Nitrous oxide misuse is a serious concern

As a Long Island native and clinician who works closely with individuals and families affected by substance use, I've watched with growing concern as nitrous oxide misuse has become apparent in our local communities, particularly among young people.

For many, nitrous still carries an almost harmless reputation. People associate it with whipped cream canisters in restaurant kitchens or the "laughing gas" used at the dentist. But the products now being sold in smoke shops, convenience stores and online marketplaces often look very different: brightly packaged tanks and cartridges, flashy branding and sweet, fruit-forward flavors that can make them appear far less serious than they are.

Nassau County's recent move to restrict the sale of nitrous oxide products, commonly known as "whip-its," reflects a growing recognition that this is not simply a passing trend, but a legitimate public health concern. Although adding barriers to buy nitrous in person could prevent someone from engaging with it, the canisters are still easily available online, even on Amazon. As with all substance use, where there's a will there's a way.

From a clinical standpoint, the concern is well-founded. While the euphoric effects of nitrous may be brief, repeated misuse has been associated with oxygen deprivation, numbness, nerve damage, cognitive impairment, loss of coordination and in more severe cases, lasting neurological injury. These symptoms may sound abstract or vague, but in person it looks like someone is spacey, exhausted and shambling like a zombie. Some people may seek effects like this when using, but when they're happening past the point of the intended effect, the party's over. It can be easy to view the short high provided as negligible, but this false sense of security can lead to a snowball effect of extended use that can be devastating. Treatment providers are especially concerned about the neurological effects that can emerge with repeated use, particularly among younger individuals who may not fully understand the risks.

What makes this issue especially challenging is how easy it can be to overlook. Because these products are widely accessible and marketed in ways that feel playful or familiar, many young people do not initially recognize the danger. Their families may not either.

Policy action is an important first step in limiting access and acknowledging the seriousness of the issue, but legislation alone cannot solve the larger problem. Education must follow. Parents, educators and community leaders need clear information about what these products are, how they are being used, and the warning signs that experimentation may be escalating into something more dangerous. As we've seen with other substances, a ban can help mitigate engagement, but rest assured this is not the last we'll see of NO2 in Nassau.

As someone who grew up on Long Island, this issue feels deeply personal. Especially considering my time in the field during COVID-19, I've seen how quickly casual substance use gets out of hand. The people I worked with when the world shut down often shared a similar story to those suffering from nitrous abuse.

We must ensure that our communities have accurate information and that young people can get support before short-term experimentation leads to long-term harm. The people who are impacted by this are not caricatures of people who use substances. They're our children, our parents, our siblings, our friends.

The sooner we treat nitrous misuse as the serious health issue it is, the better chance we have to intervene early and protect our community.

This guest essay reflects the views of Daniel Sexton, program manager of outpatient services at Mountainside Treatment Center, located in Huntington and Manhattan.