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Hippy Crack/Nitrous Oxide Addiction: An Overview of its Effects, Withdrawal Symptoms, and Treatment Options

Written By Stuart Croft
Reviewed By Tiffany Green
Medically Reviewed By Dr David Barker
Updated June 21, 2024

Nitrous oxide, often referred to as ‘hippy crack’, ‘laughing gas’, ‘whippets’, or ‘NOS’, has seemingly come out of nowhere over recent years, overtaking nearly all other drugs in popularity among teenagers and young adults aged 16 to 24. According to the UK Office for National Statistics, 3.9% of people in the aforementioned age group were abusing nitrous oxide, with only cannabis remaining more popular (Glasper). In many Western countries, it is becoming increasingly commonplace to find evidence of nitrous oxide abuse; the discarded aluminium canisters and balloons in parks, festival grounds, and other places where young people gather.

While nitrous oxide-related deaths pale in comparison to those of alcohol and opioids with roughly 36 deaths per year recorded between 2001 and 2020 (Glasper), its reputation for providing a ‘harmless and short-lived burst of euphoria’, along with its ease of availability and growing popularity, all contribute to growing use numbers. This has led to a recent government clampdown on the drug, and as of the 8th of November 2023, nitrous oxide has been reclassified as a class C controlled substance with sentences of up to 14 years for dealers (GOV.UK).

The rest of this article will aim to put nitrous oxide abuse and addiction into context; explaining the history of this 140-year-old anaesthetic, how and why it’s abused, the long-term effects of NOS abuse, and treatment options. 

An Overview of Nitrous Oxide

History

Nitrous oxide was originally discovered more than 250 years ago by English chemist Joseph Priestley in 1772. While many scientists studied it further, it wasn’t until 1844 that Horace Wells, a dentist, discovered its anaesthetic properties and propelled it into the spotlight in the medical community. By combining nitrous oxide with oxygen at the right concentrations, physicians could produce a state of euphoria, analgesia, and a reduction in anxiety in their patients, especially useful in the dentist’s chair, during labour, and other minor medical procedures. This made many procedures much more bearable and paved the way for the development of modern anaesthesia.

Classification and mechanisms

Within a medical and narcotic context, nitrous oxide is classified as a dissociative anaesthetic. This type of drug distorts the perception of sight and sound and produces a feeling of detachment (dissociation) from the environment and the self. Other dissociative anaesthetics include ketamine and PCP. As a recently-classified class C drug in the UK, nitrous oxide is still available for legitimate uses in the hospitality (cream guns), medical (anaesthetic), and other industries; however, those in possession of nitrous oxide cartridges with the intent of misusing and unscrupulous dealers are subject to a fine and/or imprisonment. 

When inhaled, nitrous oxide produces a short-lived (typically 1 to 5 minutes) feeling of euphoria and relaxation. The feeling has been described as being ‘happy drunk’. N2O works by interacting with the central nervous system. It inhibits the action of the NMDA receptors, which produces an analgesic effect by preventing the transmission of pain signals. It simultaneously stimulates the release of endogenous opioids (naturally occurring painkillers in the brain and CNS) and dopamine (the neurotransmitter responsible for pleasure, satisfaction, and motivation), further enhancing the drug’s analgesic and euphoric effects. Finally, nitrous oxide also inhibits the brainstem’s respiratory centre, which increases CO2 blood levels (Gillman and Lichtigfeld) and contributes to the overall ‘high’.

Nitrous oxide doesn’t form the same sort of physical dependence experienced by opioid and other hard drug users; however, it can easily lead to psychological addiction and dependence as it interferes with normal dopamine levels. 

Effects of Nitrous Oxide

Immediate and short-term effects and dangers of N2O

Nitrous oxide is taken by emptying an aluminium N2O canister into a balloon or plastic bag and then inhaling the gas. This colourless and odourless gas’ effects kick in almost instantaneously, causing feelings of:

  • Euphoria and laughter: Its intense euphoric effect, coupled with induced and uncontrollable laughter, makes it a popular drug in social settings.
  • Dissociation: The user might feel as if their brain is floating free and separate from the body, further enhancing the euphoric effect.
  • Altered perception: The user may experience distorted sounds, images, and even hallucinations when taken with other psychoactive drugs.
  • Dizziness and nausea: Some users experience a sudden burst of dizziness and nausea; however, this feeling typically quickly passes.
  • Impaired motor skills: This can lead to clumsiness and difficulty coordinating even simple movements and tasks. 

Nitrous oxide has a very short half-life within the body, and most users return to their normal selves after roughly 5 minutes. On the one hand, it’s a blessing that the N2O doesn’t stay in the system causing harm over an extended period of time, but on the other hand, the short duration of its effects causes many users to ‘pop multiple whippets’ in a single session. A 2024 study of patients suffering from harm related to nitrous oxide abuse found that some used up to 500 canisters per session (Crisp).

Medically speaking, a single hit of N2O is extremely unlikely to have any lasting negative effects on the brain or body; however, its effects on one’s perception and motor skills increase the risk of accident or injury. Extra-large hits or too-frequent N2O inhalation can also lead to a drop in brain oxygen levels, leading to a loss of consciousness and possible injury. Other immediate risks of nitrous oxide abuse include problems with the law if caught with the canisters and frostbite when N2O is sprayed directly into the mouth. 

Long-Term Effects of N2O Abuse

Regular or ongoing nitrous oxide abuse can have serious and potentially irreversible health implications. Some of the more commonly reported long-term effects include:

  • Myeloneuropathy: This is a serious condition with various degrees of symptom severity and is reported in 4.2% of recreational N2O users (McCormick et al.). Nitrous oxide rapidly oxidises vitamin B12, leading to a B12 deficiency and myeloneuropathy, which can cause pins-and-needles, numbness in the extremities, muscle weakness, and loss of motor skills. If detected early, a combination of vitamin supplements, lifestyle changes, and medication can bring rapid improvement; however, if left untreated, myeloneuropathy can result in permanent nerve damage and disability.
  • Memory and cognitive function impairment: This includes concentration problems, the inability to pay attention, and a reduced ability to solve problems. These issues may impair one’s ability to meet responsibilities at home, work, and within relationships. 
  • Increased risk for mood disorders: Prolonged N2O abuse causes dopamine imbalances, which may contribute to the development of mood swings, emotional dysfunction, and general feelings of anxiety or irritability. 
  • Immune system degradation: Nitrous oxide interferes with the production of white blood cells, increasing one’s susceptibility to disease and infection. 

Considering the potential severity of these effects, which could include paralysis and death, finding professional care for loved ones suffering from nitrous oxide becomes imperative. Whether you decide to go through detox and treatment at home or in a dedicated facility, quick and decisive action now can prevent devastating consequences down the line.

Nitrous Oxide Withdrawal Symptoms and Timelines

Fortunately, as a non-physical dependence-forming drug, nitrous oxide withdrawal is relatively comfortable and painless compared to alcohol or opioids. It’s not exactly pleasurable but poses little risk to your physical or psychological well-being. Nitrous oxide withdrawal symptoms are similar to the withdrawal symptoms experienced by chronic cannabis smokers and even heavy smokers giving up nicotine. The symptoms can be broken down into:

  • Psychological symptoms: Feelings of unease, worry, irritability, and a low tolerance for frustration. It could also manifest as depression in certain patients.
  • Neurological symptoms: Difficulty sleeping, headaches, and light-headedness.
  • Cognitive symptoms: Short-term memory loss and difficulty focusing on tasks and maintaining attention. 
  • Physical symptoms: Fatigue and muscle weakness

These withdrawal symptoms are usually not severe and are typically treated with non-prescription drugs such as painkillers and sleeping aids. The neurological symptoms can be expected to last for around a week after the last use, while the psychological and physical symptoms typically last for around two weeks. Depending on the individual, anxiety and some cognitive issues may persist for several weeks, especially in heavy users’ cases. 

Nitrous Oxide Addiction Rehab Treatment

Nitrous oxide addiction can be treated safely and effectively with residential rehab and therapy. Gladstones Clinic is a leader in substance abuse rehab and is currently one of only two accredited residential rehab clinics dealing with teenage substance abuse rehab in the UK. 

With over two decades of experience helping people from all walks of life overcome substance abuse, Gladstones Clinic is the ideal recovery partner if you value a modern and scientific approach to therapy coupled with a holistic view of recovery. Our skilled team takes the time to understand each patient’s unique health and addiction profile, enabling them to design personalised treatment schedules that address the root causes of each patient’s addiction.

If you or a loved one are struggling with nitrous oxide abuse, especially if they’re a teenager with their whole life ahead of them, please don’t hesitate to contact Gladstones Clinic at 0808 258 2350 or through our online portal. We’ll gladly talk you through our treatment options and answer any of your questions. 

Feel free to visit these pages to learn more about Gladstones Clinic.

Looking for effective treatment for nitrous oxide addiction?

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Works Cited

Crisp, Rehman S. “Cracking the Whippet: The Inconsistent Treatment of Myeloneuropathy Secondary to Chronic Nitrous Oxide Misuse.Cureus, vol. 16, no. 1, 2024. National Library of Medicine, https://pubmed.ncbi.nlm.nih.gov/38406057/. Accessed 29 May 2024.

Gillman, M. A., and F. J. Lichtigfeld. “Nitrous oxide and carbon dioxide: their similar and contrasting biological effects.South African Journal of Science, vol. 103, 2007, pp. 104-106. South African Journal of Science, https://journals.co.za/doi/pdf/10.10520/EJC96665. Accessed 29 May 2024.

Glasper, Alan. “Nitrous Oxide Deaths Among Children and Young People is No Laughing Matter!Nitrous Oxide Deaths Among Children and Young People is No Laughing Matter!, Taylor & Francis Online, 6 January 2023, https://www.tandfonline.com/doi/full/10.1080/24694193.2023.2230798. Accessed 29 May 2024.

GOV.UK. “Possession of nitrous oxide is now illegal.GOV.UK, GOV.UK, 8 November 2023, https://www.gov.uk/government/news/possession-of-nitrous-oxide-is-now-illegal. Accessed 29 May 2024.

McCormick, J. P., et al. “Nitrous oxide-induced myeloneuropathy: an emerging public health issue.Irish Journal of Medical Science, vol. 192, 2022, pp. 383-388. Springer Link, https://link.springer.com/article/10.1007/s11845-022-02945-8#citeas. Accessed 29 May 2024.

Cover photo “Empty Laughing Gas Canisters”, by Pro-Mo Cymru, licensed under CC BY 2.0, used in background.

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