Ambulance officers and paramedics have not reported a noticeable spike in emergency attendances to ACT incidents involving substance abuse using nitrous oxide cartridges, despite an upsurge of this issue in NSW.
Yet hundreds of the discarded nitrous oxide cartridges - colloquially known as "nangs" - have been reported in and around the streets of Civic and Belconnen indicating the problem of it used as a recreational drug is emerging, although potentially going largely unreported.
Medical professionals are calling for tighter restrictions on the sale of nitrous oxide gas cartridges due to the potential for them to cause serious harm for users including lasting neurological damage.
Nitrous oxide or 'laughing gas' is normally used by dentists and medical professionals to provide sedation and pain relief to patients undergoing minor procedures. It's also a food additive, used to aerate whipped cream, and sold in gas cartridges online and in convenience stores.
Inhaling the gas is said to produce a fleeting feeling of euphoria and excitement.
Medical authorities say heavy use of nitrous oxide can lead to a depletion of vitamin B12, which can result in numbness, and if B12 deficiency is left untreated, long-term nerve damage can result.
When inhaled by inexperienced users, nitrous oxide often leads to unconsciousness resulting from hypoxia due to the displacement of oxygen from the lungs of the user.
The NSW National Drug and Alcohol Research Centre (NDARC) said that short-term exposure can result in blackouts and fainting, while prolonged exposure to nitrous oxide can result in a range of physical and psychological issues including memory loss, incontinence, limb spasms, depression, psychosis and psychological dependence.
Not a lot is known about nitrous oxide use in the general population, but this also appears to be increasing over time, with anecdotal reports in the ACT of teenagers, some as young as 12 and 13, inhaling the products openly on city streets.
The latest available data from the Australian Institute of Health and Welfare reported that the use of inhalants has steadily increased. The most common forms of inhalants used in 2019 were nitrous oxide and amyl nitrate and other nitrates.
Using the substance is not a criminal offence but on October 1 this year, the Therapeutic Goods Administration implemented the reclassification of nitrous oxide as a Schedule 6 poison, which means product labels must contain warnings and safety directions.
Some states, including Western Australia and South Australia, have introduced restrictions on purchasing nitrous oxide, such as age limits, although these are easily circumvented by online purchasing.
The NDARC's Professor Shane Darke said the real danger is that people inhaling the nitrous oxide recreationally are running the real risk of asphyxia.
"If you're in a medical situation and you're being given nitrous oxide... it's mixed with oxygen. These people aren't doing that. What they're doing is covering their faces and inhaling pure gas," Professor Darke said.
"Now the problem with that is there's no oxygen. You run the risk of asphyxia."
Users, he said, "can be a risk to themselves and others".
"There have been spontaneous suicides and accidents," he said.
In NSW, emergency physicians have also started noticing people presenting with jerking and odd movements after using nitrous oxide. That's not just an unsteady gait due to intoxication rather, a sign of significant nerve damage.
