Nitrous oxide is far from fun
Laughing gas stands on the shelf at the corner store and is causing supposedly funny challenges on TikTok. However, especially with heavy consumption, there are dramatic consequences. After Britain and the Netherlands, a ban is now also imminent in Germany.
A young man jumps onto a couch, his friends cheering him on in front of and behind the camera. Their cheering gets louder as he pulls on a balloon, and when he finally stumbles off the sofa, dazed, they all laugh together. Videos like this have been circulating on social media platforms like TikTok for months, fueling the debate about the carefree handling and underestimated dangers of the substance in the balloon: laughing gas.
Primarily teenagers and young adults are inhaling the gas through balloons, ideally followed by laughter and a brief feeling of euphoria. Less funny, however, are side effects such as unconsciousness, auditory and visual hallucinations, or persistent headaches.
Laughing gas is a chemical compound of nitrogen and oxygen, known as dinitrogen monoxide. Due to its numbing effect, it was first used in medicine for anesthesia in the mid-19th century. However, it has a longer tradition as a recreational drug. Shortly after its discovery in England in the 1770s, it was making the rounds at parties of the British upper class as "paradise gas." In the 1970s, it experienced a revival at music festivals and was popular among hippies.
The popularity of laughing gas has shown historical waves, says Heiko Bergmann from the Institute for Therapeutic Research. "In the 1990s, it was popular at raves, then it only appeared sporadically for a few years." Bergmann contributed to a "trendspotter" survey published last April for the National Early Warning System. The national early warning system is designed to detect and classify trends in the consumption of psychoactive substances.
Balloons come with the order
Nearly three-quarters of those surveyed reported experiencing dizziness after consuming laughing gas, almost as many felt a tingling in their fingers and toes. More than half described a feeling of confusion. When asked about their reasons for consumption, they mentioned "positive effects" and the consumption of their friends. Availability came in third place.
This is why laughing gas is currently being politically discussed regarding its dangers. The gas cartridges are legal and can be bought almost everywhere: in the neighboring corner store, on Amazon - they have even appeared in a snack machine. Laughing gas does not currently fall under the Narcotic Drugs Act and thus counts as one of the so-called legal highs. The business has grown rapidly in the past year.
Officially, the cartridges are marketed as refill containers for whipped cream dispensers. The appearance of the steel bottles from providers like Exotic Whip has little to do with a coffee maker. They are decorated with palm patterns or coconuts and equipped with a carrying handle. "The product is exclusively intended for the production of whipped cream products and must not be used for any other purpose," it says on the website of an online retailer - but balloons conveniently come with the order.
In Britain, laughing gas was the third most common party drug, and in the Netherlands, it was the most consumed recreational drug among youth - until both countries banned possession and sale for private use in 2023. A ban also applies in Belgium, France, and Denmark have made acquisition more difficult and banned sale to minors.
Last year, the Federal Ministry of Health merely referred to existing warning notices, but now a ban is imminent in Germany. The ministry's draft proposes to prohibit the production, import, and trade, as well as the acquisition and possession of nitrous oxide. Industrial or scientific applications, such as in agriculture or the chemical industry, would be excluded. This is expected to come into effect after the summer break.
Dramatic Individual Cases
Meanwhile, assessing the actual health risks of nitrous oxide is challenging. On the one hand, the number of injuries caused by nitrous oxide compared to other drugs is negligible. A "Trendspotter" survey found that the assumption that the consequences of nitrous oxide consumption were a significant problem in neurological clinics could not be confirmed in surveys of the respective institutions. International studies even described the consumption of small amounts as relatively safe. On the other hand, the consequences can be severe in individual cases.
Only three consumers of nitrous oxide contacted the poison information center's hotline in 2020. "Last year, it was 19, and this year, it's already 19 as well," says Andreas Schaper, clinical toxicologist and director of the center. Since his institution is only responsible for the federal states of Bremen, Hamburg, Lower Saxony, and Schleswig-Holstein, a similar trend can be assumed nationwide.
Callers mainly expressed concerns about long-term effects and occasionally reported neurological symptoms. "Consuming nitrous oxide can lead to a deficiency in vitamin B12, which can result in nerve damage and fatigue or loss of sensation," explains Schaper.
Thin Data Base
The data situation in Germany is manageable, says Heiko Bergmann. "We estimate that five to ten percent of young partygoers have consumed nitrous oxide in the last twelve months." There are indications of an increased consumption among young people, but the extent of this increase cannot be verified. "Compared to other drugs, nitrous oxide plays a minor role, especially among adults," says Bergmann. Also, severe cases treated in hospitals as a result of nitrous oxide consumption are too rare to indicate a dramatic increase.
Nitrous oxide is not yet a mass phenomenon in Germany. For comparison: According to the Federal Statistical Office, around 11,700 children and young people aged 10 to 19 were treated in a hospital as inpatients due to acute alcohol poisoning in Germany in 2021.
Nevertheless, particularly with excessive consumption, severe health consequences can occur. Due to its short effect, the temptation to quickly fill the next balloon is great. Neurologists warn of lasting nerve damage, especially in young people whose nervous system is more susceptible. Studies from France or England report consumers with spinal cord nerve damage who had to sit in a wheelchair for a longer time. Cases of suffocation have also been documented, but these were in combination with a mask or plastic bag over the head to enhance oxygen deprivation.
The popularity of inhaling laughing gas through balloons, often leading to side effects like dizziness, tingling fingers and toes, and confusion, has fueled the debate about its carefree handling and underestimated dangers. Despite its legal status and easy availability, the federal ministry of health in Germany has announced an imminent ban on the production, import, and trade, as well as acquisition and possession of nitrous oxide.
