Eighteen Young People Develop Neurological Disorders from Nitrous Oxide

Doctors at Tallaght University Hospital in Dublin have diagnosed 18 young individuals with a neurological disorder linked to the inhalation of nitrous oxide, commonly known as “laughing gas.” Over a 20-month period from October 2022 to July 2024, these patients presented at the hospital’s emergency department with symptoms of myeloneuropathy, a condition arising from damage to both the spinal cord and peripheral nerves.

The patients, the youngest being just 16 years old, all reported recent use of inhaled nitrous oxide. This gas is frequently utilized as an anaesthetic in medical settings but has gained popularity among young adults as a recreational substance. A recent study highlighted that the abuse of nitrous oxide is “rapidly becoming ubiquitous” among this demographic, marking a significant public health concern for health authorities.

The research indicates a troubling trend: many patients were using larger canisters of nitrous oxide, specifically 580g or 640g, as opposed to the previously popular 8g canisters. Some individuals admitted to the hospital had been using nitrous oxide for years, while others were first-time users. One patient reported consuming an astonishing 14 canisters daily for three weeks, and another had “binged” on six large canisters prior to their hospital admission.

The symptoms observed among the patients were alarming. Nearly all complained of paraesthesia, which is characterized by numbness or tingling sensations in the skin. Additionally, 13 patients reported weakness in their limbs, and eight exhibited gait impairment. The study found that the median length of hospital stay for these individuals was eight days, with some requiring extended care due to “significant functional disability.”

Nitrous oxide can interfere with the metabolism of vitamin B12, leading to damage or loss of the protective myelin sheath around nerve fibers in the dorsal spinal column. In a proactive approach, three patients had attempted to mitigate this risk by taking multivitamins or receiving vitamin B12 injections. All 18 patients were treated with high doses of vitamin B12 replacement, which the doctors stated prevented potentially life-altering disabilities among this cohort of previously healthy young people.

The findings of this case series are particularly concerning from a public health perspective. The authors emphasized that despite ongoing public education efforts, the abuse of nitrous oxide remains a persistent issue for medical professionals and health officials in Ireland.

In their publication in the latest issue of the Irish Journal of Medical Science, the authors noted that nitrous oxide poses complex challenges from a legislative standpoint. The gas is used without restrictions in the catering industry, which complicates efforts to regulate its recreational use.

The growing prevalence of nitrous oxide abuse among young people highlights the need for increased awareness and intervention strategies to address this emerging public health challenge.