Nitrous oxide: Laughing gas users risk spine damage, say doctors

Heavy use can lead to a vitamin deficiency that damages nerves in the spinal cord.

ISLAMABAD (Online) - Doctors at an east London hospital say they are seeing so many risky cases of laughing gas misuse that they have drawn up treatment guidelines for colleagues in the UK.

Nitrous oxide, sold in metal canisters, is one of the most commonly used drugs by 16 to 24-year-olds.

Heavy use can lead to a vitamin deficiency that damages nerves in the spinal cord.

The Royal London Hospital team say medics need to be on alert.

They have been seeing a new case almost every week.

These patients come in with nerve-related symptoms - being unable to walk, falling over or experiencing tingling or loss of sensation in their feet and hands.

Some have nerve-related bladder or bowel problems or incontinence.

Importantly, for NHS workers, few mention nitrous oxide use.

Prof Alastair Noyce, a consultant neurologist at Queen Mary University of London, told BBC News: "These are young people we are seeing - teenagers and people in their 20s.

"What's striking now is the severity. We've seen that increase over the last 12 months or so."

He said that might be linked to people using large cylinders of the gas which can contain a similar amount to 60 or 70 of the small silver canisters that can be seen scattered on streets and in parks.

"If you have been using and you develop symptoms, stop using it immediately and seek medical help as soon as possible," he said.

The drug can damage the nervous system by interfering with the metabolism of vitamin B12. This damages a protective layer on nerves, typically those in the rear of the spine.

Correcting the vitamin B12 deficiency quickly, with vitamin injections, can prevent permanent damage.

The guidelines, endorsed by the Association of British Neurologists and written with experts from Manchester, Birmingham, Nottingham and the Queen Mary University of London, warn doctors what to look for and how to treat.

What are the risks of nitrous oxide?

• Nitrous oxide slows down your brain and your body's responses

• Too much can make you faint, lose consciousness, or suffocate

• Chronic heavy use can also cause nerve damage

• Inhaling directly from the canister is particularly dangerous - the gas is freezing cold and under high pressure, which can damage the throat and lungs, stop breathing or slow the heart

• It can also cause short-lived but intense feelings of paranoia

The government in England and Wales is considering a ban on use and sales over health concerns.

In January, the Netherlands became the first country in the world to make its use illegal.

Authorities say the gas can still be used for medical purposes, as an anaesthetic, and in the food industry - as a propellent for making whipped cream.