An increasing number of Australians are inhaling store-bought laughing gas, putting themselves at risk of neurological damage as doctors call for tighter sales restrictions.
Nitrous oxide, or 'nangs', is used for sedation and pain relief during medical treatment and in food production to aerate whipped cream.
When inhaled the gas produces a fleeting feeling of euphoria and excitement and medical professionals are reporting an increase in the number of Australians using the gas recreationally.
Experts are concerned recreational users are unaware of the dangers and long-term neurological effects of improperly using the product.
Users are at risk of entering a delirious state, said Shane Darke from the National Drug and Alcohol Research Centre.
"They can be a risk to themselves and others. There have been spontaneous suicides and accidents."
Jerking and odd movements are a familiar result of inhalation.
And while an unsteady gait may be believed to be a result of intoxication, Prof Darke said that is a sign of significant nerve damage.
"It interferes with the absorption of Vitamin B12. This leads to neurological damage and eventually in severe cases, spinal degeneration," he said.
The rise in the product's popularity could be related to perceptions of safety, the centre's Rachel Sutherland said.
"It's also quite easily available - you can purchase it very easily at convenience stores or online. And it's pretty cheap," she said.
Nang usage has jumped in recent years among those who use ecstasy or other illicit substances, according to the Ecstasy and Related Drugs Reporting System.
From 2003 to 2015, about a quarter of the group reported using nangs. This increased to one-in-two since 2018.
In a study of 60 emergency departments across NSW, people presenting for issues related to the gas increased from fewer than 10 in 2012 to more than 60 in 2018.
Despite Australia's medical regulator - the Therapeutic Goods Administration - reclassifying the product in October, requiring it to contain warnings and safety directions, experts are calling for more action.
"With any kind of regulatory intervention, it's really important that it's accompanied by harm reduction and education campaigns," Dr Sutherland said.
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