Laughing gas: the law changed in 2023, the danger didn’t
By Trevor, founder of Privacy Architect
There is a particular kind of litter that turns up in park hedges, bus shelters and the gutter outside a takeaway: small silver canisters, sometimes a balloon still tied to a bin. It is the debris of nitrous oxide — laughing gas — and it has been among the drugs most used by young adults in England and Wales for more than a decade. Using ONS figures, the ACMD records it as the third most-used drug in England and Wales in 2018, 2019 and 2020, after cannabis and cocaine, with use among 16 to 24 year olds peaking at 9.0 per cent in 2016-17.
What changed recently was the law, not the gas. Since 8 November 2023, nitrous oxide has been a Class C controlled drug. That is worth being clear about, because plenty of people still think of it as the thing that was never quite illegal. It is now. And the harm it can do was never as small as the laughter suggests.
What the law says now
The Home Office announced the change on 8 November 2023. Nitrous oxide was added to Class C under the Misuse of Drugs Act 1971 by a short amendment order — two articles, no drama, and a gas that had sat outside the Act was suddenly inside it.
Possession is an offence where the person intends to wrongfully inhale the gas for a psychoactive effect. That wording matters: it is not the canister in your kitchen that the law is aimed at, it is what you mean to do with it.
The consequences the Home Office set out at the time: an unlimited fine, a community punishment, a caution that stays on your record, and prison for repeat serious offenders. Supplying or producing it is treated far more seriously — the maximum sentence for supply, production and import or export was doubled from seven years to fourteen.
This is a map of what the law says, not legal advice. If you are facing a charge, talk to a solicitor.
What is still perfectly legal
This is the part people get wrong in both directions, so it is worth spelling out. The Home Office listed the settings where nitrous oxide remains in ordinary lawful use: catering, maternity wards and other medical settings, industry, dentistry, and model rocketry.
No special individual licence is required for those uses. But the Home Office’s own words are that users “will need to demonstrate they are lawfully in possession” and are not intending to inhale it.
Why “it’s only laughing gas” is the wrong sentence
The serious harm from nitrous oxide is not a story about one night out. It is a story about repeated exposure, and it runs through vitamin B12.
The government’s own drug advisers, the Advisory Council on the Misuse of Drugs, set this out in their updated harms assessment in 2023. Repeated exposure can inactivate vitamin B12, and that can lead to megaloblastic anaemia. The same mechanism is behind the nerve damage that has put young people in wheelchairs.
The council’s report records what that looks like in practice: in the Netherlands, 64 young adults were treated for a partial spinal cord injury caused by nitrous oxide use in 2018 and 2019. The symptoms that bring people to hospital are not dramatic — numbness, tingling, a foot that will not do what it is told — which is exactly why they get ignored for too long.
There is also the blunt physical harm. The metal of a canister turns freezing cold as the gas escapes, and holding one against bare skin causes soft tissue damage — frostbite, in plain terms. The ACMD points out a particular trap: the gas dulls pain as it is inhaled, so the person may not notice the cold at the time, and the injury can end up worse than it would otherwise have been. Holding a large tank between the thighs to fill balloons is how the legs get hurt (ACMD, updated harms assessment, paragraphs 4.27 and 4.28).
And the harm is not confined to people using it recreationally. The council’s report notes that before maximum exposure limits were introduced, medical staff in dental and midwifery practices, operating theatres and ambulance transport were exposed to high levels of nitrous oxide. The recorded effects on those staff included congenital anomalies, miscarriage and reduced fertility in women. That is why the exposure limits exist, and why the gas is handled with such care in the settings where it does real good.
The numbers are small. The injuries are not.
Here is where we have to be honest rather than dramatic, because the figures are genuinely mixed.
The Advisory Council’s 2023 assessment recorded 56 deaths linked to nitrous oxide in England and Wales between 2001 and 2020, from Office for National Statistics data — against 2,041 involving benzodiazepines over the same period. Three of those nitrous oxide deaths were registered in 2020. The council’s conclusion was blunt and unsentimental: every drug-related death is a tragedy, but the annual number of deaths related to nitrous oxide remains low compared with other drugs.
That is the honest picture, and it would be wrong of us to pretend otherwise. What is rising is the harm that does not kill you. The National Poisons Information Service reported, in its annual report for 2022 to 2023, a rise of about 175% in all forms of its activity linked to nitrous oxide in a single year. Those are clinicians ringing for advice about real patients.
Where deaths do happen, the mechanism is usually oxygen. The council’s report notes that inhaling the gas in a confined space — inside a car, or with a mask or a bag — can cause asphyxiation through lack of oxygen. No drama, no villain: just a small space, a lot of gas, and air that stops being air.
What we don’t know yet
We could not find an official UK-wide figure for nitrous oxide harms published since the 2023 assessment, and we are not going to dress up an old number as a new one. Whether the 2023 change in the law has reduced use, pushed it further out of sight, or made no difference to the people most at risk is a question the data does not yet answer.
What the evidence does support is narrower and more useful than a slogan. Heavy, repeated use can cause permanent nerve damage. Occasional use in a car with the windows shut can kill you through lack of oxygen. And the fact that the second is rare does not make the first less real for the person learning to walk again.
If you are worried about your own use, or someone else’s
Numbness, tingling or weakness in the legs or hands after using nitrous oxide is a reason to see a GP promptly rather than wait and see. It is treatable, and earlier is better.
For anyone who wants to talk about their own use, the NHS suggests starting with a GP, who can discuss it and refer you into treatment. It also points to the FRANK drugs helpline, which is free and confidential, on 0300 123 6600, and to local drug and alcohol services that you can contact yourself without going through a doctor first.
If you have been charged with possession, that is a legal question rather than a health one, and it needs a solicitor rather than a blog.
Read the law yourself
We would rather you checked us than trusted us. Two short documents do most of the work.
The Misuse of Drugs Act 1971 (Amendment) Order 2023 is the instrument that made the change: https://www.legislation.gov.uk/uksi/2023/1091/made
The Home Office announcement of November 2023 sets out the offences, the penalties and the lawful uses: https://www.gov.uk/government/news/possession-of-nitrous-oxide-is-now-illegal
The Advisory Council’s updated harms assessment (2023) is the clinical picture, in its own careful language: https://www.gov.uk/government/publications/nitrous-oxide-updated-harms-assessment/nitrous-oxide-updated-harms-assessment-accessible
The poisons service figures: https://www.gov.uk/government/news/npis-reports-significant-increase-in-nitrous-oxide-related-activities
Penalties by class: https://www.gov.uk/penalties-drug-possession-dealing
NHS help and the FRANK helpline: https://www.nhs.uk/live-well/addiction-support/drug-addiction-getting-help/