From "Laughing Gas" to "Galaxy Gas": An Updated Review on the Neurological, Pathologic, and Psychiatric Sequelae of Nitrous Oxide Abuse.
Cureus September 1, 2025 Aditya Lal Vallath, Ratan P Yadav, Michelle Bass et al.
Nitrous oxide (N2O) abuse is rising among adolescents and young adults, driven by easy access to flavored canisters sold as cooking aids and promotion on social media platforms like TikTok and YouTube. This review of 13 studies (retrospective cohorts, case series, cross-sectional surveys) found that use is highest among those aged 16–30, with males and socioeconomically disadvantaged groups disproportionately affected. The most serious physical consequence is subacute combined degeneration of the spinal cord, causing numbness, tingling, muscle weakness, and coordination problems. Biochemically, N2O abuse causes functional vitamin B12 deficiency, raising homocysteine and methylmalonic acid levels.