Mental health experts have cautioned Nigerians against inhaling nitrous oxide popularly known as laughing gas, stressing that it may cause brain and nerve damage.
They said people who inhale nitrous oxide to get ‘high’ may also develop mental disorders known as schizophrenia or psychosis.
While noting that the substance creates a temporary feeling of relaxation and euphoria, the psychiatrists stressed that it is more dangerous than cocaine.
According to Healthline, Nitrous oxide is a colourless gas that is commonly used for sedation and pain relief but is also used by people to feel intoxicated or high.
Lately, there have been several trending videos on social media of young people inhaling gas from inflated balloons to get high.
In one of the videos, the substance was pumped from canisters into balloons before being inhaled.
But mental health experts, during an exclusive interview with PUNCH Healthwise, warned that the new trend may lead to a rise in cases of nerve damage and mental disorders across the country.
A consultant psychiatrist at Federal Neuropsychiatric Hospital, Oshodi Annex, Dr Jaiyeola Kajero, explained that nitrous oxide makes the brain experience a state of euphoria, which is an excessively heightened emotion that typically makes the user happy.
He added that persistent use of the substance could slow down heartbeats, resulting in a heart attack.
He further said abusing nitrous oxide can also lead to vitamin B12 cobalamin deficiency, which can cause brain and nerve damage.
According to him, it could also cause a tingling sensation and numbness in the feet.
“It can actually cause confusion, disorientation, and panic, and those involved would feel as if they are on top of the world. It gives this feeling of being highly elevated.
“When you inhale it, if you don’t do it properly by using a balloon or any other means, and take it directly from the canister, it could actually choke you, burn your mouth, lung, and throat, and give you this choking sensation. It denies you of oxygen and some people have been known to pass on while doing this.
“Vitamin B12 deficiency could also lead to anaemia, and the liver could be damaged. It could cause hallucinations, delusions, and cold.
“The effect can be permanent after suffering from vitamin B12 deficiency. Some effects can be reversed, but not all.”
Another psychiatrist, Dr. Sunday Amosu said nitrous oxide is a painkiller that is administered to hospital patients undergoing medical procedures.
He, however, lamented that continuous exposure to nitrous oxide beyond medical use has a damaging effect, especially on neurological symptoms related to brain communication.
Amosu, who is the Head of Drug Addiction Treatment Education Research at the Federal Neuropsychiatric Hospital, Aro, Abeokuta, Ogun State, said persistent use of ‘laughing gas’ can make people develop symptoms that include fatigue, irregular breathing, difficulty in breathing, loss of appetite, digestive problem, numbness in the fingers and toes, difficulty in walking and poor vision.
The psychiatrist maintained that the substance affects the neurons and also causes irreversible brain damage in the abuser.
He said: “We know that we depend on oxygen. The brain depends on oxygen and glucose. If nitrous oxide takes over, it means the brain will develop what is called hypoxia, and that is how it causes damage to the brain.
“It is a public health problem. Today, there are many studies about nitrous oxide. It is like heroin and cocaine that are being abused.
“The effect of this substance is that it affects the central nervous system; that is why people must avoid it. Today, we need to educate people about nitrous oxide and all other drugs of abuse.
“The common mental illnesses it can cause schizophrenia or psychosis, which can lead to hallucinations or hearing voices others cannot. It may also lead to the individual being admitted. And you know when somebody has such a problem and is admitted, it means that such a person has brought illness to the family and other family members can inherit it because of genetic disposition”.
While describing the substance as a ‘hydra-headed monster’, the mental health expert stressed the need for drug education to be instilled in households to lower the prevalence in society.
On his part, a Senior Registrar in Psychiatry at the Federal Neuropsychiatric Hospital Yaba, Lagos, Dr Samuel Aladejare, said although the effects are transient, nitrous oxide could reduce the ability to perceive pain and affect the nervous system controlling muscles.
“In terms of mental health, there could be a feeling of dissociation (a floating feeling), depression, memory problems, hallucinations, and unusual thoughts which are also usually transient. These feelings could cause falls, accidents, and other physical injuries.
“These effects are usually dependent on quantity used and lengths of time. Different body types, gender, and weight, among others, would determine how each person responds to the substance.
“Sometimes, they are mixed with other substances and could lead to acute poisoning, which could cause loss of consciousness, seizures, and even death, hence young people are advised to stay away generally.
“Some young persons have been known to also put a nylon bag around their heads while using it, to increase the efficacy. This is dangerous as people can easily pass on while doing this.”
On how to reduce the availability of the drug in the market, the psychiatrist urged the government to regulate the importation and selling of the substance.
He added, “For the government, there is a need for a lot of education about the dangers of nitrous oxide. There should also be control around its sale so that it doesn’t end up in the wrong hands.
“There might be a need for its reclassification as a psychoactive drug to allow for proper regulation by the relevant agencies.
“They should also strengthen the mental health service delivery system and increase the workforce to be able to cope with this new menace in society.”
Meanwhile, a report titled; “Recreational use of nitrous oxide: a growing concern for Europe”, published by the European Monitoring Centre for Drugs and Drug Addiction pointed to the risks and harms associated with the drug, which is now widely available, cheap and popular among some young people.
The report examined the current situation, risks, and responses to the recreational use of the gas in Europe and reviews its chemistry, pharmacology, and toxicology.
Seven case studies were presented in the report from Denmark, Ireland, France, Lithuania, Netherlands, Portugal, and the United Kingdom.
Another key factor linked to the increased recreational use of the gas is the widespread availability of small 8-gram cartridges of nitrous oxide (used to fill balloons from which the gas is inhaled).
These cartridges commonly used as an aerosol propellant to make whipped cream are inexpensive and easy to buy from legitimate sources, such as convenience stores, supermarkets, and online suppliers.
The report noted, “A profitable and expanding supply chain has developed, with specialised internet stores directly promoting the gas for its recreational use or offering it under the guise of its use to make whipped cream.
“As the number of people using nitrous oxide has grown, so too has the number of poisonings. These poisonings, although still relatively small in number, tend to be associated with heavier or more frequent use.”
The report showed a small but significant rise in reports of poisoning to poison centres.
It indicated that in Denmark, cases rose from 16 in 2015 to 73 in 2021, while in France, 134 cases were reported in 2020 up from 10 in 2017.
That of the Netherlands rose from 13 in 2015 to 144 in 2020.
Many of the cases reported to poison centres from 2017 onwards involved varying degrees of damage to the nervous system (neurotoxicity) as a result of the irreversible inactivation of vitamin B12 in the body (an essential vitamin for healthy nerve functioning).
Other concerns include severe frostbite (burns caused by exposure to the freezing gas released from the container) and lung injuries, typically caused by larger cylinders due to high pressure.
In addition, car accidents involving gas have also significantly increased in at least one country (the Netherlands).
Nevertheless, the report stressed, “It is important to recognise that the vast majority of people do not use nitrous oxide. Those that do, typically use relatively small amounts infrequently.”
Similarly, a study revealed young people, especially males, are most likely to experience nerve damage from the use of nitrous oxide.
The study, which was carried out on patients admitted to a hospital in England, revealed a predominance of young men of Asian ethnicity among those experiencing neurological harm.
Led by researchers from Queen Mary University of London, it is the largest complete clinical case series of recreational users of laughing gas to date.
It investigated a group of 119 young individuals who experienced neurological problems as a result of using nitrous oxide.
The majority of the patients (57 per cent) were of Asian or British Asian background, with the highest proportion found in London (73 per cent).
People of Asian or Asian British ethnicity made up a large proportion of cases in east London (73 per cent), Birmingham (54 per cent) and Manchester (29 per cent).
White patients comprised 19 per cent of the total, followed by black patients at 7.5 per cent, and mixed-race individuals at 6 per cent.
In approximately one out of ten cases, ethnicity was either unknown or not recorded.
These patients were admitted to hospitals in three major cities in England—London (56), Birmingham (35), and Manchester (28), between 2014 and 2022.
While the average age of those requiring treatment was 22, their ages ranged from 14 to 39.
The study found that three out of four patients were male, although around a third of the patients in London were female.
The study found a correlation between weekly consumption of nitrous oxide and elevated levels of methylmalonic acid.
This biomarker suggests impaired functioning of vitamin B12, indicating that nerve damage is not solely attributed to a B12 deficiency but rather, a functional deficiency.
This means that there might be an adequate amount of B12 in the body, but its effectiveness is compromised.
The primary treatment method involves intramuscular injections of vitamin B12, although it is believed that these injections are only effective if the use of nitrous oxide is also discontinued.
In recognition of the significance of prevention, the researchers within this group launched a campaign called ‘N2O: Know the Risks’ to increase awareness among young individuals in east London about the neurological risks associated with nitrous oxide.
It involves conducting workshops to educate the participants.
