January 20, 2023

Nitrous oxide – uses, impacts and risks

Nitrous oxide bulbs

During summer party season, some young people may take drugs, including nitrous oxide.

Nitrous oxide bulbs are commonly referred to as ‘nangs’ when used recreationally.

What is nitrous oxide?

Nitrous oxide is a colourless and tasteless gas.

It’s used in many ways, including:

  • as a medical anaesthetic
  • when baking, to whip cream
  • in some car engines, to increase power (referred to as NOS)
  • recreationally, as a way to get ‘high’.1

When it’s used recreationally, the gas is inhaled, usually by discharging nitrous gas cartridges (bulbs or whippets) into a balloon, or directly into the mouth.

The bulbs or whippets are commonly referred to as ‘nangs’ due to the distorted and repetitive sound some people hear when the gas is inhaled.2

How common is recreational use of nangs?

While there’s no isolated data collected on nitrous oxide use in Australia, recent use of inhalants (including nangs) has been gradually increasing—from 0.4% in 2001 to 1.7% in 2019.3

The 2021 Global Drug Survey also lists it as the 13th most popular recreational drug in the world.4

Nitrous oxide bulbs are cheap and readily available.

Short term effects of nangs

Inhaling nitrous oxide produces a rapid and short lived rush of euphoria, happiness or excitement.5

Other effects can include:

  • dissociation of the mind from the body (a sense of floating)
  • changes in thoughts, feelings and perceptions
  • visual and auditory hallucinations (more likely to occur when mixed with other drugs).

Injury

  • If inhaling directly from tanks or crackers (a handheld device used to ‘crack’ a nitrous oxide bulb/whippet), the gas is intensely cold (minus 40 degrees Celsius) and can cause frostbite to the nose, lips and throat (including vocal cords).
  • As the gas is also under constant pressure, it can cause ruptures in lung tissue when inhaled directly from these containers.5,10
  • Faulty gas dispensers can explode and cause harm.
  • Dispensing several gas canisters consecutively with one cracker can also cause cold burns to the hands.6

Mixing with other drugs

Combining nitrous oxide with stimulants and other drugs can place additional pressure on the heart, increase blood pressure and disrupt heart rate.7,8

Mixing nitrous oxide with other drugs such as cannabis, ketamine, LSD, magic mushrooms (psylocibin) and salvia can cause more intense dissociation and visual or auditory hallucinations.6,8

Taking nitrous oxide while drinking can also increase nausea and dizziness, and may result in vomiting.9

Overdose

Signs of overdose can include:

  • loss of consciousness caused by a fall in blood pressure, or asphyxia (when the body is deprived of oxygen)
  • irregular heartbeat
  • seizures.7

In the event of an emergency, call triple zero (000). Emergency services are there to help and can provide instructions over the phone.

Long term effects of nangs

Regular use or prolonged exposure to nitrous oxide may result in:

  • memory loss
  • vitamin B12 depletion (long-term depletion causes brain and nerve damage)
  • ringing or buzzing in the ears
  • incontinence
  • numbness in the hands or feet
  • limb spasms
  • potential birth defects (if used during pregnancy)
  • weakened immune system
  • disruption to reproductive systems
  • depression
  • psychological dependence
  • psychosis.6, 10-12

How to reduce risk when using nitrous oxide

  • Try not to use nangs alone or in dangerous or isolated places.
  • Use a balloon instead of inhaling straight from the canister, as releasing into a balloon helps to warm the gas and normalise the pressure before inhaling.6, 8
  • Never put plastic bags over your head or impede breathing in any way.
  • Keep nitrous oxide away from flammable substances, such as naked flames or cigarettes.
  • Try not to mix with alcohol or other drugs.
  • Take B12 vitamins after use (nitrous oxide depletes this in the body).
  • Don’t stand or dance while inhaling, as it can increase the risk of passing out.6, 13

Nangs and the environment

Nitrous oxide bulbs are not very environmentally friendly.

Although most are made of recyclable steel, unused cannisters can’t be placed in recycling bins as they may explode during compression.

When at a festival try to avoid littering - place used ‘nangs’ in the bins supplied, or if the festival or event doesn’t have bins, take them home and dispose of them.

For recycling options, you can contact your local recycling or scrap metal company, to see if they take pressurised materials.

  1. Xiang Y, Li L, Ma X, Li S, Xue Y, Yan P, et al. Recreational Nitrous Oxide Abuse: Prevalence, Neurotoxicity, and Treatment. Neurotoxicity Research : Neurodegeneration, Neuroregeneration, Neurotrophic Action, and Neuroprotection [Internet]. 2021 [14.11.2022]; 39(3):[975-85 pp.].
  2. Cutcliffe J. What are Nangs? – A History of Nitrous Oxide 2021 [14.11.2022].
  3. Australian Institute of Health and Welfare. National Drug Strategy Household Survey 2019. Canberra 2020 [16.11.2022].
  4. Winstock AR, Maier LJ, Zhuparris A, Davies E, Puljevic C, Kuypers KPC, Ferris JA, Barratt MJ.Global Drug Survey (GDS) 2021 [14.11.2022].
  5. Alcohol and Drug Foundation. Nitrous Oxide facts 2021 [updated 10/11/2021 17.11.2022].
  6. Drug Science.Nitrous oxide (laughing gas) [17.11.2022].
  7. Schneir A. Poisoning & Drug Overdose [17.11.2022].
  8. Zacny J, Camarillo, VM, Sadeghi, P, & Black, M. Effects of ethanol and nitrous oxide, alone and in combination, on mood, psychomotor performance and pain reports in healthy volunteers. Drug and Alcohol Dependence [Internet]. 1998 [17.11.2022]; 52(2):[115-23 pp.].
  9. DanceWize NSW. Nitrous 2020 [17.11.2022].
  10. Brands B, Sproule, E & Marshman, J. Drugs and Drug Abuse 1998 [17.11.2022].
  11. Re-Solv. Nitrous oxide the low down n.d. [22.11.2022].
  12. Garland E, Howard, MO, & Perron, BE. Nitrous oxide inhalation among adolescents: Prevalence, correlates, and co-occurrence with volatile solvent inhalation. Journal of Psychoactive Drugs [Internet]. 2009 [17.11.2022]; 41(4):[337-47 pp.].
  13. Papanastasiou CD, P. Poster. Melbourne: . Just a laughing matter? Nitrous oxide use among a group of regular psychostimulant users in Melbourne, Victoria.2015 [17.11.2022].

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