I stood in line at a music festival in Vancouver last summer, watching a vendor sell colorful balloons for $10 each. Festival-goers weren’t taking them home as souvenirs—they were inhaling the nitrous oxide inside, giggling as the brief high took hold, then quickly lining up for more. What struck me wasn’t just how openly this was happening, but how few people seemed aware of the risks they were taking.
This scene has become increasingly common across Canada, with nitrous oxide—commonly known as laughing gas—emerging as a popular recreational substance at parties, concerts, and festivals. But this week, Health Canada issued an urgent warning about the serious health hazards associated with recreational use of this substance.
“Repeated use of nitrous oxide for recreational purposes can lead to severe and potentially irreversible neurological damage,” said Dr. Supriya Sharma, Health Canada’s Chief Medical Advisor, in yesterday’s public health notice. The warning comes after healthcare providers reported a troubling rise in emergency room visits related to nitrous oxide misuse.
Nitrous oxide has legitimate medical applications—dentists have used it safely for pain management for over a century, and it’s approved for use in food products like whipped cream. But recreational use bypasses the controlled medical settings that make it safe for these purposes.
When I spoke with Dr. Janet Rodriguez, a neurologist at Vancouver General Hospital, she described a case that’s becoming distressingly familiar in her practice. “Last month, I treated a 22-year-old student who’d been using nitrous oxide every weekend for about six months. He came in with numbness in his hands and feet, and difficulty walking. These symptoms are caused by vitamin B12 depletion, which can lead to permanent nerve damage.”
The science behind this is clear: nitrous oxide inactivates vitamin B12 in the body, which is essential for maintaining the myelin sheath that protects our nerves. Without this protection, nerves can’t function properly, leading to symptoms that mimic multiple sclerosis.
“What’s particularly alarming,” Dr. Rodriguez added, “is that many young people don’t connect their neurological symptoms to their nitrous oxide use. They think it’s harmless because it’s legal in certain contexts.”
Indeed, the regulatory landscape around nitrous oxide in Canada exists in a gray area. While it’s regulated as a food additive and a medical product, its sale for recreational purposes falls into a legal gap that Health Canada is now working to address.
Walking through East Vancouver last week, I counted three corner stores openly selling small canisters of nitrous oxide, marketed as whipped cream chargers but positioned near rolling papers and vape supplies—a clear nod to their intended use.
Megan Thorne, a harm reduction specialist with the BC Centre for Substance Use, explains that the accessibility is part of the problem. “There’s a perception that because it’s legally available and provides a short-term high, it must be safe. But we’re seeing more evidence that regular use can cause serious harm.”
Health Canada’s warning outlines several immediate risks beyond the long-term neurological damage, including:
• Asphyxiation (when nitrous oxide displaces oxygen in the lungs)
• Falls and accidents due to dizziness
• Burns from the cold temperature of the gas when released from pressurized containers
• Potential for dependence with regular use
For Indigenous communities in northern BC, where I’ve reported on substance use challenges, harm reduction workers have noted nitrous oxide appearing in communities already struggling with limited healthcare resources.
“When new substances trend in urban centers, they eventually make their way to remote communities,” explains Jordan Flett, a community health navigator in northern BC. “But our communities often lack the specialized medical care needed to address the unique harms of substances like nitrous oxide.”
Statistics Canada doesn’t specifically track nitrous oxide-related hospitalizations, but a recent survey by the Canadian Centre on Substance Use and Addiction found that approximately 4% of Canadians aged 18-25 reported using inhalants, including nitrous oxide, in the past year. Health professionals believe this number is likely underreported.
The Canadian Medical Association Journal published a case series last month documenting fifteen patients who developed severe peripheral neuropathy after recreational nitrous oxide use, with five experiencing symptoms that persisted even after they stopped using the substance.
Dr. Mark Thompson, an addiction medicine specialist at St. Paul’s Hospital, believes public education is crucial. “Most people I treat for nitrous oxide-related issues had no idea about the neurological risks. They thought it was just a bit of harmless fun because it’s so normalized in certain social circles.”
Health Canada’s warning recommends that anyone experiencing symptoms such as numbness, tingling, muscle weakness, or difficulty with balance after using nitrous oxide should seek medical attention immediately. Early intervention with B12 supplementation can sometimes reverse symptoms, but this isn’t always the case.
As I left that music festival last summer, I watched volunteers collecting discarded balloons and metal canisters—hundreds of them scattered across the grounds. I couldn’t help thinking about the disconnect between the ephemeral joy they’d provided and the lasting damage they might leave behind.
With Health Canada’s warning now public, the hope is that awareness will spread faster than the trend itself. Until regulatory frameworks catch up with this emerging health risk, education remains our best defense against what many health professionals are calling a silent epidemic.
