Nitrous Oxide to Become a Class C Drug

The UK government has recently released the Anti-social Behaviour Action Plan, a policy paper outlining plans to tackle behaviours seen as antisocial which would include more punitive responses to ‘rough sleeping and begging’, ‘tackling empty shops’ and a crack down on the use of drugs. The policy paper specifically mentions the use of Nitrous Oxide and the government’s intention to move the control of possession and sale of nitrous oxide into the Misuse of Drugs Act 1971 (MoDA).

Crew have prepared a position statement on this proposal to reclassify nitrous oxide which you can read below.

Crew Position Statement on Nitrous Oxide, March 2023

UK Government announced the intention to bring possession of nitrous oxide into the Misuse of Drugs act 1971, criminalising possession and doubling the sentence for dealing 26.03.23

Nitrous oxide is a gas with anaesthetic and pain-relieving properties. It has been used in medicine such as midwifery and dentistry, and as a recreational drug since the late 1700s. Nitrous oxide is commonly used in the catering industry as an aerosol spray propellant for cartridges of squirty cream.

It is a colourless, slightly sweet smelling gas sold in small silver canisters or large medical grade canisters usually dispensed into a balloon from a “cracker” or dispenser. Nitrous oxide is a quick acting and short lasting dissociative drug with anaesthetic and psychedelic effects. 

Nitrous oxide is currently legal to possess, buy and sell in the UK for “legitimate uses” such as catering, engineering, medicine and dentistry. Under the Psychoactive Substances Act 2016, it is illegal to sell if knowingly sold in order to produce a “psychoactive effect”.

The Advisory Council for the Misuse of Drugs (ACMD) recently were asked to review the harms of nitrous oxide and reported that ‘the types of harms caused by nitrous oxide have not changed since the last ACMD report in 2015’ and did not recommend rescheduling of nitrous oxide.

Nitrous oxide should remain under the Psychoactive Substances Act 2016, but additional measures are needed to tackle non-legitimate supply and alert people who use nitrous oxide and healthcare professionals to the risks of nitrous oxide use.

Current evidence suggests that the health and social harms of nitrous oxide are not commensurate with control under the Misuse of Drugs Act 1971.

Publication of ACMD’s review on nitrous oxide, 6th March 2023

Apparent antisocial behaviour linked to the use of nitrous oxide has been cited as one of the key reasons the government has decided to act in opposition to the advice from the ACMD. Littering, which was given as one of the reasons for the ban on sales and criminalising possession, is already an offence in the UK.

Despite nitrous oxide’s status under the Psychoactive Substances Act 2016, it is still widely available. That is why we have taken the decision to go further, drawing on the stronger basis to take action against illegitimate supply that the Misuse of Drugs Act 1971 provides.

Government response: ACMD nitrous oxide review, 2th March 2023

Evidence does not currently show nitrous oxide to be associated with increased violence, vandalism or anti-social behaviour in the same way that alcohol is.

Should Possession and all Sales be criminalised? 

The Advisory Council Misuse of Drugs (ACMD) consists of doctors who treat people who take drugs and/or scientists who research drug harm prevention, the effects of drugs on individuals and communities and treatment.  These professionals who work for free to advise the Government on how to reduce drug harms and promote public health, as required by law.  The ACMD’s 2023 review of nitrous oxide concluded that the likely harms of nitrous oxide did not justify control under the Misuse Of Drugs Act 1971 and that criminalising possession was disproportionate and could lead to unintended harmful consequences.  The ACMD recommended improving the implementation of existing laws regulating sale for legitimate uses and on littering; supporting risk education and harm reduction. 

The ACMD and British Medical Association, both advise, from their research evidence base, that criminalising people for drug possession is costly and does not work, and that we should focus on an evidence-based, public health approach.

Risks of criminalising possession: 

  • People will continue to take nitrous oxide, just less safely. They may also be more likely to discard cannisters improperly once possession is criminalised.
  • Supply will be less safe if it is unregulated and forced fully into the illicit market – banning sales will create a new opportunity for organised crime groups to scoop up existing stocks, then obtain and distribute nitrous oxide without the safety measures or accountability that exist now.
  • More use of larger cannisters, which leads to prolonged sessions of use at higher doses thereby increasing the acute risk of fatal oxygen deprivation, and more long-term serious health harms linked to nerve damage and neuropathy.
  • An increased burden on police forces and courts, disproportionately criminalising vulnerable, racialised youth. Under the proposed anti-social behaviour plan police will have greater powers to search and drug test people they suspect of dealing with a focus on stimulant drugs which appears to be an attempt to respond more punitively to low level social supply.

“The nos ban, ‘crackdowns’ on public use —incl. ‘cannabis smell’ dogwhistle, and all related recent announcements on antisocial behaviour & public drug use allow the state both to capitalise on social anxieties + relinquish responsibility for the pain & harm caused by drug policy….. 

Juan Fernandez, Support Don’t Punish on Twitter @jfernandezochoa

What Might Work Better than Criminalising People? : 

  • An evidence-based public health response making better use of existing supply controls, which as these are for catering and medical use, are stringent. It is important people are protected from the supply of mechanical grade nitrous oxide which is not fit for  human consumption
  • A stronger focus on and support for non-judgemental, evidence-based drug education and harm reduction
  • Improving our understanding and evidence about young people’s drug taking and engagement/non-engagement with treatment services.
  • Building up the skills of the drug treatment workforce so that we can meet the needs of people who take drugs associated with recreational settings like nitrous, cocaine and cannabis.
  • Provide whippet or canister deposit and recycling schemes –young people are well educated and generally concerned about the environment and these schemes are proven to work.

We are aware of the following risks associated with the recreational use of nitrous oxide:  

Oxygen Deprivation: Inhaling nitrous oxide can result in a lack of oxygen to the brain. This can result in a person falling unconscious and even dying through suffocation or heart problems (acute asphyxiation due to hypoxia, or, less frequently, sudden cardiac arrhythmia). This risk is likely to be greater if nitrous oxide is consumed in an enclosed space (e.g. car or tent), the gas is allowed to fill the room/space or if a lot is used at once or if a medical mask (or any other face/head covering) attached to a larger cannister is placed over the face.

Frostbite: Risk of damage to the lips, nose, throat, lungs and face if inhaled directly from any kind of cannister (the gas is pressurised when released from the cannister and becomes very cold ) 

Injury: Nitrous oxide is a drug with dissociative anaesthetic and depressive properties  so it can make people feel detached, unsteady on their feet so they might fall or lack judgement about keeping safe 

Nerve Damage: Prolonged and heavy use of nitrous oxide can deplete an essential vitamin, B12. This can lead to nerve damage– this is uncommon but also serious. Symptoms may include tingling and numbness in fingers and toes and can lead to weakness in arms and legs, brain fog and issues with memory. If treated early some of this damage may be reversible. 

Harm Reduction

Detailed harm reduction information for nitrous oxide is available in our Drugs A-Z. We also have a nitrous oxide postcard and social media graphics. As with any drug it is important to be aware of the expected effects, how to spot any unexpected or unusual effects and what to do in an emergency.

Its important that if people choose to take nitrous oxide:

  • Chose somewhere, grounded, wellventilated and with people you trust.  
  • Avoid rivers, roads and anywhere with a sheer drop or risk of falling
  • Always dispense the gas from a cartridge into a balloon (avoid sharing balloons) and avoid the use of large cannisters, the use of inhalation masks and never place a bag over your head
  • Sit down before taking nitrous in case you fall over
  • Keep an eye on use – including frequency and amount. Consider supplementing B12
  • If you experience numbness or tingles in extremities visit your GP

Support from Crew

Our website has lots of information about the effects and risks of nitrous oxide and other drugs, how you can look after yourself and others. Our digital Drop-in is open week days and Saturday afternoons. You can message @crew_2000 on Instagram or email dropin@crew2000.org.uk for support, advice or you can text 07860047501 for free if you’d like a phone call back.

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