Medsafe advised that nitrous oxide would be reclassified as a psychoactive substance rather than a restricted medicine in 2024.
This means that selling nangs for recreational use is punishable by up to 2 years imprisonment or a $500,000 fine. Minister of Health at the time Shane Reti believed that this was in the best interest of protecting youth from the dangers of this drug.
Read the One News article about the law change
With increasing awareness of nitrous oxide in New Zealand, and with more frequent use, questions are bubbling up: how harmful is nitrous oxide, really? Is it causing us harm, or is it still okay to laugh it off?
What is nitrous oxide?
Nitrous oxide is a dissociative anaesthetic gas, used in medical settings for pain relief and sedation. Recreationally, it’s typically inhaled from small steel cartridges, known as whippets (in the UK or USA), chargers (in the culinary world), or more commonly here in New Zealand, nangs.
Inhaling nitrous oxide causes a short dissociative high lasting anywhere between 30 seconds and 5 minutes. Effects can include:
- Light-headedness or floating
- Giggles, euphoria, or dreamlike detachment
- Distorted sound and sensations
- In higher doses: anxiety, confusion, or even hallucinations
The effects are usually brief, wearing off within a few minutes
But are nangs really harmful?
A recent study of young people that assessed the harm of various drugs both on individuals and on the wider community. It ranked nitrous oxide as the least harmful drug in New Zealand. Interestingly alcohol was at the top of this list.
Read The New Zealand drug harms ranking study: A multi-criteria decision analysis by Dr. Rose Crossin et al
All that being said, nangs are like most substances — if you do too much for too long, it’s going to have a negative effect.
The cases in the news last year were all people that were doing up to between 1L and 2L of nitrous a day over a series of consecutive days.
To give you an idea, one of those little metal cannisters holds about 8ml of gas. To get through a 2L tank in 24 hours you’d need to do about 250 cannisters (no, this is not a challenge).
Woman loses ability to move legs after ‘nangs’ nitrous oxide overdose, RNZ 2024
‘Restrict access’: Person hospitalised for 26 days after consuming 720 ‘nangs’, Newstalk ZB, 2024
Chronic effects of nitrous oxide use
Inhaling nitrous oxide prevents B12 from being absorbed by your body, and this then affects two key enzymes that are crucial for making sure our nerves function properly.
This stops your body from using B12 properly, which affects key enzymes that keep your nerves healthy, especially the protective myelin around them. Over time, this can lead to serious nerve and brain issues.
Disruption of these two enzymes has been linked to significant neurological and psychiatric symptoms:
- Tingling in extremities
- Overall weakness
- Damage to the spinal cord (including spinal cord lesions)
- Hallucinations
- Agitation
- Depression
- Personality changes
Even if your B12 is within a normal range, you might still have some of these symptoms that are caused by nitrous oxide use. While B12 levels are normal, these two enzymes are low or not functioning as they should.
There are several studies that have found that people who take high amounts of nitrous oxide for a longer period of time (at least several weeks) do start to experience these symptoms. Reported use in these studies ranged from 50-300 nangs a day, with symptoms appearing after a few weeks in some cases, several months in other cases. The majority of people also appear to have fully recovered after both taking a break from nitrous oxide use and B12 supplementation.
Reduce your risks with nangs
Even if you’re not using nitrous oxide regularly in high doses, it is still a drug. There are ways to use nitrous oxide more safely
Set and setting matter
Make sure you pick an environment free of hazards, and ideally consume while seated/lying down. One of the most common ways people get hurt taking nangs is by falling over onto something sharp/hard/on fire/all of the above.
Your balance and coordination are often impacted, and the dissociative effects mean you have a lot less connection to your body and awareness of your surroundings while high on nitrous oxide. You are much more likely to fall and hurt yourself than when you haven’t had any nos.
We definitely don’t recommend trying high risk activities like swimming or driving. Nitrous oxide can cause confusion, anxiety and paranoia in the aftermath of inhaling. Like all drugs, you are more likely to have a better experience if you take them with people you feel comfortable with.
Equipment safety
Cracking a nang releases gas at temperatures as low as -40°C, cooling the canister and gas enough to freeze skin on contact. Inhaling from the cylinder directly can cause frostbite on your lips, tongue, throat and even your lungs.
Know your dose
While most nangs are consumed from a small single-serving canister, which most folk use as a standard dose. In saying that, nitrous can also be found in large tanks holding up to 3kg. Consuming from a large tank with no clear dose markers makes it more difficult to figure out how many doses you’ve had, increasing your risk of overdoing it.
Balloons
If you’re going to do nangs, balloons are the best way to reduce your risks.
Decanting your nang into a balloon helps you remember how many you’ve had if you’re using a big tank, and reduces the pressure that you’re inhaling the gas at. Breathing out into the balloon as you have your nang helps warm the gas and reduce the risk of frostbite.
Also if everyone has their own balloon it reduces the risk of spreading viruses via saliva and breath.
Take a breath
Finally, make sure you take breaks between balloons, and keep track of how many times you fill your balloon in a session. A common dose is around 1-3 of the small canisters. And make sure to take breaks between sessions.
Read more nang harm reduction tips on The Level and The Australian Alcohol and Drug Foundation
Dangerous interactions
Mixing nangs with any type of sedative increases the chances of passing out, vomiting, or both. This can lead to choking on said vomit while unconscious if your friends don’t put you in the recovery position. Alcohol, GHB/GBL/1,4-BD, opioids (including pain relievers like tramadol and codeine), and benzos are particularly risky if you mix them with nangs.
What overdoing it feels like
You can feel a bit overwhelmed, lightheaded, anxious or confused after having a few too many. This is easy to fix by
- Focus on your breathing. We like box breathing for this, but even taking long, slow breaths in through your nose and out through your mouth is helpful if you’re too anxious
- Find someone you trust. Ideally you’ll have a tripsitter or a friend with you to remind you what reality is and help talk you down.
- Find a quiet, safe space. Most events will have a chill space with designated helpers. PsyCare and Deep Space are brilliant and their volunteers are highly skilled at helping people who are having an unexpected time. If you’re at a house party, find a quiet spot with your friends to ground.
When to call an ambulance/get to the medics:
- Seizures
- heart palpitations
- chest pain
- loss of consciousness
- shallow breathing
- skin colour changes, typically bluish purple or greyish/ashen skin (especially lips and fingernails)
Signs your body needs a break from nangs
If you use nangs regularly and in large amounts you’re increasing your risks of permanent nerve damage and diffusion hypoxia.
Early warning signs your system is struggling with nangs
- numbness or tingling, especially in the fingers, toes, and lips
- unexplained weakness or tiredness
Time off from nangs is key. B12 supplements from the healthfood stores or even B12 injections from your GP alone won’t reverse the damage, as nitrous oxide denatures B12. It doesn’t really matter how much extra B12 you’re putting into your body, if you’re still doing nangs on the regular it’s not going to do its job.
People on plant-based diets should also take extra care with their B12 levels if they’re doing nangs on the regular. Their B12 intake is lower than omnivorous people, so will be starting with a lower baseline.
Further reading
Ballooning panic around nitrous oxide helps no one – Newsroom Article, 2024
Nitrous oxide (nos) laughing yourself sick? – KYSNZ blog, 2022