The senior and academic director of the Michigan Poison and Drug Information Center told the Detroit Free Press he’s seeing a disturbing trend among otherwise young, healthy people in the state: They’re calling the poison center, 911 or are turning up in hospital emergency departments with numbness and tingling in their hands and feet, and feeling faint or weak.
Some have lost coordination, and others have racing heart rates or blood-clotting problems. Still others report hallucinations, delusions, anxiety and depression.
The mysterious constellation of symptoms isn’t tied to a virus or bacterial infection. Rather, what these people have in common is that they inhaled nitrous oxide, said Dr. Varun Vohra, who also is an associate professor in the department of emergency medicine at Wayne State University School of Medicine.
Large cannisters of nitrous oxide — also known as whippets or laughing gas — are widely available and sold at Michigan gas stations, convenience stores, smoke and vape shops, ranging in size from 2 liters to 6 liters. The big cannisters allow people to inhale the gas in large quantities, taking hits repeatedly from the same cannister.
“These are being marketed to youth via various social media outlets and Reddit forums,” he said, noting that the canisters now come in colorfully decorated packaging and in various flavors aimed at increasing the appeal to recreational drug users looking for a high. “Historically, it’s been thought of as sort of a harmless substance that people just do recreationally at parties or festivals and concerts and whatnot.”
Nitrous oxide gas has approval from the U.S. Food and Drug Administration for use as a pain reliever at dental offices and medical clinics. It’s also used to create the foamy texture in whipped cream, and can boost the horsepower in certain automobiles when it’s added to the fuel intake system.
However, when it’s inhaled — especially in large volumes — it can have dangerous effects on the body, said Vohra, who also is a pharmacologist and clinical toxicologist.
That’s because nitrous oxide can effectively shut off the body’s ability to use the vitamin B12, which can result in a cascade of health problems.
Most commonly, he said, people report numbness and tingling in the extremities, loss of coordination and feeling faint or weak. Some have lost consciousness. Among the cardiovascular problems are stroke-like symptoms, pulmonary embolisms or deep-vein thrombosis.
“All are related to the inactivation of that vitamin B12,” he said, adding that there also is “growing evidence in literature that suggests recreational use of nitrous oxide in younger people can affect the developing brain and reduce cerebral perfusion. That can lead to brain atrophy, and damage to the hippocampus, which is responsible for memory.”
And then there are the neuropsychiatric and psychiatric effects.
“It’s been linked to hallucinations, delusions, mood disorders, depression, anxiety, etc.,” he said. “So, that’s, obviously, a really big cause for concern.”
Rare reports have identified heavy users who’ve so badly damaged their nervous systems, they became paralyzed.
“There are cases out there where patients literally have to relearn how to walk because their nervous system is so badly damaged because of the frequent and chronic use,” Vohra said.
Data from the Michigan Poison and Drug Information Center shows the number of people who had adverse medical effects from using nitrous oxide was nearly five times higher in 2023 than in 2019.
Hospital emergency department visits involving people who used nitrous oxide jumped 757% in that timeframe — from 10 cases in 2019 to 60 in 2023 — and response calls from emergency medical services rose 420%.
In that four-year span, EMS first responders identified 14 deaths with nitrous oxide involvement.
The numbers, he said, are an underestimation: “We’re not capturing every case.”
What complicates data collection, Vohra said, is that there isn’t a simple test to detect the use of nitrous oxide. If a person doesn’t disclose it, their doctors might not recognize the true cause of the symptoms.
“Clinicians who may not be familiar or are just not even thinking about it because it’s not on their radar … are just not picking it up,” Vohra said.
Still, he said, preliminary data from the last 2½ years — from 2024 until May 2026 — shows ongoing increases beyond 2023 levels.
Of the 112 known cases of intentional nitrous oxide use that resulted in injury reported to the state poison center in the last 2.5 years, Vohra said, 48 people were hospitalized. Of them, 10 needed treatment in a hospital intensive care unit.
“We’ve run into patients who have gotten into motor vehicle accidents because of the numbness and tingling,” Vohra said. “So, they can’t actually feel their feet on the brake pedals and the accelerator, which places them and, obviously, other motorists at risk from driving while impaired.”
New state laws were enacted in 2024 to ban the sale of devices specifically designed to help people recreationally inhale nitrous oxide — making it a misdemeanor — and imposed stiffer penalties on those who sell whippets to minors.
But based on the data, it appears as if the ban on the so-called “crackers,” which are used to puncture or pierce the nitrous oxide canisters so the gas can be more easily inhaled, don’t appear to have made much of a difference in the number of incidents involving injuries among whippet users.
The U.S. Food and Drug Administration issued an advisory in 2025, warning consumers not to inhale nitrous oxide products, whether they come from large or small canisters, tanks, or chargers, and whether they are flavored or unflavored.
Some of the brands they’re sold and marketed under include:
Vohra said the state poison center is working to find ways to improve screening and detection of nitrous oxide use when people seek care in medical settings while informing toxicologists and clinicians of the most common symptoms and helping them understand what to look for to spot signs of its use in laboratory testing.
He said he hopes state lawmakers will consider an outright ban on the sale of nitrous oxide cannisters at gas stations, convenience stores and smoke/vape shops. The easy access, he said, makes it too easy for people to buy large quantities of the drug — and use it.
“I think change starts with access and the ease of availability … and tackling what’s right in front of us first,” he said. “It’s affecting our actual local communities right in our backyards. That, to me, is high yield and can make a pretty significant impact.”
Contact Kristen Shamus: kshamus@freepress.com. Subscribe to the Detroit Free Press.
This article originally appeared on Detroit Free Press: Michigan sees sharp rise in nitrous oxide use that lead to ER visits
Reporting by Kristen Jordan Shamus, Detroit Free Press / Detroit Free Press
USA TODAY Network via Reuters Connect
By Kristen Jordan Shamus, Detroit Free Press | USA TODAY Network
