Nitrous Oxide Hallucinations: What Are They Like?

Nitrous oxide is a popular recreational inhalant, ranking as the 7th most popular drug globally. Its gross popularity is put down to its short-term dissociative effects and lack of after-effect or unpleasant smell.

However, while some reactions are common, such as getting the giggles and feeling euphoric and calm, some less enjoyable effects occur sometimes but not always. One such symptom is hallucinations.

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.

Nitrous Oxide Hallucinations: A Closer Look

Nitrous oxide hallucinations are false perceptions of sensory experiences brought about by the inhalation of nitrous oxide. The hallucinogenic effects of nitrous oxide appear short-lived, but the psychosis induced is sometimes, in very rare cases, irreversible.

Below, we find out why nitrous oxide-related hallucinations occur, what they look like and whether nitrous oxide has any other psychotic effects.

Symptoms of Nitrous Oxide Hallucinations

The research on the symptoms of nitrous oxide hallucinations is limited. However, case study reports suggest that nitrous oxide hallucinations may involve:

• Seeing things that aren’t there
• Sound distortion (including a “helicopter effect” where it feels like a helicopter is chopping overhead)
• Hearing voices

For example, a rather extreme case of a 20-year-old woman displaying extreme nitrous oxide abuse reported visual and auditory hallucinations, including the false perception that a “transmitting” device in her throat was weakening her legs. Alongside this experience, she heard voices telling her to commit suicide.

How Much Nitrous Oxide Causes Hallucinations?

Only some people experience hallucinations after inhaling nitrous oxide.

Does this mean it comes down to the amount you consume? The quick-fire answer is: No one really knows.

Individuals who inhale extreme amounts of the substance, such as around 100 whippets daily, report hallucinations the most. However, there is no evidence suggesting this can’t occur in light users too.

The health risks of nitrous oxide inhalation appear to get more severe with heavy, regular use.

While short-term effects may involve shivering and sweating, long-term health implications of N2O abuse might include nerve damage and vitamin B12 deficiency.

More evidence is needed to fully unpick the relationship between the intensity and frequency of nitrous oxide use and its hallucinogenic effects.

How Long Do Nitrous Oxide Hallucinations Last?

Nitrous oxide-related hallucinations kick in within seconds and last between 1 to 5 minutes. This fleeting reaction occurs because nitrous oxide has a short half-life, and breathing quickly eliminates it from your system.

This may indicate that inhalation methods involving long exposure produce longer-lasting effects (and are also typically considered to be very dangerous).

All forms of inhalation and recreational use of nitrous oxide can pose significant risks to your health. Methods involving long exposure to nitrous oxide are considered extremely unsafe. 

We strongly recommend you avoid any method of inhaling nitrous oxide without proper medical supervision or consultation with a licensed health professional.

Methods involving long exposure typically include:

• Placing a bag filled with nitrous oxide over the head
• Filling a room with nitrous oxide
• Inhaling nitrous oxide directly from the canister or tank via a mask

The above methods are especially dangerous, because they drastically increase the risk of oxygen deprivation, which can have various serious repercussions:

• Brain damage
• Comatose state
• Death

Can Nitrous Oxide Cause Psychosis?

Psychosis is a group of symptoms, also referred to as a syndrome, rather than an individual sensation (like hallucinations).

Hallucinations and delusions are significant psychotic symptoms that fall under the umbrella term of psychosis.

When someone experiences an episode of psychosis, they lose touch with the real world. Typically, psychosis involves:

• Hearing voices
• Delusions of being followed or watched
• Delusions of grandeur (such as having super or magical powers).

Some researchers warn that heavy nitrous oxide users risk irreversible psychosis, cognitive impairment, and nerve damage.

Further evidence supports this claim. Roberts and colleagues discovered that a patient who had been using nitrous oxide for two years developed a persistent psychotic illness.

Psychosis was still present even when the patient stopped using N2O and undertook treatment for vitamin B12 deficiency.

So, nitrous oxide abuse can trigger long-term psychosis, but what is the drug’s relationship with delusions?

Can Nitrous Oxide Cause Delusions?

Yes, nitrous oxide can cause delusions. But how do delusions differ from hallucinations?

Delusions and hallucinations share some of the same symptoms, causing people to mix the two up.

The main difference between the two is that one relates to the senses, whereas the other mainly involves the way a person thinks.

• Hallucinations: Sensory perceptions where the user falsely believes a sensory experience is real.
• Delusions: False beliefs caused by a cognitive disturbance. Individuals can experience delusions about religion, infidelity, love, grandeur, persecution, and more.

One example where nitrous oxide led to delusions is a case report of a 19-year-old man abusing nitrous oxide daily over the course of six months. Alongside auditory hallucinations, this individual was experiencing persecutory delusions and emotional instability.

Additional evidence presenting 13 cases of nitrous oxide abuse found that 8 of these individuals experienced delusions. This rate was higher than those suffering from hallucinations (4 individuals).

Can Nitrous Oxide Cause Paranoia?

While nitrous oxide can cause paranoia, these effects appear to be short-lived. Users may experience paranoia alongside a severe headache, dizziness, and thought disruption in the short term.

Evidence focusing on six nitrous oxide users receiving treatment during the COVID pandemic found that, of these, two showed signs of paranoid ideation.

Therefore, not all nitrous oxide users experience paranoia. However, due to the nature of the psychotic symptom, even short-term paranoia can lead to feelings of isolation and anxiety.

Why Do People Experience Hallucinations?

There is little research on how nitrous oxide inhalation leads to hallucinations. Instead, most research focuses on people with schizophrenia, as around 70% of this population are estimated to experience hallucinations.

However, research on hallucinations in this context hasn’t uncovered why people experience them. Nevertheless, neuroscientific findings identify several key brain areas involved:

• Sensory cortex
• Insula
• Putamen (the outer portion of the basal ganglia)
• Hippocampus

Animal research highlights what may occur in the brain after hallucinogenic drug use. In a study looking into the effect of a hallucinogen on mice, researchers found that the intake of the substance led to a reduction in visual cortex activity.

Furthermore, while the visual signals received by the visual cortex were similar in the control and drug samples, the brain couldn’t process the visual information correctly after consumption of the hallucinogenic drug.

Senior author Cris Niell suggests that the combination of placing less weight on your surroundings and overinterpreting it could cause the hallucinations.

Unfortunately, like all animal research, it’s vital to question the replicability of this effect in human samples. Moreover, Niell et al.’s findings still do not explain what happens during recreational nitrous oxide use.

Conclusion

Recreational nitrous oxide use can bring a bundle of psychotic symptoms, including hallucinations, delusions, and paranoia.

The evidence shows that frequent and heavy users report these symptoms more often.

However, more evidence is needed to identify if light users also experience these adverse consequences.

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