Mixing Nitrous Oxide and Alcohol: What Are the Risks?

By day, nitrous oxide is an analgesic that proves useful in minor medical and dental procedures.

However, by night, this substance is inhaled recreationally by many. In fact, around ⅓ of the UK and US populations try nitrous oxide within their lifetime.

Initially, experts thought nitrous oxide inhalation poses little risk. Now, with more research emerging, the adverse effects of nitrous oxide abuse are becoming apparent: seizures, nerve damage, and even fatality.

So, what about mixing nitrous oxide and alcohol? And what are the risks associated? Find out below.

Please note that inhalation and recreational use of nitrous oxide can pose significant risks to your health. We strongly recommend you avoid using nitrous oxide without proper medical supervision or consultation with a licensed health professional.

Dangers and Health Risks of Mixing Nitrous Oxide and Alcohol

While there is limited evidence that mixing nitrous oxide with other substances poses additional risks, the Alcohol and Drug Foundation warns that mixing alcohol and nitrous oxide may further increase blood pressure and heart strain and disrupt your heart rhythm.

Mixing nitrous oxide and alcohol also increases the likelihood of:

• Accidental injuries
• Vomiting
• Vitamin B12 deficiency
• Alcohol and drug dependency

Let’s take a look at these in more detail.

Health Risk 1: Accidental Injuries

Clumsiness is a characteristic effect of both substances, so mixing the two increases the risk of accidental injuries such as trips and falls.

The dangers of mixing these substances increases when the individual steps behind the wheel—evidence suggests that 13.5% (93,970) of fatal car crashes in the US between 2000 and 2019 were drug-related, and around 32 people die daily in the USA due to drunk-driving-related incidents.

Health Risk 2: Vomiting

In some individuals, nitrous oxide inhalation can lead to headaches. When these people mix nitrous oxide with alcohol, this increases the risk of vomiting.

As alcohol abuse can cause people to pass out, this combined effect is hazardous, potentially resulting in stomach contents entering the lungs and obstructing the airways. In extreme circumstances, this can lead to death by asphyxiation.

Health Risk 3: Vitamin B12 Deficiency

Both alcohol and nitrous oxide use can result in B12 depletion.

If abuse occurs in either substance, this may cause vitamin B12 deficiency, which is associated with nerve problems, weakness, tiredness, lightheadedness, and shortness of breath.

Health Risk 4: Alcohol and Drug Dependency

Like alcohol consumption, nitrous oxide inhalation stimulates the brain’s opioid receptors, making users feel pleasure. This may make addiction to the substance more likely, particularly when mental illnesses are present.

Experts do highlight that nitrous oxide addiction is reported less frequently than other addictive substances. However, this does not necessarily mean that it is less addictive.

What’s the Combined Effect of Nitrous Oxide and Alcohol on the Body?

Nitrous oxide and alcohol have stand-alone effects on the body and stimulate feelings of elation, confusion, sluggishness, and lethargy when mixed.

Alcohol appears to exacerbate N2O’s influence on the psychomotor system but doesn’t enhance its pain-relief properties.

Nitrous oxide and alcohol both have analgesic properties—they relieve pain. They also produce a feeling of intoxication in those that consume them and hinder psychomotor performance, slowing thinking and physical movement.

Although some may expect enhanced effects when the two substances are combined, evidence suggests this may not be true.

A 1998 study found that ethanol didn’t increase the analgesic effects of nitrous oxide. However, they discovered that combining the substances influenced the body differently.

Participants reported feeling:

• ‘Confused’
• ‘Elated’
• ‘Good’
• ‘Heavy or sluggish’
• ‘Sleepy’

These sensations were significantly higher in combination users than those who partook in nitrous oxide inhalation or alcohol consumption in isolation.

Other noticeable findings were that the participants felt significantly less ‘in control of body’ and ‘in control of thoughts’ than the abstainers.

Regarding cognitive/psychomotor performance, ethanol potentiated nitrous oxide’s effects, slowing participants’ thinking speed and motor movements.

Can You Drink Alcohol Before or After Taking Laughing Gas?

The research around drinking alcohol before N2O inhalation is limited.

However, various dental practices warn against drinking alcoholic beverages up to 24 hours before a sedation appointment, as it can reduce the effectiveness of nitrous oxide’s analgesic capabilities.

As the effects of nitrous oxide are short-lived and the substance leaves the body within minutes, it should be safe to consume alcohol after taking laughing gas.

However, proceed with caution, as more research is needed to clarify the effects of alcohol consumption after nitrous oxide inhalation.

Does Nitrous Oxide Use (Without Alcohol) Cause a Hangover?

Nitrous oxide doesn’t have hangover effects because it doesn’t linger in your system. In fact, NO2 leaves the body within just a few minutes of consumption. Evidence suggests that the side effects of nitrous oxide are quickly reversed.

So, it’s perfectly safe to drive off after a minor medical or dental procedure (unless your doctor or dentist tells you otherwise!).

Can Nitrous Oxide Treat Alcohol Dependence?

As we know, mixing alcohol and nitrous oxide has many potentially harmful effects. So, is it all bad? According to recent research, nitrous oxide can help treat some psychological conditions.

A research study by Gillman and Lichtigfeld highlights a technique used by the largest alcoholic rehabilitation center in South Africa. Practitioners here administer analgesic concentrations of N2O to their patients for 20 minutes when they experience alcohol withdrawal symptoms. 

They found that, within one hour of inhalation, withdrawal symptoms subsided to such an extent that patients can eat a meal. Evidence suggests that this has been successful in roughly 7,000 cases over 10 years. Gillman and Lichtigfeld describe nitrous oxide as the “most rapidly acting of the current therapies available” for treating alcohol withdrawal state.

And the potential benefits of nitrous oxide don’t end with alcoholic rehabilitation. Evidence also suggests that nitrous oxide may help alleviate the debilitating symptoms of mood disorders.

One study found a reduction in depressive symptoms in a sample of 20 patients with severe treatment-resistant major depression after an inhalation session of a 50/50 nitrous oxide-oxygen mix.

Further evidence looking into the efficacy of nitrous oxide for those with post-traumatic stress disorder (PTSD) found that a 30-minute inhalation session of 50% nitrous oxide was associated with a reduction in intrusive thought frequency.

Who Typically Mixes Laughing Gas and Alcohol?

Alcohol is the USA’s most used intoxicant. Therefore, it should be no surprise that people frequently mix alcohol with other substances, including nitrous oxide.

Here, we explore the demographics of those most likely to combine these substances and the effects of doing so.

A study by Regier and colleagues presents a strong link between substance use and mental health concerns. Within a sample of 20,291 people:

• 27% of those with a mental illness abused drugs or alcohol
• 37% of those with alcohol disorder had a mental illness
• 53% of those with drug disorder had a mental illness

These findings suggest that individuals with a psychological condition may be more likely to use nitrous oxide and alcohol than abstainers.

Further evidence supports this: Another study found that heavy alcohol consumers are more likely to dabble in non-medical drugs, including nitrous oxide, cocaine, and psychedelics, than individuals who had not consumed alcohol in the past month.

Conclusion

Alcohol is a popular intoxicant, but nitrous oxide’s popularity is gaining speed. When you mix them, there may be severe health repercussions.

Despite this, some evidence suggests that nitrous oxide may positively impact alcohol withdrawal symptoms and the debilitating effects of depression and PTSD when in a controlled medical environment.

So, is mixing nitrous oxide and alcohol fun or fatal? When used recreationally, nitrous oxide may be deadly.

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