Although nitrous oxide, better known as laughing gas, is banned in the United Kingdom, in fact its possession is illegal, this does not mean that there are no young people who consume it. But, perhaps the biggest problem is when traveling to other countries this substance begins to generate social alarm.

In September of this year, there was a warning in Spain about the risk of consuming laughing gas at botellones (meetups for binge drinking in the street), and in Barcelona many bottles of what is known as laughing gas were seized by Police. But why is it so dangerous and can it cause death in young people who try it?

Nitrous oxide is actually a simple molecule, composed of two nitrogen atoms and a single oxygen atom. This substance is used in medicine, since, together with other volatile liquids (halogenated anesthetics), it is part of the general group of inhalation anesthetics. For this reason, nitrous oxide is always administered by inhalation, but in a very controlled manner.

Precisely because of its anesthetic effects, it has been used for years as an adjuvant for sedation and maintenance of anesthesia. Thus, in anesthesia, it is used in concentrations between 40 and 70%, never exceeding the latter figure, since it can cause nitrogen hypoxia, i.e., a state of oxygen deprivation in the organism. Its anesthetic and analgesic mechanism of action is unknown, although it has been shown to be an NMDA receptor antagonist and dissociative anesthetic (i.e., reflexes and coordinated but not conscious movements are maintained). In this respect, it is similar to ketamine and dextromethorphan. It also appears to interact with the opioid system.

What happens with young people? They do not measure the amount of nitrous oxide they inhale and this, like any other drug, can have serious health consequences. While in medicine this substance can be useful as an anesthetic in dental procedures, for example, great care must be taken to ensure that oxygen concentrations are safe.

When nitrous oxide is inhaled in an uncontrolled manner, it causes a state of euphoria. The sensation of relaxation, to which euphoria is added, provokes fits of laughter in which the person who has just inhaled nitrous oxide does not quite know what is happening. This can cause him to inhale even more gas with the health consequences that this can have.

What can happen if you inhale more nitrous oxide than you should? The most important risk associated with inhaling nitrous oxide is determined by its rapid and massive occupation of the pulmonary alveoli, which decreases blood oxygen and, if used repeatedly, can lead to cardiovascular, hematological and immunological toxic effects. It also blocks the action of vitamin B12, mainly in chronic consumers, so that megaloblastic anemia, leukopenia and, secondarily, subacute myelopathy and even chronic neuropathy may occur.

Alcohol, which is also often present in environments where nitrous oxide is consumed, can increase undesirable effects of nitrous oxide such as dizziness, vomiting, decreased reflexes, uncontrolled or antisocial behavior, etc.

Laughing gas may have a flashy and apparently innocent name, however, its effects may not cause so much joy. In extreme cases, it can lead to the death of young people who just wanted to have a good time.

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