September to December 2025

 From "Laughing Gas" to "Galaxy Gas": An Updated Review on the Neurological, Pathologic, and Psychiatric Sequelae of Nitrous Oxide Abuse The review of 13 studies, which included retrospective cohorts, case series, and cross-sectional surveys, highlights the severe neuropsychiatric and physical consequences of N₂O abuse.

July and August 2025

US Nitrous Oxide Mortality From 2010 to 2023, there was a total of 1240 deaths attributable to nitrous oxide poisoning among people aged 15 to 74 years in the US, with 23 deaths observed in 2010 and 156 deaths observed in 2023.

Treatments for Inhalant and Volatile Substance Misuse: A Scoping Review This scoping review examines the proposed treatment options for inhalant and volatile substance misuse. It categorizes the proposed treatments and specifically outlines their effectiveness and limiting factors. 

Recreational Nitrous Oxide Misuse: Anaesthetic Challenges and Perioperative Complications Including Airway Burns and Neurological Sequelae This review highlights the perioperative implications of N2O misuse, with a focus on airway injury, neurological sequelae, and anaesthetic management. Cold burns from direct inhalation can compromise airway safety, while chronic use leads to functional vitamin B12 inactivation, resulting in subacute combined degeneration and peripheral neuropathy.

Diagnostic Challenges and Key Insights of Nitrous Oxide Neuropathy: A Case Series  We present two cases highlighting diagnostic challenges consisting of a 34-year-old male and a 52-year old, both initially misdiagnosed as chronic inflammatory demyelinating polyneuropathy (CIDP). They were eventually diagnosed as N2O-induced neuropathy based on lab testing and electrodiagnostic findings.

Impact of Nitrous Oxide on Neuropsychiatric Impairment in Adolescents: A Scoping Review  This scoping review investigates recent and foundational studies on the long-term neuropsychiatric effects associated with prolonged and frequent use of this volatile gas.

January to June 2025

 

Butane Intoxication: A Case Report with Brain Images Resembling Wernicke Encephalopathy and a Delayed Sequela of Slow Orthostatic Tremor  A 34-year-old male with a butane abuse history for 6 years presented with fever, change in consciousness, and seizures.

Poppers retinopathy: What is it and how do we treat it? Poppers retinopathy is a relatively unknown phenomenon which afflicts users of poppers but should be considered as a differential in sudden-onset or sub-acute visual acuity loss – particularly in patients with a history of recreational drug use.

April to December 2024

 

Assessing the prevalence of nitrous oxide usage in patients aged 35 years or under presenting with unprovoked VTE between 2021-2023 Nitrous oxide (N2O), often known as "laughing gas," ranks as a widely used recreational drug among young people in the UK, with 3.9 % of young adults aged 16–24 reporting its use in 2021–2022. Besides its known neurological risks, there is emerging evidence linking N2O misuse to serious haematological issues, including arterial and venous thrombosis.

Fatal Consequences of Lighter Gas Abuse: A Case Report.

Volatile solvent abuse among young people poses a significant public health threat due to its accessibility and fatal outcome potential. This case report presents a 22 year old otherwise healthy male who died after lighter gas abuse, which highlights the severity of inhalant abuse related outcomes.

A fatal case of accidental asphyxia following nitrous oxide inhalation and alcohol consumption

...the inhalation of N2O using balloons is traditionally regarded as a relatively safe method. In this report, we present an unusual fatal case of a 16-year-old girl who died after drinking alcohol and inhaling N2O from balloons.

January to March 2024

Analytical methods for detecting butane, propane, and their metabolites in biological samples: Implications for inhalant abuse detection This comprehensive approach provides valuable insights into the detection and assessment of inhalation to these volatile substances.

Cracking the Whippet: The Inconsistent Treatment of Myeloneuropathy Secondary to Chronic Nitrous Oxide Misuse  We present six cases from a single centre in the United Kingdom between 2016 and 2020 with neurological complications from N2O abuse, ranging from paraesthesia to subacute combined degeneration of the spinal cord.

Frostbite injuries from recreational nitrous oxide use Recreational use of inhaled nitrous oxide is rapidly increasing. As liquid nitrous oxide (N2O) is cooled to its gaseous form for inhalation, container mishandling can cause frostbite injuries to the face and extremities.

Sudden death due to butane abuse – An overview In the forensic field, it may be useful to shed more light on intoxications, deaths, and butane encephalopathies, as the latter can be mistaken for a hypoxic-ischemic encephalopathy.

Butane-related deaths in post-mortem investigations: A systematic review When death by butane inhalation is hypothesized, autopsy and histological findings may be nonspecific, therefore toxicological investigations assume a crucial role along with attention to the methods used to collect biological samples.

April to December 2023

 

Effectiveness of interactive workshops to raise awareness of the neurological harms associated with nitrous oxide use: a cross-sectional study The Royal London Hospital, East London, receives a case of nitrous oxide (N2O) myeloneuropathy roughly every 9 days. No formal education programme is widely available to warn young people of the risks of recreational N2O use. Our aim was to develop and evaluate the effectiveness of workshops focusing on the neurological risks of N2O, with the primary outcome to increase awareness of these risks among young people.

Crime Scene and Autopsy Findings in two Cases of Sudden Death Caused by Inhalation of Butane Gas Solvent inhalation is still an important public health problem that is responsible morbidity and mortality of young people worldwide and has adverse effects on society. In Turkey, solvent inhalation is the most common substance abuse following smoking and alcohol addiction, and butane and propane have been reported to be the most frequently inhaled substances.

The Clinical Assessment and Treatment of Inhalant Abuse Although inhalant abuse is common, it is one of the most neglected and overlooked forms of substance abuse. Inhalants refer to a wide variety of substances including volatile solvents, aerosols, gases, and nitrites.

February & March 2023

Use of the Rehabilitation Treatment SpecificationSystem (RTSS) in the management of nitrous oxide(N2O)-induced spinal cord injury  Previous studies have discussed the medical management. However, none have specified the sensorimotor rehabilitation management. This case report documents the investigations, physical rehabilitation and functional outcomes in two cases of N2 O-associated myelopathy.

Neurological and cardiac symptomatology in a teenager in the context of chronic nitrous oxide use: A case report We report the case of a 15-year-old boy with rapid onset of lower limb paralysis after massive nitrous oxide intake. 

December 2022

Nitrous oxide abuse leading to extreme homocysteine levels and thrombosis in young adults: a case series With increasing dosages and frequency of N2O use, an additional association with thromboembolisms is becoming apparent.

Martine G.Carisemko S.Kuipers, Baruch E.Kiestra, Barry J.Ruijter, Robert K.Riezebos, MichielCoppens, Hans L.Mooij, 2022

 

The Effects of the Inhalant Toluene on Cognitive Function and Behavioral Flexibility: A Review of Recent Findings In this work, we review what is currently known regarding the sites and mechanisms of action of inhalants with a focus on the volatile solvent toluene that is contained in a wide variety of legal and easily obtained products. 

John J.Woodward Kevin M.Braunscheidel, 2022

October 2022

 

Recreational use of nitrous oxide Smart legislation, prevention, and harm reduction are required to reduce the risks

1. h.sumnall@ljmu.ac.uk, 2022

August 2022

 A Systematic Review of Recreational Nitrous Oxide Use: Implications for Policy, Service Delivery and Individuals The aim of this mixed method systematic review was to collate and synthesise the disparate body of research on recreational nitrous oxide use to inform harm reduction approaches tailored for young people.

J Allan, J Cameron, J Bruno - 2022