Understanding Nitrous Oxide (Nangs) Misuse

Understanding Nitrous Oxide (Nangs) Misuse

Nitrous oxide (N₂O) is a colourless, non-flammable gas with a mildly sweet smell. It has established uses in medical and dental sedation and in food preparation — for example, as the propellant in whipped cream chargers. Outside of these settings, N₂O is sometimes inhaled for recreational purposes.

When nitrous oxide is inhaled, it can produce effects that begin rapidly and are usually short in duration. Reported experiences include brief feelings of euphoria, dissociation, dizziness, and mild changes in sensory or body perception. These effects generally resolve within minutes, and normal functioning usually returns shortly thereafter. The brief duration of effects has been associated with repeated inhalation within a single session in some cases, and nitrous oxide has also been described as being used alongside other substances.

This overview summarises findings reported in publicly accessible research and reporting, including work co-led by researchers at the University of Queensland and data from the Global Drug Survey. It is intended to provide general awareness and does not constitute medical or legal advice.

Patterns of Use Reported in Survey Data

The Global Drug Survey (GDS) is an anonymised international survey on substance use patterns that has included nitrous oxide in its questionnaires. Data collected between 2014 and 2016 indicate:

• Around 17 per cent of respondents reported having used nitrous oxide at least once.

• Of those users, approximately 42 per cent reported using it within the previous 12 months.

• Higher reported lifetime use was observed among respondents in the United Kingdom and the United States, compared with some other regions.

• Australian respondents to the survey reported increases in recent use over the same period.

These findings are based on self-reported survey data and reflect patterns among those who chose to participate.

Reported Health Effects and Patterns of Use

A large analysis of responses from over 16,000 survey participants who reported recent nitrous oxide use identified a range of reported experiences. One of the effects reported by some participants was persistent numbness or tingling in the hands or feet — a symptom known as paraesthesia — which was more common among respondents who reported higher numbers of doses in a session.

In medical literature and research abstracts, persistent paraesthesia associated with high-dose or prolonged nitrous oxide exposure has been linked to changes in vitamin B12 metabolism. Vitamin B12 plays a role in nerve function, and depletion of this nutrient has been associated with neurological symptoms in some case reports.

Dose–Response Patterns in Survey Data

Analysis of survey responses identified a dose-response relationship between the number of nitrous oxide exposures within a session and the predicted likelihood of reporting neurological symptoms such as paraesthesia. While the median number of doses per session reported in the sample was relatively low, some individuals reported far higher use within a single session.

This pattern suggests that as the number of doses used in a session increased, so did the probability of experiencing certain reported symptoms. These observations are based on survey data and do not reflect clinical diagnoses or individual health outcomes.

Additional Reported Effects in associated settings

Survey data and case reports have noted a range of other effects reported in association with nitrous oxide inhalation, including:

• Gagging, coughing, or vomiting

• Temporary changes in blood pressure

• Asthma‐like symptoms

• Ringing in the ears (tinnitus) or seizures

• Fainting or falls when oxygen intake is reduced

• Cold burns to lips or airway from rapid gas expansion

• Pneumothorax (collapsed lung) in rare cases

• Fatalities involving accidental asphyxiation have been reported internationally in a limited number of cases

  
  

These outcomes have been documented in a variety of settings and do not represent every possible experience.

Is It Legal?

Yes. Under the Australian Consumer Law, the legitimate sale of the small gas canisters relate to whipping cream or medicinal effects, and so Fair Trading does not ban these products that are then misused.

Current New South Wales laws state that it is an offence for someone to supply or sell N₂O to another knowing it is to be used for human consumption, however enforcing these laws has proven difficult due to the lack of legislation.

Research and Public Data

Understanding patterns of nitrous oxide use and associated reported experiences relies on ongoing data collection and analysis. Large-scale surveys such as the Global Drug Survey provide anonymised self-reported data that researchers and public health analysts can use to observe patterns over time.

This article is based on publicly available research and reporting, including:

• Recreational Use of Nitrous Oxide: research summaries and reports published by the University of Queensland Centre for Health Services Research

• Global Drug Survey publications on nitrous oxide use

• Publicly reported analytical summaries of survey findings

For reference and context, the original detailed report summarising aspects of nitrous oxide use is available at the University of Queensland website: https://stories.uq.edu.au/medicine/blog/2019/recreational-use-of-nitrous-oxide/index.html?ref=thewhippet.org

As with any drug there is no safe level, and use of them always carries a risk. For free and confidential advice about N₂O, call the 24/7 National Alcohol and Other Drugs Hotline on 1800 250 015.

The 2020 Global Drug Survey is now open; add your response to help researchers to improve our understanding of drugs and related harms. http://www.globaldrugsurvey.com/GDS2020