Laughing gas, what the ‘laughter drug’ is and why Europe is concerned

A report from the EU agency Emcdda reported an increasing use at the end of 2022

It was November 2022 when the Emcdda, the European Monitoring Center for Drugs and Addiction, drew up a report dedicated torecreational use of nitrous oxide (or nitrous oxide)commonly known as laughing gas, calling it a “growing concern for Europe.” A Premier League footballer has become the first player to go to rehab for a laughing gas addiction, the Daily Mail has reported.


Food additive, anesthetic in medicine: nitrous oxide – explains the EU agency – has a variety of legitimate medical, industrial, commercial and scientific uses. This colorless and almost odorless gas, heavier than air, was discovered in 1772. It has also been used for its psychoactive effects for over 200 years. Which? “Feelings of euphoria, relaxation and detachment” are the ones listed. Over the last decade, the Emcdda reports, there has been a “strong increase” in this recreational use in many regions of the world. In some European countries, particular concerns have been raised since 2017-2018, when the drug became more widely available and in larger quantities.

“The growing popularity”, especially among young people, even adolescents, “could be explained to some extent by its easy availability, low price, short-lasting effects and general consumer perception as a relatively safe drug” , we read in the report. Another key factor was the widespread availability of small 8-gram nitrous oxide cartridges (with which balloons are filled from which the gas is inhaled). These cartridges, commonly intended for use in whipped cream aerosols for example, are cheap and easy to purchase from legitimate sources, such as convenience stores, supermarkets and online suppliers, the Emcdda wrote, highlighting that “suppliers have started selling also larger cylinders (15kg) of gas. This makes the gas significantly cheaper and is believed to promote wider, heavier and more regular use.”

In some areas, “social media plays an important role in advertising and selling” was another highlight. The report noted that “a profitable and expanding supply chain has developed, with specialty online stores directly promoting the gas for recreational use or offering it under the guise of its use to make whipped cream.” But as the number of people using nitrous oxide has increased, so has the number of poisonings. The data contained in the report: cases grew from 16 in 2015 to 73 in 2021 for example in Denmark; from 10 in 2017 to 134 in 2020 in France; from 13 in 2015 to 144 in 2020 in the Netherlands.

The experts do not comment on the possible role of the pandemic as a detonator of consumption in some areas of the Old Continent. But a report from French poison control centers is cited according to which in many of the 134 cases recorded beyond the Alps in 2020 there was evidence of a start or increase in the use of laughing gas during the first lockdown.

The dangers

What dangers can heavy use have? Poison control centers are reporting varying degrees of damage to the nervous system (neurotoxicity) due to the irreversible inactivation of vitamin B12 in the body, a vitamin essential for healthy nerve function. Other concerns include severe frostbite (burns caused by exposure to freezing gas released from the container) and lung injury, typically caused by larger cylinders due to high pressure. Furthermore, in at least one country (the Netherlands) road accidents involving gas also increased. And the Netherlands was among the first to react to this alarm by announcing a ban on possession and sale from the beginning of 2023, with a few exceptions.

In any case, in the 2022 report the Emcdda specified that the phenomenon of recreational use of laughing gas was still limited and that “those who use it generally use relatively small quantities rarely”. But the increase in recreational use, reported Agency Director Alexis Goosdeel, “in some parts of Europe is a cause for concern. There is a general perception among users that inhaling nitrous oxide is safe. We see that more frequent or heavier use increases the risk of serious harm, such as damage to the nervous system. It is therefore important to avoid normalizing and unintentionally promoting its use. Targeted interventions and further research are needed to increase understanding risks and reduce harm”.

As for the measures to be implemented, the report – in addition to the crucial monitoring role – underlined the need to consider the legitimate and widespread uses of nitrous oxide by industry, healthcare and consumers. Uses for which few or no alternatives exist. In most cases, the path chosen by countries has been to limit supplies and provide targeted health promotion.