of dichotomies into unity and a revelation of ultimate truth during the inhalation of nitrous oxide. The memory of this experience, however, quickly faded and any attempt to communicate was difficult at best. James described a man who, when under the influence of the gas, claimed to know the secret of the universe. [16]

1840 illustration of a man inhaling nitrous oxide, and another experiencing its effects A man breathing in nitrous oxide (cropped).jpg
1840 illustration of a man inhaling nitrous oxide, and another experiencing its effects

Until at least 1863, low availability of equipment to produce the gas, combined with low usage of the gas for medical purposes, meant it was a relatively rare phenomenon that mainly happened among students at medical universities. When equipment became more widely available for dentistry and hospitals, most countries also restricted the legal access to buy pure nitrous oxide gas cylinders to those sectors. Even so, its use in parties continued, with gas provided by medical professionals or restaurant workers, [17] [18] and by other legal or illegal sources.

20th century

A report from Consumers Union report from 1972 (based upon reports of its use in Maryland 1971, Vancouver 1972, and a survey made by Edward J. Lynn of its non-medical use in Michigan 1970) found that use of the gas for recreational purposes was then prevalent in the US and Canada. [17] [18]

It was not uncommon [in the interviews] to hear from individuals who had been to parties where a professional (doctor, nurse, scientist, inhalation therapist, researcher) had provided nitrous oxide. There also were those who work in restaurants who used the N
2O stored in tanks for the preparation of whip cream. Reports were received from people who used the gas contained in aerosol cans both of food and non-food products. At a recent rock festival, nitrous oxide was widely sold for 25 cents a balloon. Contact was made with a "mystical-religious" group that used the gas to accelerate arriving at their transcendental-meditative state of choice. Although a few, more sophisticated users employed nitrous oxide-oxygen mixes with elaborate equipment, most users used balloons or plastic bags. They either held a breath of N
2O or rebreathed the gas. There were no adverse effects reported in the more than one hundred individuals surveyed. [18]

21st century

Discarded whipped cream chargers in a London car park, 2017 Mosa cream chargers fly-tipped at Bakers Hill car park 04.jpg
Discarded whipped cream chargers in a London car park, 2017

As of 2019, the gas enjoys moderate popularity in some countries as a recreational drug. Nitrous oxide has the street names hippy crack and whippets (or whippits). [1] In Australia and New Zealand, nitrous oxide bulbs are known as nangs, possibly derived from the sound distortion perceived by consumers. [19] [20] In China, recreational nitrous oxide use is on the rise and has become a social issue. [21] [22]

In the United Kingdom, as of 2014, nitrous oxide is estimated to be used by almost half a million young people at nightspots, festivals and parties. Officials in Norfolk, Hertfordshire and Thames Valley had reported increasing numbers of discarded whipped-cream chargers being found. [23]

Recreational users generally use 8 gram (¼ oz) containers of nitrous oxide "whippets", which they use to fill balloons or whipped cream dispensers. The gas is then inhaled from the balloon or dispenser. [24] This is necessary because nitrous oxide is very cold when it undergoes adiabatic decompression on exit from a canister; inhalation directly from a tank is dangerous and can cause frostbite of the larynx and bronchi. [25]

Legality

Australia

Supply of nitrous oxide for recreational purposes is illegal; however, it is permissible to supply it for cooking and baking purposes. As a deleterious substance, the supply of the substance for the purposes of inhalation can result in a two-year period of imprisonment. [26]

The canisters are commonly referred to in Australia as nangs. [27]

Netherlands

Sign stating "forbidden to use nitrous oxide" in the Poelestraat in Groningen which is also known as the main nightlife area with bars, pubs, and clubs. Since 1 January 2021 has the use of nitrous oxide in the area been prohibited. Ban of Nitrous oxide use.jpg
Sign stating "forbidden to use nitrous oxide" in the Poelestraat in Groningen which is also known as the main nightlife area with bars, pubs, and clubs. Since 1 January 2021 has the use of nitrous oxide in the area been prohibited.

Since 1 January 2023, the possession, importing, and sale of nitrous oxide is banned in the Netherlands, with exceptions for medical use, and the food industry. [28] It is illegal under the Opium Act. [29]

Sweden

Using nitrous oxide for recreational use is called "boffning" as slang. It is not illegal, and whipped cream chargers with nitrous oxide can be purchased as kitchen supply. [30] [31] Most retailers have a voluntary age restriction of 18 years for purchase. At festivals or bigger events, sales have been stopped, referring to "environmental hazardous chemical handling". [32]

United Kingdom

Supply of nitrous oxide for recreational purposes is illegal under the Psychoactive Substances Act 2016. This means anyone found to be selling or giving away nitrous oxide for illicit purposes could face up to 7 years in prison and/or an unlimited fine. [33] On 3 March 2023, it was announced that nitrous oxide will be prohibited under the Misuse of Drugs Act 1971. [34]

On 5 September 2023, it was announced by the British government that nitrous oxide will be categorised as a class C drug by the end of 2023, in an effort to crack down on anti-social behaviour. [35]

Slang terms used for the canisters in the United Kingdom include balloons, nos, whippits, laughing gas, hippie crack, chargers and noz. [36]

United States

Under United States federal law, possession of nitrous oxide is legal and is not subject to DEA purview. It is, however, regulated by the Food and Drug Administration under the Food Drug and Cosmetics Act. Prosecution is possible under its "misbranding" clauses, prohibiting the sale or distribution of nitrous oxide for the purpose of human consumption (the recreational drug use market). Given the necessity of proving the intent of either buyer or seller in this case, though, such prosecutions are rare.

Many states have laws regulating the possession, sale, and distribution of nitrous oxide; but these are normally limited to either banning distribution to minors, or to setting an upper limit for the amount of nitrous oxide that may be sold without a special license, rather than banning possession or distribution completely. In most jurisdictions, like at the federal level, sale or distribution for the purpose of human consumption is illegal. In California, for instance, inhalation of nitrous oxide "for the purpose of causing euphoria, or for the purpose of changing in any manner one’s mental processes," is a criminal offense under its criminal code (Cal. Pen. Code, Sec. 381b). In most jurisdictions, small N2O cartridges, used to make whipped cream, can be legally purchased by anyone. In some jurisdictions, sales of canned whipped cream using nitrous oxide are limited to adults. [37]

In all US jurisdictions, however, distribution, possession, and inhalation are legal when done under the supervision and direction of licensed medical professional such as a physician or dentist.

See also

Related Research Articles

<span class="mw-page-title-main">Amyl nitrite</span> Chemical compound

Amyl nitrite is a chemical compound with the formula C5H11ONO. A variety of isomers are known, but they all feature an amyl group attached to the nitrite functional group. The alkyl group is unreactive and the chemical and biological properties are mainly due to the nitrite group. Like other alkyl nitrites, amyl nitrite is bioactive in mammals, being a vasodilator, which is the basis of its use as a prescription medicine. As an inhalant, it also has a psychoactive effect, which has led to its recreational use, with its smell being described as that of old socks or dirty feet. It was first documented in 1844 and came into medical use in 1867.

<span class="mw-page-title-main">Inhalant</span> Chemical, often household, breathed in to cause intoxication

Inhalants are a broad range of household and industrial chemicals whose volatile vapors or pressurized gases can be concentrated and breathed in via the nose or mouth to produce intoxication, in a manner not intended by the manufacturer. They are inhaled at room temperature through volatilization or from a pressurized container, and do not include drugs that are sniffed after burning or heating. For example, amyl nitrite (poppers), gasoline, nitrous oxide and toluene – a solvent widely used in contact cement, permanent markers, and certain types of glue – are considered inhalants, but smoking tobacco, cannabis, and crack cocaine are not, even though these drugs are inhaled as smoke or vapor.

<span class="mw-page-title-main">Recreational drug use</span> Use of drugs with the primary intention to alter the state of consciousness

Recreational drug use is the use of one or more psychoactive drugs to induce an altered state of consciousness, either for pleasure or for some other casual purpose or pastime. When a psychoactive drug enters the user's body, it induces an intoxicating effect. Recreational drugs are commonly divided into three categories: depressants, stimulants, and hallucinogens.

<span class="mw-page-title-main">Nitrous oxide</span> Colourless non-flammable gas

Nitrous oxide, commonly known as laughing gas, nitrous, nitro, or nos, is a chemical compound, an oxide of nitrogen with the formula N
2O. At room temperature, it is a colourless non-flammable gas, and has a slightly sweet scent and taste. At elevated temperatures, nitrous oxide is a powerful oxidiser similar to molecular oxygen.

<span class="mw-page-title-main">Club drug</span> Category of recreational drugs

Club drugs, also called rave drugs or party drugs, are a loosely defined category of recreational drugs which are associated with discothèques in the 1970s and nightclubs, dance clubs, electronic dance music (EDM) parties, and raves in the 1980s to today. Unlike many other categories, such as opiates and benzodiazepines, which are established according to pharmaceutical or chemical properties, club drugs are a "category of convenience", in which drugs are included due to the locations they are consumed and/or where the user goes while under the influence of the drugs. Club drugs are generally used by adolescents and young adults.

<span class="mw-page-title-main">Head shop</span> Retail outlet for cannabis and tobacco products

A head shop is a retail outlet specializing in paraphernalia used for consumption of cannabis and tobacco and items related to cannabis culture and related countercultures. They emerged from the hippie counterculture in the late 1960s, and at that time, many of them had close ties to the anti-Vietnam War movement as well as groups in the marijuana legalization movement like LeMar, Amorphia, and the National Organization for the Reform of Marijuana Laws.

<span class="mw-page-title-main">Whipped-cream charger</span> Steel cylinder filled with nitrous oxide

A whipped cream charger is a steel cylinder or cartridge filled with nitrous oxide (N2O) that is used as a whipping agent in a whipped cream dispenser. The narrow end of a charger has a foil covering that is broken to release the gas. This is usually done by a sharp pin inside the whipped cream dispenser. The nitrous oxide in chargers is also used as an oxidizer in hybrid model rocket engines.

<span class="mw-page-title-main">Inhalation</span> Flow of the respiratory current into an organism

Inhalation is the process of drawing air or other gases into the respiratory tract, primarily for the purpose of breathing and oxygen exchange within the body. It is a fundamental physiological function in humans and many other organisms, essential for sustaining life. Inhalation is the first phase of respiration, allowing the exchange of oxygen and carbon dioxide between the body and the environment, vital for the body's metabolic processes. This article delves into the mechanics of inhalation, its significance in various contexts, and its potential impact on health.

<span class="mw-page-title-main">Anesthetic</span> Drug that causes anesthesia

An anesthetic or anaesthetic is a drug used to induce anesthesia ⁠— ⁠in other words, to result in a temporary loss of sensation or awareness. They may be divided into two broad classes: general anesthetics, which result in a reversible loss of consciousness, and local anesthetics, which cause a reversible loss of sensation for a limited region of the body without necessarily affecting consciousness.

<span class="mw-page-title-main">Horace Wells</span> American dentist who pioneered the use of anesthesia (1815–1848)

Horace Wells was an American dentist who pioneered the use of anesthesia in medicine, specifically the use of nitrous oxide.

<span class="mw-page-title-main">Nitrous oxide (medication)</span> Gas used as anesthetic and for pain relief

Nitrous oxide is an inhaled gas used as a pain medication and together with other medications for anesthesia. Common uses include during childbirth, following trauma, and as part of end-of-life care. Onset of effect is typically within half a minute, and the effect lasts for about a minute.

<span class="mw-page-title-main">Megaloblastic anemia</span> Medical condition

Megaloblastic anemia is a type of macrocytic anemia. An anemia is a red blood cell defect that can lead to an undersupply of oxygen. Megaloblastic anemia results from inhibition of DNA synthesis during red blood cell production. When DNA synthesis is impaired, the cell cycle cannot progress from the G2 growth stage to the mitosis (M) stage. This leads to continuing cell growth without division, which presents as macrocytosis. Megaloblastic anemia has a rather slow onset, especially when compared to that of other anemias. The defect in red cell DNA synthesis is most often due to hypovitaminosis, specifically vitamin B12 deficiency or folate deficiency. Loss of micronutrients may also be a cause.

<span class="mw-page-title-main">Gas duster</span> Product used for cleaning or dusting sensitive devices that cannot be cleaned using water

A gas duster, also known as tinned wind or compressed air, is a product used for cleaning or dusting electronic equipment and other sensitive devices that cannot be cleaned using water.

<span class="mw-page-title-main">Subacute combined degeneration of spinal cord</span> Medical condition

Subacute combined degeneration of spinal cord, also known as myelosis funiculus, or funicular myelosis, also Lichtheim's disease, and Putnam-Dana syndrome, refers to degeneration of the posterior and lateral columns of the spinal cord as a result of vitamin B12 deficiency (most common). It may also occur similarly as result of vitamin E deficiency, and copper deficiency. It is usually associated with pernicious anemia.

<span class="mw-page-title-main">Drug</span> Substance having effect(s) on the body of an individual

A drug is any chemical substance that when consumed causes a change in an organism's physiology, including its psychology, if applicable. Drugs are typically distinguished from food and other substances that provide nutritional support. Consumption of drugs can be via inhalation, injection, smoking, ingestion, absorption via a patch on the skin, suppository, or dissolution under the tongue.

<span class="mw-page-title-main">Cyanocobalamin</span> Form of vitamin B-12

Cyanocobalamin is a form of vitamin B
12 used to treat and prevent vitamin B
12 deficiency except in the presence of cyanide toxicity. The deficiency may occur in pernicious anemia, following surgical removal of the stomach, with fish tapeworm, or due to bowel cancer. It is used by mouth, by injection into a muscle, or as a nasal spray.

Nang or nangs may refer to:

<span class="mw-page-title-main">Psychoactive drug</span> Chemical substance that alters nervous system function

A psychoactive drug, psychopharmaceutical, psychoactive agent, or psychotropic drug is a chemical substance that changes the function of the nervous system and results in alterations of perception, mood, cognition, and behavior. These substances may be used medically, recreationally, for spiritual reasons, or for research. Some categories of psychoactive drugs may be prescribed by physicians and other healthcare practitioners because of their therapeutic value.

Whip It or Whippit may refer to:

<span class="mw-page-title-main">Inhalation sedation</span>

Inhalation sedation is a form of conscious sedation where an inhaled drug should:

  1. Depress the central nervous system (CNS) to an extent that surgeons can operate with minimal physiological and psychological stress to the patient
  2. Modify the patient's state of mind such that communication is maintained and the patient can respond to verbal command
  3. Carry a margin of safety wide enough to render the unintended loss of consciousness and loss of protective reflexes unlikely.

References

  1. 1 2 3 4 5 Xiang Y, Li L, Ma X, Li S, Xue Y, Yan P, Chen M, Wu J (June 2021). "Recreational Nitrous Oxide Abuse: Prevalence, Neurotoxicity, and Treatment". Neurotox Res (Review). 39 (3): 975–985. doi:10.1007/s12640-021-00352-y. PMID   33770366. S2CID   232376295.
  2. 1 2 van Amsterdam JG, Nabben T, van den Brink W (2022). "Increasing recreational nitrous oxide use: Should we worry? A narrative review". J Psychopharmacol. 36 (8): 943–950. doi:10.1177/02698811221082442. PMID   35678512.
  3. 1 2 3 4 Evans EB, Evans MR (November 2021). "Nangs, balloons and crackers: Recreational nitrous oxide neurotoxicity". Aust J Gen Pract (Review). 50 (11): 834–838. doi: 10.31128/AJGP-10-20-5668 . PMID   34713284. S2CID   240153502.
  4. ↑ Quax, Marcel L. J.; Van Der Steenhoven, Timothy J.; Bronkhorst, Martinus W. G. A.; Emmink, Benjamin L. (July 2020). "Frostbite injury: An unknown risk when using nitrous oxide as a party drug". Acta Chirurgica Belgica. 120 (1–4). Taylor & Francis on behalf of the Royal Belgian Society for Surgery: 140–143. doi:10.1080/00015458.2020.1782160. ISSN   0001-5458. PMID   32543291. S2CID   219702849.
  5. ↑ Allan J, Cameron J, Bruno J (2022). "A systematic review of recreational nitrous oxide use: implications for policy, service delivery and individuals". Int J Environ Res Public Health. 19 (18): 11567. doi: 10.3390/ijerph191811567 . PMC   9517250 . PMID   36141850.
  6. ↑ van Amsterdam, Jan; Nabben, Ton; van den Brink, Wim (2015-10-22). "Recreational nitrous oxide use: Prevalence and risks". Regulatory Toxicology and Pharmacology. 73 (3): 790–796. doi:10.1016/j.yrtph.2015.10.017. ISSN   1096-0295. PMID   26496821.
  7. ↑ Noh, Thomas; Osman, Gamaleldin; Chedid, Mokbel; Hefzy, Hebah (July 2020). "Nitrous oxide-induced demyelination: Clinical presentation, diagnosis and treatment recommendations". Journal of the Neurological Sciences. 414: 116817. doi:10.1016/j.jns.2020.116817. ISSN   0022-510X. PMID   32302804. S2CID   214779625.
  8. ↑ Erowid F, Erowid E. "N2Oily: Nitrous Oxide Chargers—Residue and Usage Surveys." Erowid Extracts. Nov 2009;17:12–14.
  9. ↑ Schuster-Bruce, Catherine (18 March 2023). "A man woke up unable to walk. It turned out vitamin B12 was inactivated in his body after he took laughing gas". Insider. Retrieved 18 March 2023.
  10. ↑ "Drug-related deaths involving nitrous oxide, 1993 to 2016". Office for National Statistics. 28 September 2017. Retrieved 14 February 2019.
  11. ↑ Dakin Andone and Carma Hassan. "Family files lawsuit in death of fraternity pledge at Ohio University". CNN. Retrieved 10 November 2019.
  12. ↑ "'Just say no' - heartbroken father whose son died from laughing gas warns others to stay away from 'lethal' drug". independent. Retrieved 10 July 2020.
  13. ↑ Gleeson, Colin (8 July 2020). "Minister seeks report on use of laughing gas following death of a teenager". The Irish Times. Retrieved 10 July 2020.
  14. 1 2 Kelsey-Sugg, Anna (19 February 2019). "When people partied with nitrous oxide, it sparked a medical breakthrough". www.abc.net.au. Retrieved 6 July 2020.
  15. ↑ Davy, Humphry (1800). Researches, chemical and philosophical : chiefly concerning nitrous oxide, or diphlogisticated nitrous air, and its respiration. London : printed for J. Johnson, St. Paul's Church-Yard, by Biggs and Cottle, Bristol.
  16. ↑ James, William (1882), The Subjective Effects of Nitrous Oxide , retrieved 27 November 2015
  17. 1 2 Brecher EM (1972). "Consumers Union Report on Licit and Illicit Drugs, Part VI – Inhalants and Solvents and Glue-Sniffing". Consumer Reports Magazine. Retrieved 18 December 2013.
  18. 1 2 3 Lynn, Edward J.; Walter, Richard G.; Harris, Lance A.; Dendy, Robert; James, Mary (1972). "Nitrous Oxide: It's a Gas" (PDF). Journal of Psychoactive Drugs. 5. Journal of Psychedelic Drugs: 1–7. doi:10.1080/02791072.1972.10471462. Archived from the original (PDF) on 2019-07-25. Retrieved 2017-02-15.
  19. ↑ Emory, Sami (1 March 2017). "Will Nangs Kill You?". Vice.
  20. ↑ "'Nanging' out: the rise of nitrous oxide as a Sydney party drug". The Sydney Morning Herald. 22 August 2015.
  21. ↑ "In Depth: China Needs to Get Serious About the Growing Abuse of Laughing Gas, Experts Say". Caixin Global. 2020-12-21.
  22. ↑ "年轻人滥用笑气该怎么管？". Xinhua. 2023-04-13.
  23. ↑ "Warning over laughing gas misuse". The Guardian. 9 August 2014.
  24. ↑ Garland EL, Howard MO, Perron BE (December 2009). "Nitrous oxide inhalation among adolescents: prevalence, correlates, and co-occurrence with volatile solvent inhalation". J Psychoactive Drugs. 41 (4): 337–47. doi:10.1080/02791072.2009.10399771. PMC   2921531 . PMID   20235440.
  25. ↑ van Amsterdam, Jan; Nabben, Ton; van den Brink, Wim (December 2015). "Recreational nitrous oxide use: Prevalence and risks". Regulatory Toxicology and Pharmacology. 73 (3): 790–796. doi:10.1016/j.yrtph.2015.10.017. ISSN   1096-0295. PMID   26496821.
  26. ↑ "Are nangs actually legal?". Leave Law to Criminals. 16 February 2019. Archived from the original on 17 February 2019. Retrieved 16 February 2019.
  27. ↑ "'It's flat-out stupid': Warnings on the dangerous rise in use of 'nangs'". www.abc.net.au. October 16, 2017.
  28. ↑ Rankin, Jennifer (2022-11-15). "Dutch to ban laughing gas over fears for health and road safety". The Guardian. ISSN   0261-3077 . Retrieved 2023-10-20.
  29. ↑ "Opium act (drugs)". www.belastingdienst.nl. Retrieved 2023-10-20.
  30. ↑ "Är lustgas farligt?". Ungdomsmottagningarnas öppna webb (in Swedish). RFSU and "Ungdomsmottagningarna". Retrieved 2023-04-22.
  31. ↑ Walldán, Camilla (2021-11-02). "Polisen varnar ungdomar att andas in farlig lustgas". Kungälvs-Posten (in Swedish). Retrieved 2023-04-22.
  32. ↑ Eliasson, Jessica. "Här kommer lustgasbilen med leverans". Uppsala Nys Ridning (in Swedish). Retrieved 2023-04-22.
  33. ↑ "The Law: Psychoactive Substances". Talk to Frank. 14 February 2019. Retrieved 14 February 2019.
  34. ↑ "Nitrous oxide to be banned under plans to clamp down on anti-social behaviour". Sky News. Retrieved 2023-03-26.
  35. ↑ "Nitrous oxide to be categorised as class C drug". Sky News. Retrieved 2023-09-05.
  36. ↑ "Nitrous Oxide – A colourless gas that people inhale, usually via a balloon". Talk to Frank. Retrieved 14 February 2019.
  37. ↑ "Want to buy canned whipped cream in New York state? Don't forget your ID". NBC News . 29 August 2022.
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