Nitrous oxide poisoning, deaths sharply rising among Michigan youths, experts warn

By Daniel Schoenherr, Capital News Service

LANSING – A growing number of young people in Michigan are overdosing on nitrous oxide — a dangerous misuse of the same “laughing gas” dentists use to sedate patients.

Emergency departments across the state saw a fivefold increase in nitrous oxide-related poisonings and deaths between 2019 and 2023, according to a new study from Wayne State University.

Researchers identified 462 cases that were reported to poison control centers, hospitals and emergency medical services during that period. Fourteen of those cases were fatal.

But the study’s author cautions that the true number of poisonings is likely much higher.

“This is almost certainly an undercount,” said Varun Vohra, the study’s lead author and director of the Michigan Poison & Drug Information Center.

The sharp rise in poisonings is being driven by nitrous oxide’s growing popularity online and its easy availability, Vohra said.

While recreational use of the gas isn’t new, Vohra said access has become easier.

Small metal cartridges of compressed nitrous oxide – known by the street name “whippets” – are legitimately used to make whipped cream, he said. For decades, they’ve also been sold at smoke shops and gas stations, often for recreational use.

The gas delivers a quick, euphoric high, Vohra said.

But more recently, vendors have started selling large, flavored tanks that contain hundreds of times more gas and require no special equipment to inhale.

These tanks are often labeled “for culinary use only” — a loophole used to avoid legal restrictions, Vohra said.

One such company, Galaxy Gas, made national headlines for its 2.2 liter tanks that hold enough nitrous oxide to whip about 170 liters of cream — more than enough to top 8,000 cupcakes.

Nitrous oxide is approved for sale by the Federal Drug Administration and is considered safe when used appropriately.

But repeated or heavy use can prevent the body from storing vitamin B12, Vohra said, leading to neurological symptoms like fatigue, numbness and impaired coordination.

Severe cases can result in permanent spinal damage, paralysis or death, he said.

Vohra’s findings, published in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report, show that most poisonings involved teens and young adults.

Many more cases go unreported or undiagnosed because there’s no screening test for nitrous oxide exposure, according to the study.

Follow-up studies are now underway to examine availability in cities with large student populations, Vohra said, including Kalamazoo, Lansing, Ann Arbor and Grand Rapids.

In the meantime, the Michigan Poison & Drug Information Center is ramping up its public education efforts with outreach to clinicians and billboards in Detroit, Lansing and Grand Rapids.

Lawmakers are also taking action. In 2024, Michigan banned the sale of “crackers” — devices used to release nitrous oxide from cartridges into balloons for inhalation.

The legislation was sponsored by Sens. Stephanie Chang, D-Detroit, and Joseph Bellino, R-Monroe.

It marked Chang’s second successful effort to address nitrous misuse. Her first bill prohibited the sale of nitrous oxide products to minors in 2018.

While the bans make abuse more difficult, it doesn’t eliminate access entirely.

Chang said no additional legislation is in the works to combat nitrous oxide misuse, but expressed concern about the findings of the recent study.

“We’ve been trying to attack this issue from different angles,” she said, referring to work with her constituents. “We’ve successfully passed two rounds of legislation before.”

“If there’s new ideas on what we can do to tackle nitrous misuse in a next round, we’ll be happy to do that.”