Nitrous Oxide Addiction
Confidential advice about nitrous oxide use. Speak to our team about an assessment and suitable support. Call 0800 170 1222.
Medical review: Dr Mann, GP
Approval status: Approval pending
What is Nitrous Oxide Addiction?
Nitrous oxide, often called laughing gas or nos, is a gas used legitimately in medical and other settings. When inhaled recreationally, it can cause brief feelings of euphoria, altered perception and dizziness. Although the effects may last only a short time, repeated use can cause significant harm. [1, 2]
Some people find themselves using nitrous oxide more often than intended, craving its effects or continuing despite problems with health, relationships or daily life. This pattern may indicate problematic use or a substance use disorder. Not everyone who uses nitrous oxide develops addiction, and the pattern of dependence is not the same as that seen with alcohol or opioids. [2, 3]
How Addictive Is Nitrous Oxide?
Nitrous oxide can be associated with compulsive or psychologically dependent patterns of use. A person may repeatedly seek the short-lived effects, struggle to cut down or organise their day around obtaining and using it. Evidence for a predictable physical withdrawal syndrome is limited, so it would be misleading to describe nitrous oxide withdrawal as equivalent to alcohol or benzodiazepine withdrawal. [2, 3]
Psychological and behavioural factors
Stress, social circumstances, attempts to manage difficult feelings and repeated exposure can contribute to ongoing use. Treatment should explore what maintains the behaviour rather than assume that everyone needs the same type of detoxification.
How to Get Help With Nitrous Oxide Addiction
If you are finding it difficult to stop using nitrous oxide, speak to your GP or a local drug and alcohol service. They can assess your pattern of use, mental health and any physical symptoms. Step by Step Recovery can discuss treatment options and whether our residential programme is appropriate following assessment.
Seek urgent medical assessment if you have new numbness, tingling, weakness, difficulty walking or problems with bladder or bowel control. These may be signs of neurological injury and should not wait for a routine rehabilitation appointment. [1, 2]
Nitrous Oxide Addiction Treatment
Effective support is based on individual assessment. Depending on the person’s needs, this may include motivational work, structured psychological support, help managing cravings, relapse prevention and treatment of coexisting mental health problems. Some people may benefit from residential rehabilitation; others may be better supported by community services. There is no established routine medicine that acts as a specific nitrous oxide addiction cure. [3]
Medical assessment and vitamin B12-related harm
Nitrous oxide can inactivate vitamin B12 and cause a functional deficiency, even when a standard blood B12 result appears normal. NICE recommends plasma homocysteine or serum methylmalonic acid as the initial diagnostic test when recreational nitrous oxide use is the suspected cause of B12 deficiency. Assessment and treatment should be arranged by a clinician. [1]
People with suspected neurological complications may need urgent hospital assessment. NICE recommends offering oral or intramuscular vitamin B12 replacement when nitrous oxide-related deficiency is diagnosed, according to clinical judgement and patient preference. Serious neurological presentations may require specialist management; do not delay appropriate treatment while awaiting test results. Stopping nitrous oxide use is essential because continued exposure can undermine recovery. [1, 2]
Psychological therapy and rehabilitation
A treatment plan may explore triggers, establish alternative coping strategies and address the impact of nitrous oxide use on work, study and relationships. Where residential treatment is suitable, it can provide a structured setting for therapy and recovery planning. Medical complications must be assessed and managed in an appropriate clinical service, not treated as though rehabilitation alone can reverse nerve damage.
Signs of Nitrous Oxide Addiction
Regular or heavy nitrous oxide use can cause serious physical and neurological harm. Risks increase with larger amounts, frequent use and unsafe methods of inhalation.
Behavioural signs
- Using more frequently or for longer than intended.
- Repeated unsuccessful attempts to cut down.
- Continuing to use despite concerns from others or problems with everyday responsibilities.
- Spending increasing time obtaining, using or recovering from nitrous oxide.
Physical signs
- Dizziness, poor coordination, headache or nausea around the time of use.
- Tingling or numbness in the hands or feet.
- Unsteadiness, weakness or difficulty walking, which may indicate neurological injury.
Psychological signs
- Strong urges to use and preoccupation with the next opportunity.
- Anxiety or low mood that may coexist with problematic use.
- Difficulty changing a pattern of use despite wanting to stop.
- Serious symptoms require immediate emergency help
If someone develops severe breathing difficulty, loss of consciousness, serious confusion or other severe symptoms after using nitrous oxide, call 999 immediately.
Effects of Nitrous Oxide Use
Short-term effects
Recreational inhalation can cause dizziness, disorientation and impaired coordination, increasing the risk of falls and accidents. Inhaling gas can also reduce oxygen availability and, in some circumstances, lead to loss of consciousness or serious injury. Direct contact with very cold gas or equipment can cause cold burns. [2]
Long-term effects
Repeated heavy use can inactivate vitamin B12, affecting the spinal cord and peripheral nerves. Symptoms may include altered sensation, weakness, balance problems and difficulties walking. Some people experience lasting disability, especially when recognition and treatment are delayed. [1, 2]
What Is Nitrous Oxide Poisoning or an Acute Emergency?
A person who collapses, has a seizure, is struggling to breathe or is unresponsive needs emergency help. Call 999. Do not leave an unconscious person alone. If they are breathing normally, follow emergency-service advice about positioning and monitoring them. Do not attempt to manage a serious neurological problem through self-prescribed vitamin supplements alone. [2]
Important: If nitrous oxide use causes severe breathing problems, collapse or other serious symptoms, call 999 immediately.
Dangers of Mixing Nitrous Oxide With Other Substances
Combining nitrous oxide with alcohol or other drugs can increase impairment and accident risk. Tell healthcare professionals about all substances used, including prescribed medicines, so they can assess the full picture. [2]
Nitrous Oxide Use vs Nitrous Oxide Addiction
Use does not automatically mean addiction. Clinicians look at loss of control, cravings, continued use despite harm and the impact on a person’s life. Importantly, serious nerve damage can occur in someone who does not identify as addicted. Any neurological symptoms require medical assessment regardless of whether addiction criteria are met. [1, 3]
Can Nitrous Oxide Cause Withdrawal Symptoms?
People stopping frequent use may experience cravings, disturbed sleep, low mood or anxiety, but there is no well-established, predictable physical withdrawal syndrome comparable to alcohol or benzodiazepine withdrawal. Treatment focuses on assessment, psychological support and prompt identification of medical complications. [2, 3]
Nitrous Oxide and the Law in the UK
In the UK, nitrous oxide is a Class C drug when possessed without a lawful exemption. There are legitimate medical, industrial and other uses. The legal position depends on the circumstances, so readers should consult current government guidance rather than rely on older information about the Psychoactive Substances Act alone. [2]
Support From Step by Step Recovery
If nitrous oxide use is affecting your health or daily life, our team can talk through your concerns and explain the assessment process. Where a residential programme is suitable, treatment may include structured therapy and recovery planning. We will not present residential rehabilitation as a substitute for urgent medical or neurological care.
Call 0800 170 1222 for confidential advice, or request an assessment through the Step by Step Recovery website.
Common Questions
FAQs
Here are some common questions based on the information already covered on this page. If you would rather speak to someone privately, our team is available to help.
Is nitrous oxide addictive?
It can lead to problematic, compulsive patterns of use. The physical dependence and withdrawal profile is different from that of alcohol or opioids. [2, 3]
Can nitrous oxide cause permanent nerve damage?
Yes. Repeated heavy use can cause functional vitamin B12 deficiency and neurological injury. Some people have persistent symptoms despite treatment. Early medical assessment is important. [1, 2]
Will a normal vitamin B12 blood test rule out nitrous oxide damage?
No. Nitrous oxide can inactivate vitamin B12 even when standard levels appear normal. NICE recommends homocysteine or methylmalonic acid testing when nitrous oxide use is the suspected cause. [1]
Do I need detox for nitrous oxide addiction?
Not necessarily. There is no standard medically assisted withdrawal regimen equivalent to alcohol detox. A clinician should assess your use and check for neurological or other complications before recommending the right level of support. [1, 3]
Can I take vitamin B12 and carry on using nitrous oxide?
No. Vitamin replacement does not make continued recreational use safe. NICE advises stopping nitrous oxide and receiving appropriate clinical treatment if deficiency is suspected or confirmed. [1]
Can Step by Step Recovery help?
We can discuss your circumstances and whether our treatment programme is suitable. If you have symptoms of nerve damage or another medical emergency, seek medical care first.
Other Addictions We Treat
Step By Step Recovery also provides information and treatment support for other drug and alcohol addictions.
Prescription Drug Addiction
Learn more about prescription drug addiction, warning signs and treatment support.
Cannabis Addiction
Learn more about cannabis addiction, dependency and treatment support.
Cocaine Addiction
Learn more about cocaine addiction, its effects and available treatment support.
Three specialised Clinics
Drug and Alcohol Treatment in Essex, London and Birmingham
Step By Step Recovery operates three specialist clinics providing residential detox and rehabilitation in Essex and outpatient treatment in London and Birmingham. Wherever you are in the country, help is closer than you think.
RESIDENTIAL
Essex Clinic
- 1A Southchurch Avenue, Southend-On-Sea, SS3 9BA
- 01702 296 006
outpatient
London Clinic
- Finsgate House, 5 Cranwood Street, London, EC1V 9EE
- 0207 118 9400
outpatient
Birmingham Clinic
- Suite 201c Bradford Court Business Centre, 123 – 131 Bradford Street, Birmingham, B12 0NS
- 0121 401 1700
Clinical Sources
[1] NICE. NG239: Vitamin B12 deficiency in over 16s: diagnosis and management (2024), recommendations 1.3.3 and 1.5.8–1.5.10. https://www.nice.org.uk/guidance/ng239/chapter/recommendations
[2] UK Home Office. Nitrous oxide ban: guidance, including health harms and lawful exemptions. https://www.gov.uk/government/publications/nitrous-oxide-ban/nitrous-oxide-ban-guidance
[3] UK Department of Health and Social Care. Drug misuse and dependence: UK guidelines on clinical management (2017), general assessment and psychosocial treatment principles. https://www.gov.uk/government/publications/drug-misuse-and-dependence-uk-guidelines-on-clinical-management
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