Researchers studied 18 young people who misused nitrous oxide (laughing gas) and developed serious nerve damage. Most were male, averaging 20 years old, and reported heavy, repeated use of the drug. They experienced tingling, weakness, and walking problems. Tests showed low vitamin B12 levels and damage to their spinal cords and nerves. This study highlights a growing health problem, especially among young people, showing that nitrous oxide abuse can cause lasting nerve and spine damage that requires medical attention.

The Quick Take

  • What they studied: What happens to the nerves and spine when young people repeatedly misuse nitrous oxide (laughing gas)
  • Who participated: 18 patients, mostly male (78%), with an average age of 20 years, all reporting heavy use of inhaled nitrous oxide over time
  • Key finding: Heavy nitrous oxide use caused nerve and spine damage in nearly all patients studied, with tingling (83%), weakness (72%), and walking problems (44%) being the most common symptoms
  • What it means for you: If you or someone you know uses nitrous oxide recreationally, this research suggests it can cause serious, potentially lasting damage to nerves and the spinal cord. This is a real health risk that shouldn’t be ignored, and medical help should be sought if symptoms develop.

The Research Details

Researchers at Tallaght University Hospital in Ireland collected information on 18 patients who came to the hospital with nerve and spine problems linked to nitrous oxide abuse between October 2022 and July 2024. They gathered data both by looking back at past patient records (retrospective) and by following new patients as they arrived (prospective). For each patient, they documented their symptoms, ran medical tests like blood work and imaging scans, and tracked how they were treated. This approach allowed them to see patterns in how the drug affected different people and what warning signs doctors should watch for.

By studying actual patients with these problems, researchers can understand the real-world effects of nitrous oxide abuse rather than just laboratory findings. This helps doctors recognize the condition faster and treat patients more effectively. The study also shows that this is becoming a more common problem, which is important information for public health officials and healthcare systems.

This is a case series from a single hospital, which means it describes what the researchers observed in their patients but doesn’t compare them to a control group. The sample size is relatively small (18 patients), so findings may not apply to everyone who uses nitrous oxide. However, the detailed medical documentation and consistent patterns across patients strengthen the reliability of the observations. The study’s main strength is that it documents a real clinical problem that doctors are increasingly seeing.

What the Results Show

Nearly all 18 patients experienced tingling sensations (83%), most had muscle weakness (72%), and about half had difficulty walking. These symptoms appeared after heavy, repeated use of nitrous oxide. Blood tests revealed that most patients had low or low-normal vitamin B12 levels—11 out of 18 patients. Almost all patients tested (14 out of 16) had elevated homocysteine, a chemical in the blood that can indicate B12 deficiency and nerve damage. Spinal cord imaging showed damage in half of the patients who had scans, with some showing damage extending from the neck down to the mid-back. Nerve conduction tests, which measure how well nerves work, showed a pattern of nerve damage that primarily affected motor nerves (the nerves that control movement).

Only 3 out of 18 patients were taking vitamin B12 supplements before their symptoms developed, suggesting that supplementation alone may not prevent damage in heavy users. The consistency of findings across patients—similar symptoms, similar blood test results, and similar nerve damage patterns—suggests this is a predictable consequence of heavy nitrous oxide use rather than a random occurrence. The fact that most patients were young (average age 20) indicates this is becoming a problem in younger populations.

This study adds to growing evidence that nitrous oxide abuse is causing an increasing number of nerve and spine injuries, particularly in young people. Previous research has linked nitrous oxide to B12 deficiency and nerve damage, and this study confirms those findings while documenting the specific patterns of damage seen in a hospital setting. The research suggests this is becoming a more recognized public health concern than it was a few years ago.

This study only included 18 patients from one hospital, so the findings may not apply to all people who misuse nitrous oxide. The study didn’t include a comparison group of people who don’t use nitrous oxide, so we can’t be completely certain the drug caused all the problems observed. Some patients didn’t have all the same tests done, making it harder to compare results across the group. The study doesn’t tell us how common this problem is in the general population or what percentage of heavy users develop these complications. Long-term follow-up information about whether patients recovered is limited.

The Bottom Line

If you use nitrous oxide recreationally, especially heavily or frequently, this research strongly suggests you should stop. If you experience tingling, numbness, weakness, or walking difficulties, seek medical attention promptly. If you’re struggling with substance use, talk to a healthcare provider about support options. There is no evidence that vitamin B12 supplements alone prevent nerve damage in heavy users.

Young people and anyone using nitrous oxide recreationally should be aware of these risks. Healthcare providers, emergency room doctors, and neurologists should consider nitrous oxide abuse when patients present with unexplained nerve or spine symptoms. Parents and educators should understand this is a real health risk. People with existing B12 deficiency or nerve problems should definitely avoid nitrous oxide.

Symptoms can develop after months of heavy use. Recovery from nerve damage can be slow and incomplete—some patients may experience lasting effects. The longer someone uses nitrous oxide heavily, the greater the risk of permanent damage. Seeking help early when symptoms first appear may improve outcomes.

Want to Apply This Research?

  • Track frequency and amount of nitrous oxide use (if applicable), along with any symptoms like tingling, numbness, or weakness in hands/feet. Note the date symptoms first appear and their severity on a scale of 1-10.
  • If using the app to monitor substance use, set a goal to reduce or eliminate nitrous oxide use. Use the app to log days without use and track improvements in any symptoms. Share tracked data with a healthcare provider to support treatment discussions.
  • For people in recovery or reducing use, monitor for symptom improvement over weeks and months. Track energy levels, walking ability, and any tingling or numbness. Regular check-ins with a doctor can help assess whether nerve damage is improving or if additional treatment is needed.

This research describes serious health risks associated with nitrous oxide abuse. It is not a substitute for professional medical advice. If you or someone you know is experiencing symptoms like tingling, numbness, weakness, or walking difficulties, especially in connection with nitrous oxide use, please seek immediate medical attention from a healthcare provider or emergency room. If you’re struggling with substance use, confidential help is available through healthcare providers and addiction support services. This information is for educational purposes and should not be used for self-diagnosis or self-treatment.