Overview
There are legitimate and safe uses of the gas nitrous oxide for medical, culinary arts and industrial use. However, recreational use of nitrous oxide is on the rise, due in great part due to it’s popularity on social media. Given the significant short-term and long-term health impacts of nitrous oxide use, public health officials and community organizations should examine their state laws to determine if law change, or just law enforcement, is needed.
Nitrous oxide is a gas of all trades: it is most commonly used as a sedative for minor medical and dental procedures, but it is also used in the culinary arts (whipping cream and infusing flavors into cocktails and cooking oils), and in high-performance car engines, and in other industrial applications. These are legitimate and safe uses of the gas. Medical and dental professionals have used the fast-acting sedative that wears off quickly with almost no side effects since the mid-1800s. Before its success in medicine and dentistry, however, nitrous oxide was coined “laughing gas” and used recreationally by British elite who enjoyed the euphoria caused by inhaling the sweet odorless gas. History is repeating itself now as recreational use of nitrous oxide is on the rise.
Recreational use of nitrous oxide is of concern in the public health community and finds instigation for its popularity on social media. Popular products include Galaxy Gas, Baking Bad, and Miami Magic, and are sold through major retailers online and at brick-and-mortar stores and at chain and mom-and-pop convenience stores. Although use in the U.S. is low, most who use nitrous oxide recreationally are adolescents and the rate of use has spiked in recent years.
Beyond recreational use, there is concern for workers exposed to nitrous oxide in the workplace. The National Institute for Occupational Health and Safety provides guidance on avoiding excessive exposure in the workplace.
The euphoria experienced by users of nitrous oxide is brief, but one-time, chronic, or excessive use contributes to negative health outcomes. Short-term outcomes include dizziness, impaired functioning, nausea and vomiting, and lethargy. Rapid and irregular heartbeats and severe asphyxia from use can lead to sudden death even with a single, first-time use. Long-term complications include neurological damage, harm to myriad organs, and mental health disorders. Pregnant people, in particular, should avoid nitrous oxide as exposure in utero may cause physical and developmental harms to the fetus.
We know why young people seek out nitrous oxide—the same euphoria that enticed British partygoers in the 19th century entices young people today. But how does a young person acquire a compressed gas that is produced for use in medical, culinary, or industrial settings? And is it legally sold, purchased, and used? Is any entity regulating the sale of these youth-enticing, dangerous products?
Federal regulation of nitrous oxide as a product is limited to the Food and Drug Administration’s (FDA) regulation of the gas for use in medical settings and as used in food. The Environmental Protection Agency does regulate certain activities that release nitrous oxide into the environment, but the environmental impact of nitrous oxide is outside the scope of this article.
On the drug regulatory side, the FDA considers nitrous oxide a safe and effective analgesic under the Food, Drug, and Cosmetic Act (FDCA). Though medical gasses like nitrous oxide have long been regulated by the FDA, after an arduous regulatory process, in 2024 the FDA finalized new regulations on medical gasses. These regulations establish safeguards in the production, storage, and use of medical gases for patient safety. Nitrous oxide is not a controlled dangerous substance under federal law, meaning there is no role for the federal Drug Enforcement Administration in policing the recreational use of nitrous oxide.
On the food regulatory side, the FDA generally allows the use of nitrous oxide in food preparation so long as good manufacturing practices are followed. As a result of the FDA regulatory scheme, the sale of nitrous oxide for human consumption outside the parameters set for medical and food preparation use is unlawful. But the current marketing of the popular, misused products, allegedly for culinary purposes, may creatively avoid federal action against the sales. To date, the FDA has taken no enforcement action against the popular products, but the Agency has used its public health education pulpit to warn the public about the risks of recreational nitrous oxide use.
Many states restrict the sale of nitrous oxide for human consumption. For example, under Oregon law, retailers may not sell nitrous oxide containers from which a consumer can directly inhale the gas to consumers under age 18. In 2024, Louisiana passed House Bill 64, prohibiting the sale of nitrous oxide except for medical, automotive, industrial, or food preparation purposes. Florida law makes the sale of more than 16 grams of nitrous oxide a felony, with exceptions consistent with the FDA permitted uses. Some states prohibit the possession and use of nitrous oxide for recreational purposes. Most states criminalize the use of a range of inhalants; only some explicitly include nitrous oxide in the prohibition though others may cover nitrous oxide through the general description of inhalant.
For example, compare Maryland’s inhalant prohibition that explicitly applies to nitrous oxide to Nebraska’s law with an extensive list of prohibited inhalants, not listing nitrous oxide but including “any other substance for the purpose of inducing a condition of intoxication, stupefaction, depression, giddiness, paralysis, inebriation, excitement, or irrational behavior, or in any manner changing, distorting, or disturbing the auditory, visual, mental, or nervous processes.” That description likely includes nitrous oxide.
Even with these laws, the products remain readily available, instigating some enforcement action. For example, the Indiana Alcohol and Tobacco Commission recently warned tobacco retailers about selling nitrous oxide cannisters in violation of state law prohibitions. Further, people injured, or families of people killed by nitrous oxide are filing lawsuits. In Florida, the mother of a young woman who died from nitrous oxide consumption sued manufacturers and retailers, asserting claims for strict product liability, unjust enrichment, and violation of consumer protection statutes. That and other cases remain pending.
Federal law restricting the sale of nitrous oxide for human consumption; state laws that impose criminal penalties for the sale of nitrous oxide cannisters for the purpose of intoxication; state laws punishing those who use or possess nitrous oxide containers for intoxication; threats of regulatory action against retailers; and lawsuits against manufacturers and sellers have created a complex legal environment.
Given the increase in use of these intoxicating products, public health officials and community organizations should examine their state laws to determine if law change, or just law enforcement, is needed. No doubt public education is needed. Any approach to curbing the dangerous use of nitrous oxide should be based on effective, ethical public health principles of harm reduction and not on historically unsuccessful prohibitionist laws that target end users.
Network attorneys are available to assist in researching and examining relevant laws in your state. You can submit a request for legal technical assistance on the Network’s website.
This article was written by Kathleen Hoke, director, Network for Public Health Law—Eastern Region. The Network promotes public health and health equity through non-partisan educational resources and technical assistance. These materials provided are provided solely for educational purposes and do not constitute legal advice. The Network’s provision of these materials does not create an attorney-client relationship with you or any other person and is subject to the Network’s Disclaimer.
Support for the Network is provided by the Robert Wood Johnson Foundation (RWJF). The views expressed in this post do not represent the views of (and should not be attributed to) RWJF.
