• Between 2020 and 2025, six young people were admitted to the Guttmann Neurorehabilitation Hospital for this reason.
• Regular exposure to this drug can cause serious injuries affecting the spinal cord or peripheral nerves, sometimes irreversibly. According to the Ministry of Health, 1% of young people aged 14 to 18 use it.

Nitrous oxide, or “laughing gas,” is used as a recreational drug because it produces an almost immediate euphoric effect. Its use has become popular among young people due to its low cost, easy availability, and lack of awareness about its side effects. However, between 2020 and 2025, six patients were admitted to the Guttmann Neurorehabilitation Hospital with severe neurological sequelae as a result of its use. Professionals warn that habitual exposure can cause severe and irreversible damage, such as loss or alteration of sensation and voluntary movement in the limbs, as well as impairments in coordination and balance.

Nitrous oxide is colorless, nearly odorless, and has a slightly sweet taste. As a recreational drug, it is inhaled using balloons or cylindrical metal canisters, and its effects last between 15 and 45 minutes, depending on the dose. “All of this, combined with its high availability and low price, creates a false social perception that it is safe to use,” explains Dr. Margarita Vallès, a rehabilitation physician at the Guttmann Neurorehabilitation Hospital. “However, continued use can cause serious and irreversible neurological damage because it interferes with vitamin B12 metabolism, which is essential for cellular and metabolic processes.” This can lead to a loss of myelin, a structure in neurons that enables the transmission of impulses between them, particularly in the spinal cord, but also in peripheral nerves and at the brain level.

The six patients treated at Guttmann were five men and one woman aged between 19 and 25, who were hospitalized for one to three months. All presented tetraparesis or paraparesis (muscle weakness in all four limbs or in the legs, respectively), five had hypopallesthesia (loss of the ability to perceive vibrations), and two had hypoesthesia (reduced sense of touch). In some cases, these symptoms resulted in difficulty walking and even the need to use a wheelchair.

Up to 200 balloons a day

One of these cases was described by Dr. Vallès in 2021 in the journal Revista de Neurología. It involved a 22-year-old man with subacute spinal cord degeneration secondary to prolonged use of this substance. He had started using it sporadically two years earlier and had been using it daily for the previous eight months, inhaling up to 200 balloons a day.

The typical patient profile is that of “people without routines or stable habits, sometimes with difficult family situations, who use it as a means of escape. As is generally the case with drugs, it starts as recreational use but eventually gets out of control,” says Dr. Joan Saurí, a psychologist at the Guttmann Neurorehabilitation Hospital. He adds that there is often “comorbidity with anxiety disorders or excessive alcohol consumption, creating a perfect storm in which the person also stops eating properly, as happens with alcoholism.” Saurí also warns about possible cognitive risks, “especially in adolescents and young people whose brains are still developing.”

Professionals warn that although pathological effects usually require continued use, in people over 40 and those with low vitamin B12 levels, the effects may appear much sooner. “Sometimes the person recovers fully, but in other cases long-term sequelae remain,” Vallès warns. Among the Guttmann patients, one made a full recovery, while the rest experienced persistent deficits, although with improved functional capacity.

Central nervous system depressant

As a dissociative anesthetic, the gas can also cause hallucinations, uncontrolled vocalization, perceptual disturbances, spatial and temporal disorientation, and reduced sensitivity to pain. Burns to the mouth and airways are common, as the gas is released at very low temperatures from canisters, as are traumatic accidents, since the drug alters perception and increases the risk of falls or traffic accidents.

In addition, specialists warn that cases are not always identified in initial hospitals, as they may be “masked” by neurological symptoms and diagnosed as other conditions.

Increase in use

Until recently, nitrous oxide use was considered marginal in Spain, but in recent years its consumption has resurged at parties, raves, and music clubs, mainly among adolescents and young people. It is a very easy gas to obtain, as it is sold for food-related uses. According to the 2025 ESTUDES survey by the Government Delegation for the National Plan on Drugs, 1.7% of young people aged 14 to 18 use nitrous oxide. In Catalonia, a report published by the Department of Health last week indicates that it is the most commonly used drug within the category of “New psychoactive substances”: in 2025, 1.6% of students aged 14 to 18 reported using it.