Despite a recent Food and Drug Administration warning against inhaling nitrous oxide, commonly known as laughing gas, deaths due to misusing the substance are on the rise in the United States.
Andrew Yockey, University of Mississippi assistant professor of public health, and Rachel Hoopsick, assistant professor of health and kinesiology at the University of Illinois at Urbana-Champaign, are studying the rise of nitrous oxide misuse .
"This is a chemical that is commonly used as a sedative or anesthetic, but what we're seeing is a rise in recreational use," Yockey said. "But what we're also seeing is also a rise in hospitalizations, in poisonings and in deaths."
More than 13 million Americans have misused nitrous oxide in their lifetimes, according to the 2023 National Survey on Drug Use and Health. The number of deaths attributed to nitrous oxide poisonings rose by more than 110% between 2019 and 2023, according to the Centers for Disease Control and Prevention .
"The preliminary findings of our study are that deaths have remained fairly small compared to other dangerous substances," Hoopsick said. "But what we're seeing is that over the last couple of years, those rates have increased exponentially.
"At that continued rate, we could be looking at a much larger problem."
People have misused nitrous oxide – also called whippets – for decades to get a fleeting high, but the long-term effects of misusing the gas are potentially deadly. The FDA recently warned consumers that repeatedly inhaling it could lead to asphyxiation, blood clots, frostbite, numbness, paralysis and brain damage, among many other side effects.
Unlike many misused substances, nitrous oxide is unregulated. An online search for it yields a plethora of results, with various flavors and all in bright, eye-catching colors.
"Think back to big tobacco; they deliberately targeted young people with cartoons, fun flavors and flashy colors," Hoopsick said. "That is a parallel we're seeing now with nitrous oxide."
The gas is often marketed as a culinary ingredient to turn cream into whipped cream. The FDA warns that consumers can purchase nitrous oxide through Amazon, Walmart, eBay and many smoke and vape shops across the nation without issue.
"I really doubt anyone is buying flavored nitrous oxide to make blueberry mango whipped cream," Yockey said, reading one of the flavors listed on Amazon. "Or 'Bomb Pop.' But I can have it delivered to my house in a couple of days."
Also similar to the tobacco industry's tactics for pulling in consumers, nitrous oxide sellers minimize the potential danger of abusing the product, Hoopsick said.
"We have evidence that nitrous oxide poisoning is a very real danger, but this is very often ignored or trivialized," she said. "Sellers of nitrous oxide rarely, if ever, provide health warnings. I think the public sees it as a party drug."
Hoopsick and Yockey are also investigating the role of social media in influencing young adults to use nitrous oxide. Videos of teens and young adults inhaling the chemical are easily found across social platforms .
"We know that if you watch videos of someone else doing it, you're more likely to try it," Yockey said. "I worry about the high school and college-aged adolescents who see this online and decide to buy a fruit-punch flavored tank. Because right now, that's perfectly legal."
More research is needed to track the full scope of nitrous oxide misuse, but regulation must also catch up to prevent further harm, the researchers said.
"Policy level interventions are what are lacking at the moment," Hoopsick said. "If we have some guardrails on who can sell this, who can buy it and how it's marketed, maybe we can get ahead of the problem."
Until then, the availability of nitrous oxide continues to grow.
"Some of these brands were not here even a week ago," Yockey said, scrolling through listings on his computer. With expedited delivery, any one of them could be on one's doorstep by the end of the week.
"What they're doing here is very ingenious, but it's also incredibly dangerous," he said.
