On November 17, 2024, the twenty-six-year-old Pierpaolo Morciano he lost his life after inhaling from a balloon nitrous oxidealso known as gas exhilaratingalthough at the moment it is not known exactly what happened and what actually caused the young man’s death. Nitrous oxide is commonly used in the medical and food sectors for its anesthetic, analgesic and anxiolytic properties. However, in recent years, its use for recreational purposes is increasedas it causes feelings of euphoria and relaxation. This improper use poses serious risks to the Healthwhich is why different Villageslike the United Kingdomthey have them prohibited there sale And use to scope recreational. Nitrous oxide is also known as “Joker gas”, a reference to the famous Batman character, for its exhilarating and potentially dangerous effect. Let’s see the chemical composition, how it acts on the human body and how it can have exhilarating effects.
What is nitrous oxide, chemical composition and uses
The nitrous oxide (or nitrous oxide, N2O), for friends “laughing gas” is a colorless gas, with a sweetish smell and non-flammable, although it can act as an oxidizer if combined with oxygen. Discovered in 1772is used for a wide range of industrial processes, commercial (it is in fact used as a propellant gas in spray whipped cream packages) and medical-scientific, to the point of being listed by the World Health Organization as an essential medicine. Nitrous oxide is also the famous one NOS used to enhance engine performance.
Compared to other inhalational anesthetics, it does not cause respiratory depression, but alone it is not potent enough to induce sedation. For this reason it is associated with oxygen and used as anesthetic and analgesic during childbirth, dental interventions and surgical and emergency medicine.
How laughing gas works and what it is used for
Nitrous oxide has anesthetic, analgesic and anxiolyticbut it acts with complex and not entirely clear mechanisms. We know that it acts on the Central Nervous System, both at the cerebral and spinal level and that it is involved in mechanisms that regulate perception of pain and anxietyemotions, behavior and the reward circuit, from which abuse arises.
Most of the analgesic and anesthetic effects appear to be linked to the inhibition of particular receptors (N-methyl-D-aspartate, NMDA receptors) of the neurotransmitter glutamate: it is these receptors that convey the sensations of euphoria and dissociation given by inhalation of the gas.
The gas also causes the release of endorphinsleading to the activation of the opioid system and norepinephrine, contributing to the analgesic effect and pain reduction. As an anxiolytic, appears to act like benzodiazepinesbinding to gamma aminobutyric acid (GABA) receptors, which has a relaxing action.
The “laughter drug”: the effects and risks
The gas already acts afterwards 10-30 seconds from inhalation, but its effect wears off at maximum 5 minutes. As we said, cause either euphoriaThat calm And relaxationaccompanied by distortion of reality described as a state dreamy or psychedelic.
According to the Report on the recreational use of nitrous oxide by the European Monitoring Center for Drugs and Drug Addiction (EMCDDA) for recreational use they are emptied into balloons and then inhale 1 to 3 cartridges containing approx 8 g of gas each. There are also those who inhale it directly from cans Of cream spray, exposing yourself to risk Of burns from Freddo: The nitrous oxide in these products is pressurized and comes out at a temperature come on -40 to -55°Cburning within seconds lip, throat and in some cases ropes vowels And lungs!
The main risks are strictly connected to its pharmacological action. First of all, some effects of disorientation and dissociation are given by thehypoxia: the pure inhaled gas dilutes oxygen in the lungsin some cases to the point of replacing it. Acute use causes nausealoss of coordination And vomit.
With chronic or high-dose use the risks range from loss Of knowledgeat hallucinationsfrom psychotic episodes to anemia up to rare cases of embolism and thrombosis. The repeated hypoxia of chronic use reduces the oxygen reaching the brain, causing brain damage with a reduction in cognitive abilities, concentration and memory.
Nitrous oxide is neurotoxic, with a mechanism that seems to involve the vitamin B12. In fact, nitrous oxide oxidizes the cobalt of vitamin B12, inactivating it irreversibly, and being an essential vitamin, our body has no mechanisms to produce it, so all the processes in which it is fundamental are blocked.
The most serious consequences of vitamin B12 inactivation are myeloneuropathy (or myelopathy), a degeneration or inflammation of the spinal cord and the paresthesia. Described as a sensation of sleepy and uncoordinated legs, it is caused by damage to the peripheral neurons that carry sensory signals from the limbs to the brain, and the neurons that control muscles and movement, making it difficult to walk until complete paralysis of the legs (paraplegia) .
If acted upon promptly, some of these effects are partially reversible, but still leave slight sensory dysfunction.
