Marton König is a senior physician in the Department of Neurology at OUS, Ullevål. Recently, doctors in his department have seen an increase in nitrous oxide injuries.
– We are seeing an increase in hospitalizations due to neurological damage caused by the use of nitrous oxide. Overuse can cause serious neurological problems, König tells Dagbladet.
The doctor says he is concerned about this development.
– We’ve had patients who struggle to walk. They have pronounced paralysis and are unable to use their bodies as they wish, she says.
It usually takes a long time — weeks to months — for these injuries to heal, and some of them have the potential to become permanent.
CONCERNED: Senior physician Marton König is concerned about the increase they are seeing in the number of hospitalizations with injuries after using nitrous oxide. Photo: UiO
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Lawful
Nitrous oxide is legally sold for use in cream cartridges. But the ads that appear on Snapchat and the 2,000-gram nitrous oxide bottles that are sold online are usually not meant to make whip cream. They are intoxicating.
– Nitrous oxide affects, among other things, the reward center of the brain and provides an intoxication that young people and young adults crave, says König.
Nitrous oxide is easily available online. You can buy nitrous oxide cylinders, cartridges and tubes on various websites. They deliver to your door after a few days, some the same day.
Cartridges of nitrous oxide cream are sold freely over the counter and online. It’s second drug information still illegal to sell them for intoxicating purposes, as the gas would then be considered a medicine. But it is not illegal to use nitrous oxide for intoxicating purposes.
The police raise the alarm
Increase
– There has been a significant increase in the number of inquiries over the past two years, but the number is still relatively low, says Liv Ingrid Beck, Senior Consultant at the Department of Poisons Information, Norwegian Institute of Public Health (FHI), at Dagbladet.
Through 2021, they received one to six inquiries a year about possible poisonings after using nitrous oxide. In 2021, this increased to ten requests. Last year, it had risen to 40. These are questions about both acute exposure and what is called chronic exposure.
“Using nitrous oxide quickly can lead to both serious poisoning and long-term damage,” says Beck of Poison Information.
Emphasize that their statistics are not a national report of accidents with possible exposure to a toxic substance.
– There are several reports of serious poisonings and deaths from the use of nitrous oxide as an intoxicant. This is often due to the fact that nitrous oxide is inhaled without the supply of oxygen, so there is a lack of oxygen. Direct inhalation from nitrous oxide bottles or dispenser cartridges can also cause frostbite on the face and airways, Beck says and adds:
– In the event of chronic abuse, serious damage can occur which may be permanent. This is particularly true of bone marrow involvement, which affects the production of red and white blood cells and platelets, and neuropathy – nerve damage.
Clean gas
The nitrous oxide given to women giving birth in hospital is mixed with oxygen. About half is therefore oxygen. It is not the one being sold for party use.
The nitrous oxide sold online is pure gas condensate. Choking can therefore be a possible acute injury.
– If you use nitrous oxide incorrectly, wearing a mask and not taking care to exhale in between, in order to take in oxygen, it can lead to suffocation, says senior doctor König.
Acute vitamin B12 deficiency is the main reason nitrous oxide can cause long-term damage. Initially, nitrous oxide is relatively harmless, but overuse can cause neurological damage.
– Prolonged and excessive use can directly damage the brain. Excessive use of nitrous oxide can also lead to spinal cord damage and peripheral nerve destruction due to acute vitamin B12 deficiency.
– B12 is also an indispensable vitamin for bone marrow function and plays a central role in the formation of red blood cells, so excessive use of nitrous oxide can also lead to anemia, explains König.
Our nerves are surrounded by a layer of fat, which ensures that signals are properly conducted to and from the spinal cord. B12 deficiency leads to degreasing of nerve pathways, explains the superintendent. Then it becomes difficult for the nerves in the spinal cord to send signals to the rest of the body.
– Most of the damage is probably reversible, but this requires correct diagnosis and prompt treatment with vitamin B12. Unfortunately, we also see irreversible damage, says König.
Damage to the nervous system can lead to paralysis. An English woman tells in a Youtube videospublished by ITV News, about how she became dependent on a wheelchair after using nitrous oxide.
You should know
– If people had known what adverse events might occur after using nitrous oxide, I think they would have been more cautious, says senior physician Marton König.
It’s particularly repeated use over time that can be harmful, he points out.
In New York, USA, they have now introduced an age limit of 21 for the purchase of “whipped cream”. Grocery stores in New York will now require identification when purchasing cream cartridges.
According to Senator Joseph Addabbo Jr., who drafted the bill, the law was introduced following concerns about the rise in the misuse of nitrous oxide.
– Nitric oxide is a legal chemical for professional use, but when cartridges are used incorrectly, it can be extremely deadly, Senator Addabbo said in a statement to Newsweek.
