Social Media Trend Promotes Nitrous Oxide Misuse

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An emerging social media trend has a new generation using an old drug — nitrous oxide — with a new name: Galaxy Gas.

The trend of inhaling nitrous oxide canisters, also known as “whippets,” has found a new following with the Galaxy Gas brand that markets these products in colorful canisters with enticing flavors, like blueberry mango or vanilla cupcake.

While the canisters are bright and reminiscent of pleasant foods, misuse of nitrous oxide comes with very real risks, including death. Despite their dangers, these canisters can be bought from most major retailers, including Amazon and Walmart — though Galaxy Gas has reportedly stopped sales “out of an abundance of caution.”

Frederick Davis, DO, MPH, an emergency physician at Long Island Jewish Medical Center in Queens, New York, told MedPage Today that it’s important for healthcare professionals to be aware of these trends and the potential harms they can cause.

“It’s good to know what’s out there because if someone came to you and just used a name brand, ‘Galaxy Gas,’ you might not necessarily know what that is,” Davis said. “It’s not as safe as it might appear or as entertaining as it might appear on some of these social media [sites].”

Davis noted that Galaxy Gas differs in some important ways from the nitrous oxide used in medical procedure rooms to reduce anxiety and help patients stay comfortable during procedures. The key difference, he said, is that these canisters are designed for foaming creams, so they don’t provide the same measured amounts as in medical settings.

“When you’re doing these inhalants as a way to abuse the substance, you’re going to get effects that aren’t as well controlled and also aren’t well monitored,” Davis said. In a controlled setting, healthcare professionals can ensure that nitrous oxide intake is safe, Davis said, “as opposed to doing this in a garage, in your kitchen, or in some other place, and then trying to do things you normally would do which puts you at more of a risk.”

People who misuse nitrous oxide will commonly present with light-headedness or palpitations, Davis said, though the drug can have serious effects. It can dramatically lower blood pressure, which can lead to loss of consciousness and increase the potential for severe injury from a fall, he said.

“People will come in [and] they will be a little bit altered,” Davis said. “They might have had an episode of passing out, or even some palpitations that occur shortly after inhalation.”

Nitrous oxide can also lead to changes in oxygen levels, which could reduce the body’s ability to properly perfuse a person’s organs, potentially leading to organ damage. If the poor perfusion caused by nitrous oxide severely lowers the levels of oxygen being delivered to the brain, it could result in death, he added.

A recent case series published in the Journal of Addictive Diseases noted that nitrous oxide can cause severe, symptomatic vitamin B12 deficiency, which can lead to complications such as palmar calluses and frostbite. These signs could help clinicians quickly recognize and diagnose nitrous oxide use and toxicity, the report stated.

That B12 deficiency can be so severe that the effect can look similar to Guillain-Barre syndrome, according to the Cleveland Clinic.

Davis said healthcare professionals should understand these symptoms so they know when to ask questions about nitrous oxide misuse. Clinicians may need to ask directly about using these canisters, but it might even require more questioning to get patients to discuss their misuse of nitrous oxide, he added.

“A lot of the time this isn’t necessarily found out unless the right questions are asked,” Davis said.

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