Nitrous oxide, commonly known as laughing gas, is being misused by teenagers and young adults as a recreational drug. A new review of scientific studies shows that regular use of this gas can seriously damage the brain and mental health. The gas interferes with how the brain works, damages nerve cells, and can cause memory problems, depression, and other psychiatric issues. The research also found that teens from lower-income backgrounds, those with friends who use drugs, and those who also use alcohol or cannabis are at higher risk. Doctors say stopping use early, taking vitamin B12 supplements, and getting professional help can prevent long-term damage.

The Quick Take

  • What they studied: How nitrous oxide (laughing gas) affects the brains and mental health of teenagers and young adults who use it recreationally
  • Who participated: This was a review of many different studies, so it looked at research involving adolescents and young adults who misused nitrous oxide, with particular attention to those from lower-income backgrounds and those using other drugs
  • Key finding: Regular nitrous oxide use damages the brain in multiple ways: it interferes with vitamin B12 (which nerves need to work properly), causes memory problems, damages the part of the brain that processes vision, and increases depression and other mental health problems
  • What it means for you: If you or someone you know is using laughing gas recreationally, stopping now is important to prevent serious brain damage. Early intervention with vitamin B12 supplements and professional help can reduce long-term harm. This is especially important for teens whose brains are still developing.

The Research Details

This was a scoping review, which means researchers looked at many different studies on nitrous oxide misuse to understand what scientists have learned about it. They searched medical databases and journals for clinical trials, case reports, and public health surveys. The researchers focused on finding information about how nitrous oxide affects the brain, who is most likely to misuse it, what health problems it causes, and what treatments work. By combining information from many studies, they could see patterns and identify what we know and don’t know about this problem.

A scoping review is useful for understanding a growing public health problem because it brings together all the available research in one place. This helps doctors, public health officials, and parents understand the risks of nitrous oxide misuse and what can be done about it. Since nitrous oxide misuse among teenagers is becoming more common, having a clear picture of the science is important for creating prevention programs and treatment plans.

This review looked at multiple types of studies including clinical trials, case reports, and surveys, which gives a broad view of the evidence. However, because it’s a review of other studies rather than a new experiment, the strength of the conclusions depends on the quality of the studies reviewed. The researchers focused on recent and foundational studies, which helps ensure the information is current and well-established. Some gaps remain in the research, meaning we don’t yet have complete answers to all questions about long-term effects and the best treatments.

What the Results Show

The research shows that nitrous oxide misuse is becoming more common among teenagers and young adults, especially those facing certain risk factors. The gas works in the brain by blocking a specific type of brain receptor and triggering the release of natural pain-relieving chemicals, which can lead to addiction. Over time, regular use causes serious problems: it damages vitamin B12, which is essential for nerve function, leading to a condition called subacute combined degeneration where the spinal cord deteriorates. Brain imaging studies show that chronic users have reduced activity in the hippocampus (the memory center) and visual cortices (the vision processing areas), which explains why users experience memory loss and vision problems. Many adolescent users develop psychiatric symptoms including depression, delusions (false beliefs), and agitation.

The review identified several risk factors that make teenagers more vulnerable to nitrous oxide misuse: living in lower-income communities, peer pressure and friends who use drugs, and concurrent use of alcohol or cannabis. These findings suggest that prevention efforts should target these at-risk groups specifically. The research also found that early intervention is possible—stopping use, taking vitamin B12 supplements, and using certain medications like naltrexone and aripiprazole can help prevent or reduce permanent brain damage.

This review builds on previous research showing that nitrous oxide is more dangerous than many people realize. Earlier studies documented nerve damage from nitrous oxide use, but this review brings together current evidence showing the broader psychiatric and neurological impacts on adolescents specifically. The findings align with what we know about how other drugs affect developing teenage brains, which are more vulnerable to damage than adult brains.

The review identified important gaps in current research. We don’t yet have complete information about long-term outcomes in people who used nitrous oxide as teenagers—what happens to them 10 or 20 years later. We also don’t have enough evidence about which treatments work best, and we’re missing global data about how common this problem is in different countries. Because this is a review of existing studies rather than a new experiment, the conclusions are only as strong as the individual studies reviewed.

The Bottom Line

Based on this research, the strongest recommendation is to avoid recreational nitrous oxide use entirely, especially for teenagers whose brains are still developing. If someone has been using nitrous oxide regularly, they should stop immediately and see a doctor for vitamin B12 testing and supplementation. Mental health support and counseling are important for addressing depression or other psychiatric symptoms. Schools and communities should implement prevention programs that educate teenagers about the risks. These recommendations are supported by consistent evidence across multiple studies.

Teenagers and young adults should care about this research, as their developing brains are particularly vulnerable to damage. Parents, teachers, and school counselors should understand these risks to help identify and support at-risk youth. Healthcare providers need this information to recognize nitrous oxide-related health problems and provide appropriate treatment. Public health officials should use this evidence to develop prevention and education programs. People who use other drugs or alcohol should be especially aware, as combining substances increases risk.

Some effects of nitrous oxide use can appear quickly—memory problems and psychiatric symptoms may develop within weeks or months of regular use. Nerve damage can also develop relatively quickly. However, recovery takes longer: vitamin B12 supplementation may take weeks to months to restore nerve function, and full recovery from nerve damage may take several months or longer. Some nerve damage may be permanent if use continues for too long before stopping. The key is to stop using as soon as possible to prevent permanent damage.

Want to Apply This Research?

  • Track weekly substance use patterns by logging dates and frequency of nitrous oxide use (if applicable), along with mood check-ins (depression, anxiety, memory problems) on a 1-10 scale to monitor mental health changes over time
  • Set a specific goal to reduce or eliminate nitrous oxide use by a target date, and use the app to log daily progress toward that goal. If vitamin B12 supplementation is recommended by a doctor, use the app to remind yourself to take supplements daily and track compliance.
  • Establish a monthly review habit where you assess changes in memory, mood, and overall well-being. If you’ve stopped using nitrous oxide, track improvements in these areas. Share this data with your healthcare provider to monitor recovery and adjust treatment as needed.

This information is for educational purposes only and should not replace professional medical advice. If you or someone you know is struggling with nitrous oxide use or experiencing symptoms like memory loss, nerve pain, depression, or other mental health concerns, please consult with a healthcare provider, mental health professional, or contact a substance abuse helpline immediately. This research is a review of existing studies and does not constitute medical diagnosis or treatment recommendations. Always seek personalized medical advice from qualified healthcare professionals.