Laughing Gas (Nitrous Oxide) Addiction: Symptoms, Effects, and Treatment

Written by the medical team at Day One Rehabilitation Center, Nakhon Nayok, Thailand · Medically reviewed by Dr. Pichayut Kasemphakdeephong (Psychiatrist)

Laughing gas (nitrous oxide) is used safely and legally in medicine and dentistry — for example, as part of anesthesia or to help reduce pain. But when it’s used recreationally, without medical supervision, to get high, it can affect the brain, the nervous system, and the user’s safety, especially with frequent or heavy use.

After inhaling laughing gas, a person may feel relaxed, euphoric, and light-headed, with sounds and surroundings seeming different, along with a brief sense of fun or elevated mood. These sensations can lead some people to think laughing gas is less dangerous than other drugs. But repeated, heavy use can interfere with how vitamin B12 works in the body — vitamin B12 that the nervous system depends on — and can lead to numbness/tingling in the hands and feet, muscle weakness, unsteady walking, or damage to the nerves and spinal cord.

For families, warning signs may not start with obvious behavior — they can appear gradually, through more frequent use, wanting larger amounts each time, starting to use alone, using it to escape stress, or continuing to use even after numbness or unsteady walking begins. Understanding the symptoms of laughing gas use, its effects on vitamin B12 and the nervous system, and the path to stopping and recovering can help families recognize the problem and decide to seek help before the effects become more severe.

What Is Laughing Gas, and How Does It Affect the Brain?

Laughing gas’s chemical name is nitrous oxide (N2O). It’s a useful gas with several applications, including in medicine and dentistry. Using it under the supervision of medical professionals is very different from using laughing gas on one’s own to get high.

When inhaled, nitrous oxide acts quickly on the nervous system. Users may feel euphoric, relaxed, and light-headed, with altered perception — which is where the name “laughing gas” comes from.

The effects are usually short-lived, which leads some people to inhale it repeatedly, one dose after another, to keep the feeling going. When this pattern repeats, laughing gas use can gradually take on a larger role in someone’s life.

Some people start out using it occasionally in social settings before shifting to more frequent use, larger amounts, or using alone. If it becomes hard to control use, more time or money starts going toward laughing gas, or use continues despite effects on health and daily life, it’s worth considering an evaluation by a professional.

It’s important not to equate the safety of nitrous oxide used under medical supervision with using it recreationally to get high — the method, dose, setting, health screening, and monitoring involved are very different.

How to Recognize the Signs of Laughing Gas Use

Symptoms after using laughing gas vary depending on the dose, frequency, the person’s health, and whether other substances are used alongside it. Families should watch for both the effects that appear right after use and the changes that develop gradually with continued use.

Signs and behaviors that may appear include:

Brief euphoria or elevated mood
Light-headedness or dizziness
Altered perception of sound or surroundings
Abnormal balance and movement
Slower response to surroundings
Using laughing gas more often or in larger amounts
Repeated use within a short period
Spending more time or money obtaining and using laughing gas
Cravings to use again
Trying to cut back or stop, then relapsing
Starting to use alone or in situations where they never used before
Continuing to use despite emerging health effects
Numbness or a pins-and-needles sensation in the hands or feet
Leg muscle weakness or abnormal walking
Stumbling or a noticeable change in balance

Neurological signs deserve special attention — numbness/tingling in the hands and feet, leg weakness, unsteady walking, or a noticeable loss of motor control — because heavy or continued nitrous oxide use can interfere with vitamin B12 function and lead to nerve damage.

If these symptoms appear, don’t wait to see whether they resolve on their own after stopping use — seek a medical evaluation.

What Are the Effects and Dangers of Laughing Gas?

A common misconception is that “laughing gas wears off quickly, so it can’t be that dangerous.” But how long the high lasts doesn’t determine the full extent of the risk.

While under the effects of the gas, a person may experience light-headedness, dizziness, impaired balance, and altered perception of their surroundings — reducing their ability to judge situations and keep themselves safe.

Inhaling high concentrations of nitrous oxide can also deprive the body of enough oxygen. If someone loses consciousness, breathes abnormally, becomes severely confused, or stops responding normally after use, they need emergency medical help.

Another major effect of frequent or heavy laughing gas use is its interference with vitamin B12 function.

Vitamin B12 plays a role in nervous system function and in making blood cells. When nitrous oxide prevents vitamin B12 from working normally, it can damage the nerves and spinal cord. Some users first notice numbness or a pins-and-needles feeling in the hands or feet, which can progress to leg weakness, unsteady walking, or balance problems.

In cases with significant nerve damage, symptoms can affect a person’s ability to walk and manage daily life, and some of the damage may take a long time to heal or may never fully resolve.

There are also reports linking continued laughing gas use to memory problems, mood changes, anxiety, and psychiatric symptoms in some users. While the relationship between nitrous oxide and certain psychiatric symptoms is still not fully established, both substance use and mental health should be evaluated together, especially when other substances are involved.

Stopping Laughing Gas Use and Managing Symptoms Afterward

Caring for someone with a laughing gas problem isn’t just about waiting for the gas to clear the body — the effects of continued use, particularly nervous system damage, can persist after use stops.

The first step is to assess the pattern of use — how long, how often, roughly how much, whether other substances are involved, and whether physical or mental health symptoms have already appeared.

For anyone with numbness, muscle weakness, unsteady walking, or balance problems, a neurological evaluation and assessment of vitamin B12-related conditions is essential.

Stopping nitrous oxide use is a key part of treatment — taking vitamin B12 supplements alone while continuing to use laughing gas should not be seen as a way to prevent harm from continued use.

So the idea that “taking vitamin B12 means it’s okay to keep using laughing gas” is a misconception that can cause harm, because nitrous oxide can interfere with how vitamin B12 works in the body. Having normal supplement intake or normal levels on certain blood tests doesn’t mean there’s no underlying nervous system damage.

If numbness in the hands or feet, unsteady walking, leg weakness, or changes in motor control appear, stop use and seek a medical evaluation as soon as possible.

Treatment and Recovery After Stopping Laughing Gas

After stopping use and assessing the physical effects, the next step is understanding why the person keeps returning to laughing gas. Treating only the physical effects, without addressing the behaviors and situations tied to use, leaves the risk of relapse in place.

Some people use it in social settings or at parties, some to feel relaxed, and some to escape stress, loneliness, or unwanted emotions. Others gradually shift from using with others to using alone.

Therapy helps clients see the cycle connecting situations, emotions, thoughts, cravings, and relapse, while building new ways of responding to those situations.

Recovery may include individual therapy, group therapy, craving management, stress management skills, adjusting daily routines, sleep, exercise, and building sources of satisfaction that don’t rely on substances.

If depression, anxiety, sleep problems, mood swings, or co-occurring psychiatric conditions are present, they should be evaluated and treated alongside substance use, to understand how mental health issues relate to laughing gas or other substance use.

How to Prevent a Relapse Back to Laughing Gas

Preventing relapse starts with identifying each person’s individual triggers, since cravings can be tied to the situations and activities that used to accompany use.

Common triggers include:

Friends they used to use laughing gas with
Parties or nightlife venues
Drinking alcohol
Using other substances
Stress from work or school
Loneliness and boredom
Conflict in family or relationships
The urge to escape problems
Easy access to laughing gas
The thought “just a little won’t hurt”
The thought “I’m already taking vitamin B12, so it should be fine”

Once the triggers are identified, treatment can help build a coping plan — avoiding high-risk situations early on, changing social patterns, reducing contact with easy sources of the substance, building new activities, and practicing how to manage cravings when they arise.

If someone stops and then relapses, that shouldn’t be taken as proof that treatment isn’t working. Instead, it’s worth looking back at what happened before the relapse, what triggers or warning signs were present, and how the relapse-prevention plan can be adjusted to better fit real life.

What to Do When a Family Member Uses Laughing Gas Often but Won’t Admit There’s a Problem

Talking about laughing gas can be harder than with some other substances, because some users see it as just a fun activity and compare it to other drugs, concluding “it’s not that dangerous.”

Families don’t need to start by trying to prove the other person is “addicted to laughing gas.” They can start instead from real, observable changes.

Instead of saying “You use this much and still won’t admit it,” try starting with, “I’ve noticed you’re using more often lately, and you’ve mentioned your hands and feet feeling numb — I’m worried it might be affecting your nervous system. I’d like you to get checked out.”

Or ask, “Have you ever meant to stop but ended up using again anyway?” and “If the numbness kept getting worse, or it became hard to walk, how do you think that would affect your life?”

The goal is to help the other person explore the gap between what they want and the effects they’re actually experiencing, rather than trying to win an argument.

If someone isn’t ready for treatment yet, agreeing to a health checkup or a conversation with a professional can still count as a first step — especially for someone already showing neurological symptoms. There’s no need to wait for them to admit they’re “addicted” before getting checked and treated.

Treatment for Laughing Gas Use at Day One Rehabilitation Center

Treatment for laughing gas use at Day One Rehabilitation Center is residential care. It begins with an assessment of the pattern of use — frequency, duration, approximate amount, other substances used alongside it, physical health, mental health, sleep, mood, and the effects on school, work, and relationships.

For anyone with numbness, weakness, unsteady walking, or symptoms suspected of being neurological, a medical evaluation is essential — the goal isn’t just to stop laughing gas use, but also to address the physical effects that have already occurred. If further specialist testing or treatment is needed, the care team will arrange it as appropriate.

After stopping use and stabilizing physically, recovery focuses on identifying the factors behind repeated use and building the skills needed to return to life without relying on substances. The program includes individual therapy with a psychotherapist, group therapy activities, psychiatric assessment, and medication management by a psychiatrist as needed, along with attention to daily routine, diet, rest, and exercise.

For those who use more than just laughing gas — alcohol, ketamine, yaba (methamphetamine pills), crystal meth (ice), or other substances alongside it — the care team assesses the full pattern of use, so treatment doesn’t stop at one substance while problems with others remain unaddressed.

If depression, anxiety, sleep problems, mood swings, or other psychiatric symptoms are present, treatment addresses mental health alongside the substance use problem, to identify factors that could lead to relapse after leaving the center.

The residential setting also gives clients a temporary break from the cycles and situations where the substance is easy to access, while they build new routines, practice managing emotions and cravings, and prepare a plan for handling triggers before returning to life outside.

Frequently Asked Questions About Laughing Gas

Is laughing gas a drug?

Nitrous oxide is a gas with legitimate uses in medicine, dentistry, and other fields, but it can also be used recreationally to get high. Having medical benefits doesn’t mean using it on your own to get high is safe. If use becomes repeated, hard to control, or continues despite negative effects, an evaluation is recommended.

Can laughing gas cause a vitamin B12 deficiency?

Frequent or heavy nitrous oxide use can stop vitamin B12 from working normally in the body, affecting the nervous system and blood cell production. Some users develop numbness/tingling in the hands and feet, muscle weakness, unsteady walking, or damage to the nerves and spinal cord.

Is it dangerous if my hands and feet go numb after using laughing gas?

Numbness or a pins-and-needles feeling in the hands and feet is one of the early signs of nervous system effects from nitrous oxide use. If this happens, especially together with leg weakness, unsteady walking, or balance problems, stop use and seek a medical evaluation as soon as possible.

If I take vitamin B12, can I keep using laughing gas?

Vitamin B12 supplements should not be used as a way to make laughing gas use safe, because nitrous oxide can interfere with how vitamin B12 works in the body. Treating the neurological effects requires stopping nitrous oxide use, combined with appropriate medical evaluation and treatment.

Can you become addicted to laughing gas?

Yes, laughing gas can definitely be addictive. Many users have developed such severe arm and leg weakness that they can no longer stand, walk, or keep their balance. If cravings become more frequent, attempts to cut back fail, the amount used keeps increasing, or use continues despite harming health and life, an evaluation for a substance use problem is recommended.

Can I quit laughing gas on my own?

Whether that’s appropriate depends on the pattern of use and the effects that have occurred. If use is regular, heavy, hard to control, combined with other substances, or accompanied by numbness, leg weakness, unsteady walking, or mental health problems, a professional evaluation is recommended. Simply stopping use on your own should not be seen as a substitute for medical evaluation and treatment of physical damage that has already occurred.

Is it really possible to quit laughing gas for good?

Stopping use and recovering is possible. But once a pattern of repeated, hard-to-control use has developed, treatment needs to look beyond just stopping the substance — it should also address the physical effects, mental health, cravings, triggers, use-related behaviors, and relapse prevention.

Start Treatment for Laughing Gas Use Before the Effects Get Worse

Families don’t need to wait until a loved one can no longer walk, has obvious nerve damage, or has lost the ability to study or work before seeking help. If laughing gas use is becoming more frequent, the amounts are increasing, attempts to stop keep ending in relapse, or numbness in the hands or feet, leg weakness, unsteady walking, or balance problems have appeared, stopping use and getting a health evaluation should become a priority right away.

For families unsure whether a loved one’s laughing gas use has reached the point of needing treatment, a good starting point is consulting a professional to assess the pattern of use, the health effects, and how to talk with the person using the substance. Seeking help early, while the signs are still in their early stages, can help reduce the chance that the problem develops into nerve damage and long-term effects on life.