Opinion: Nitrous oxide misuse is rising. Michigan lawmakers must act
By Drs. Matt Dellaquila, Natasha Bagdasarian, Eric Reilly and Varun Vohra
This opinion piece was published in the Detroit News on Oct. 7, 2026
Nitrous oxide, a gas normally used in medical settings, is increasingly being misused recreationally, and emergency rooms are seeing the impact. Practical policy steps, like raising the purchase age, restricting flavored products, setting limits on retail tank sizes and adding clear health warnings to canisters, could help reduce serious health harms and even prevent deaths.
Health care providers use nitrous oxide as an anesthetic agent and pain reliever to help make care gentler. It is especially useful for nervous children or patients with developmental disabilities. For example, breathing nitrous oxide through a mask can help facilitate IV placement in a toddler, allow a wisdom tooth removal in a dental office, and even comfort a laboring mother during childbirth. However, abuse of nitrous oxide outside of medical settings has created some worrisome trends.
From 2019 to 2023, Michigan poison control calls for nitrous oxide misuse rose 380%, emergency medical service responses rose 420%, and emergency department visits rose 757%, according to the CDC. Fourteen people who required an emergency response died. Driving under the influence of nitrous oxide is another concerning trend, which made headlines in January 2025 when a driver accused of abusing "Hippie Whippy" caused a deadly crash on the highway.
As physicians, we can manage some of the injuries of nitrous oxide misuse. But only legislators can shut off the supply that causes them. Nitrous oxide is far too easy to obtain, marketing makes recreational use look attractive to young people and the current lawful restrictions are too weak to protect individuals from ending up severely ill or dead.
The damage can be devastating and lasting. Misuse can cause oxygen deprivation, brain damage and sudden death. If inhaled directly from a tank, the gas can cause frostbite on the nose, lips, throat and vocal cords. Because tanks are pressurized, inhaling without proper adapters can rupture lung tissue, and faulty dispensers have exploded in users’ hands. Prolonged use depletes vitamin B12, damages the brain and nerves and leaves users with memory loss, ringing or buzzing in the ears, incontinence and numbness in the hands and feet. Individuals are also presenting with blood clots ― some of which lead to strokes, heart attacks and loss of limbs. Unlike some conditions that disproportionately affect older or less healthy individuals, the devastating effects of nitrous oxide abuse can occur even in young, otherwise healthy people.
Nitrous oxide is legal to sell as a “culinary product” for whipped cream chargers. It is often sold at gas stations and smoke shops in colorful packaging with enticing flavors like orange creamsicle, cinnamon roll and tropical punch. It also often has fun names like “Galaxy Gas," which is clearly not being marketed to professional cooks making whipped cream. Shops often advertise large commercial-grade canisters, sometimes called "party tanks," for communal abuse at large gatherings.
Nitrous oxide is rapidly metabolized, and comprehensive abuse rates are difficult to track. However, Michigan data suggest eighth graders have the highest rates of general inhalant misuse compared to their 10th- and 12th-grade peers.
Michigan law has not kept pace. Selling nitrous oxide devices to minors is prohibited in our state, but the penalty is a civil fine of up to $500 and the culinary label gives everyday retail sales legal cover. Other states have taken the law further: Louisiana halted retail sales of recreational nitrous oxide; Washington now limits sales for medical, food and automotive purposes; and Minnesota is weighing a ban on flavored nitrous products.
Health care providers take the severe effects of nitrous oxide misuse seriously and we call on lawmakers to do the same. Policymakers must strengthen safeguards for consumers so the worrisome trend of increasing overdoses and deaths can be reversed.
Dr. Matt Dellaquila is president of the Michigan Society of Anesthesiologists. Dr. Natasha Bagdasarian is the chief medical executive for Michigan. Dr. Eric Reilly is the chair of governmental affairs for the Michigan Society of Anesthesiologists. Dr. Varun Vohra is a senior/academic director and clinical toxicologist of the Michigan Poison & Drug Information Center and an Associate Professor at the Wayne State University School of Medicine.
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