What is exactly the Laughing Gas?!

Every cheesy movie has this moment: A patient sitting on a dentist chair with a mask on, inhaling a substance that quickly changes their mood. After a few seconds, they begin to maniacally laugh. Everything is funny for no reason. The patient laughs non-stop until something hits them in the head, or they fall on the floor exhausted. That magical gas they were inhaling has a name: laughing gas.

But what is laughing gas? And do people lose their minds when they inhale it? Well, laughing gas, otherwise known as nitrous oxide or N2O, is a mild sedative agent that can be considered an analgesic or anesthetic. Unlike other anesthetics, N2O has a mild analgesic effect at subanesthetic concentrations. That means nitrous oxide will help dull the pain, but it won’t put you to sleep, like general anesthesia. N20 is a colorless gas with a sweetish taste and odor. When inhaled, it can create feelings of euphoria, relaxation, and giddiness, which causes some (but not all) people to laugh. British scientist Joseph Priestly first discovered nitrous Oxide in 1772. Fast forward 30 years. A young British chemist, Humphry Davy noted the effects of the gas in respiration, as well as its potential as an anesthetic. In 1800, Davy published his findings on the history, chemistry, physiology, and recreational use of nitrous oxide.

As you may imagine, these experiments were not up to the scientific standards that we are used to today. So, we should take them with a grain of salt. In fact, it would be accurate to say that those experiments were conducted in a similar fashion as the popular clip "David After Dentist." In 1799, Davy took the gas outside of laboratory conditions, inhaling vast amounts of it in solitary sessions in the dark. He also started offering the gas to healthy subjects, usually his friends and family and asked them to write down their experiences. Well, when I get together with friends, I like to play a board game, but apparently, Davy preferred drugging up his friends and writing reports. Well, to each their own. We still don’t exactly know how nitrous oxide works on the brain and body, but scientists have a few theories regarding the physiological mechanisms. Simply put, it is believed that nitrous oxide impacts how neurotransmitters send pain signals around the body. N2O works through regulated ligand-gated ion channels in the body - the GABAA receptors - which control a big portion of inhibitory signaling in the nervous system.

Similarly, to other anesthetics such as benzodiazepines, N2O stimulates the GABAA receptor, producing an anxiolytic-like effect. Another popular hypothesis is that the N2O-induced analgesic effect could be similar to that of the opioids like morphine. When it comes to the effect nitrous oxide has on your body, that will depend on how much you inhale and for how long. Typically, you start to experience the effects within 30 seconds to one minute after inhalation, and the effects wear off within minutes after you cease inhaling. This is why it is necessary that the patient continually inhales the gas during a medical procedure. But what do people actually experience when under the effect of laughing gas? Do they really start giggling or seeing things that weren’t there in the first place?

As a matter of fact, some people have described similar sensations to getting high, like feeling light-headed, experiencing a floating sensation, feeling sleepy, or even tingling in their arms and legs. Those effects can create a feeling of euphoria and relaxation that will make you more prone to laughing and be less aware of your fears and things that make you anxious. N2O does also have an analgesic effect, but it is important to mention that although N2O helps dull the pain, it does not eliminate it completely.

Now that we know what Nitrous oxide is, let’s find out where we use it. One of the common uses of nitrous oxide is, like we have mentioned at the beginning, Dentistry. Despite advancements in the field, many people still feel extremely anxious about attending dentist appointments and benefit from nitrous oxide's anxiolytic effects. Nitrous oxide is commonly used in conjunction with oxygen, so if you start to feel the effects too strongly, the dentist can switch off the N2O, and the effects will wear off quickly as you inhale oxygen. Headaches are also a common after-effect of nitrous oxide, so many dentists require that you inhale oxygen for at least five minutes after receiving N20 to avoid a sore head. Nitrous oxide can be used in childbirth. In some countries, women can use nitrous oxide in labor to help alleviate painful contractions during childbirth. Nitrous oxide comes as a noninvasive alternative way of managing pain without restricting mobility, slowing labor, or causing any harm to the baby. You’re probably picturing women laughing while giving birth, but that’s not the case at all. Laughing gas will only help the new mother to relax, relieve stress and anxiety, and even allow her to move around, making labor a much more comfortable experience. The use of nitrous oxide in this setting is more prevalent in some countries than in others. For example, in the UK, it's commonly used in the form of Entonox. Entonox is a mixture of oxygen and nitrous oxide gas, inhaled through a mask or mouthpiece.

Nitrous Oxide is also frequently used during childbirth in Finland, Canada, Australia, and New Zealand. The practice is less common in the US but is growing in popularity every year. Davy was not the only one using nitrous oxide recreationally. Today, in many countries, the sale of N2O is not heavily restricted. Typically, nitrous oxide sellers don't advertise its recreational use, but will promote N2O pressurized canisters to make whip cream. Looking at the data, you'd be forgiven for believing that party-goers have a passion for whip cream. My advice, don’t do it at home. Let your healthcare professional decide when you need laughing gas.

How dangerous is nitrous oxide? In a medical setting and with infrequent use, nitrous oxide is not dangerous and can make minor medical procedures or events more tolerable. Sure, there could be, just like any other treatment, some common short-term side effects like nausea, vomiting, dizziness and fatigue; however medical professionals are able to supervise the administration of N2O, so that they can lower the risk of any adverse effects, by restricting the flow of the gas or increasing the intake of pure oxygen. Nonetheless, there are some dangers associated with the recreational use of N2O. Just like any other drug, the sedative and euphoric effects could cause you to act carelessly and dangerously. On top of that, prolonged and heavy use of nitrous oxide can lead to vitamin B12 deficiency, which in turn can cause severe and irreversible nerve damage.

And that happens due to the fact that N2O converts the active monovalent form of vitamin B12 to its inactive bivalent form, which your body can't use. It's also been reported that regular use of nitrous oxide can harm your body's ability to form white blood cells effectively. Similarly, there are also some medical conditions that could increase the risk of adverse reactions. Pregnancy, history of substance abuse and respiratory illness are some of the factors that should always be taken into consideration when thinking of administering nitrous oxide.