No Laughing Matter: a Comprehensive Overview of Nitrous Oxide Abuse

No express mirth Matter A Comprehensive Overview of azotic Oxide squall Ryan Ardelle Anatomy & Physiology, Period 3 Mr. Syvret Due butt on 14, 2013 SUBSTANCE OVERVIEW The issue of inhalant ab occasion is a multifaceted problem, stretching across to a greater extent communities and locales in the entirety of the join States. intakes as a tell apart of drug vary widely, ranging from volatile solvents and aerosol propellants, to much broadly, whatever drug delivered by inhalation. nitrous oxide straddles these categories, as it finds use nary(prenominal) only a habitual alveolar consonant analgesic, but too as a propellant, in such uses as whipping beat, automotive racing, and rocketry.As a result, azotic oxide is found in m either organises medical-grade, food-grade, and industrial-grade, with various purities (Erowid). Commonly known as express mirth burn out, nitric oxide wears many hats and goes by many names. For example, those who use nitric oxide in autom otive racing or rocketry applications know it as NOS (Alai). In this usage, azotic oxide is utilise as a powerful oxidizer, allowing a fomites engine to combust fluboline more speedyly, with an associated make up in horsepower (Winter). This form of azotic oxide is packaged with many additives to non only cleanse its performance but also to deter its handle (Erowid).When ill-treat amateurishly however, nitrous oxide finds many more colourful nicknames, such as hippie crack and nangs (Erowid). It is a true accelerator, existing as a blow out chthonian atmospheric pressure at style temperature, although it assumes a liquid farming when compressed in a gas cylinder (Alai). nitrous oxide is a strong oxidizing agent with a density of 1. 9kg/m 3, and it has a linear molecular form consisting of ii atoms of atomic number 7 and one atom of atomic number 8 (Winter). azotic oxide has no color and has a sweet odor, familiar to anybody who has tasted whipped cream (Erowid).az otic oxide is commercially manufactured by heating ammonium nit prise to 240C. Impurities such as ammonium hydroxide and nitric acid in addition to extravagance water vapor be removed through an extensive gas scrubbing process. Food-grade nitrous oxide is a good deal stored in white, 8-gram cylinders with a sealed metal deflate cap and packaged in boxes of 100 cylinders. Medical-grade nitrous oxide is stored in French-blue cylinders and is pressurized to 4400 kPa at room temperature. The Pin business put outer Safety System configuration for nitrous oxide cylinders is 3-5 (Banks and Hardman). account OF NITROUS OXIDE ABUSEBritish chemist and Presbyterian minister Joseph Humphrey first synthesized nitrous oxide gas in England in 1772. Priestly later on published his clobber in a 1776 journal, Experiments and Observations on variant Kinds of Air (Priestly). This publication proved exceedingly intriguing to the scientific community, leading to additional look into and Hum phry Davys influential 1800 book, Researches, Chemical and Philosophical in the first designate C formerlyrning nitrous Oxide. Throughout the remainder of the nineteenth century, nitrous oxides usage as a recreational drug became increasingly popular.Traveling medical shows and carnivals featured dearly named Nitrous Oxide Capers, in which attendees paid a footling fee to inhale a minutes worth of gas (Brecher). In 1844, Dr. Horace Wells, a British dentist, first demonstrated the use of nitrous oxide as a dental anesthetic. His initial testing on a patient at Harvard Medical naturalise was unsuccessful, resulting in the public dismissal of nitrous oxide as a legitimate anesthetic. Nevertheless, nitrous oxide had a sudden resurgence in the dental community in the early 1860s, thanks to a series of dental institutions opened by lecturer and showman nurseryman Quincy Colton.These practices utilized nitrous oxide as their primary form of dental anesthesia, henceforth meterizing its usage in the United States (Erowid). METHODS OF ADMINISTRATION Nitrous oxide is administered via inhalation of compressed gas. Users around much obtain nitrous oxide from small, 8-gram tail endisters used to wake whipped cream dispensers. These can buoyisters atomic number 18 readily available for leverage in most restaurant supply stores, on the Internet, and in head shops across the nation (Narconon).Once obtained, the confine of the canisters are stretch forthd into empty whipped cream dispensers or into a inflate. A pressure release valve, or center, must be used in put together to safely siphon the gas into a balloon (Erowid). These valves are also available for purchase online or in head shops (Narconon). Users with access to larger cylinders of nitrous oxide sometimes inhale the gas through a nasal hood or anesthesia mask, as used in dental surgery. However, this method is extremely dangerous without proper medical supervision, as exploiters can inhale larg er amounts of gas without access to impertinent oxygen.As a result, the vast majority of nitrous oxide users pick to use the aforementioned whipped cream dispenser or balloon methods of inhalation (Wagner, Clark, Wesche, Doedens, and Lloyd). Whipped cream canisters and standard latex troupe balloons have a maximum capacity of virtually three 8-gram cylinders. Depending on personal preference, users can read their vessel of choice with one, two, or three cylinders at a time (Creamright). Once the whipped cream dispenser or balloon is filled to the users liking, the gas inside is rapidly inhaled into the users lungs.The gas is often held in the lungs for twenty to sixty seconds to bugger off hypoxia and enhance the euphoric set ups. The gas is then exhaled normally, and the user resumes firm respiration of room air (Erowid). spry effect Once inhaled, nitrous oxide is immediately cloaked through the lungs, dissolving directly into crinkle plasma. within ten to fifteen seco nds, nitrous oxide molecules replace oxygen molecules in the users lungs, thereby impact a euphoric sensation. Users then experience a brief high usually lasting in the midst of thirty seconds and two minutes with a standard dose (Erowid).Symptoms of nitrous oxide abuse include buddy-buddy speech, impaired coordination and balance, difficulty thinking clearly and touch on information, unresponsiveness to verbal and painful stimuli, and occasionally sacking of consciousness. Assuming the user returns to regularly breathing room air after the initial gas inhalation, these symptoms should dip within two minutes. The onset and peak effect timing of nitrous oxide is determined by the bar consumed (Narconon). Nitrous oxide inhalation impacts the function of numerous physiological ashess.First, nitrous oxide decreases tidal volume and increases respiratory rate following activation of the central nervous system. myocardial depression and an increase in central sympathetic outflow also occur following nitrous oxide inhalation. Inhaled nitrous oxide may produce the second gas effect, as nitrous oxide has a more rapid rate of diffusion across alveolar root cellar membranes than nitrogen gas. This rapid exit of nitrous oxide from the alveoli initiates a concentration of other alveolar gases, thereby accelerating the inhalation of nitrous oxide into the bloodstream (Banks and Hardman).The primary method of nitrous oxide elimination is via the exhalation from the lungs. Nitrous oxide exits the body whole unchanged in chemical formula and structure. smooth amounts of nitrous oxide diffuse through the skin and the renal system, and anaerobic bacteria in the GI package reduce any outstanding nitrous oxide into nitrogen gas (Erowid). ACTION ON THE BRAIN Nitrous oxide causes vasodilatation, resulting in an increase in cerebral blood flow and causing a corresponding increase in intracranial pressure (Erowid). Unlike most inhalants, nitrous oxide does not augment th e do of non-depolarizing neuromuscular blockers.Accordingly, nitrous oxide does not produce the same neuromuscular depression experienced with other inhalant abuse. Nitrous oxide activates opioid receptors in the periaqueductal grey of the midbrain, stimulating a release of norepinephrine and activation of 2-adrenoceptors in the dorsal hooter of the spinal cord (Banks and Hardman). LONG TERM EFFECTS Risks involved in nitrous oxide inhalation roll out primarily around displacing oxygen. Although nitrous oxide does not fix with hemoglobin and instead dissolves into the blood, continued inhalation of utter(a) nitrous oxide without supplemental oxygen can lead to hypoxia.Nitrous oxide-induced hypoxia is especially dangerous because users may not run into that they asphyxiating themselves the impulse to breathe is triggered by a build-up of carbon dioxide, rather than a lack of oxygen (Banks and Hardman). Aside from hypoxia, there are relatively a couple of(prenominal) physiologi c dangers associated with nitrous oxide abuse. The most significant of these effects is Vitamin B depletion and deficiency. This can probablely lead to swell or chronic paresthesia, the sensation of pins and needles, and can forbid the activity of methionine synthetase, thereby interfering with DNA price reduction in leukocytes and erythrocytes.However, Vitamin B and Folate supplements can hold these side effects (Banks and Hardman). Nitrous oxide can also induce potentially dangerous airspace enlargement in the body, such as pneumothorax or bowel obstruction, due to its rapid diffusion properties. Other potential side effects include respiratory depression, apnea, hypotension, cardiac arrhythmias, dizziness, neuropathy, nausea, vomiting, ileus, bone marrow depression, and malignant hyperthermia. Pregnant women should not use nitrous oxide, as the gas diffuses into the placenta and can cause fetal depression (Erowid).A few cases of cryopathy on the vocal cords have been recor d following direct inhalation of nitrous oxide from a canister (Banks and Hardman). Also, nitrous oxide users are at lay on the line of traumatic fall injuries such as scummy extremities and concussions due to impaired balance and possible deviation of consciousness (Narconon). STATISTICS Nitrous oxide abuse is most ballpark among younger adolescents aged 16-17, although abuse does occur among honest-to-god individuals. A 2011 training from the University of Michigan showed that 13% of eighth grade students reported abusing inhalants at least once ( home(a) found on Drug Abuse).A similar study from the University of Virginia revealed that nitrous oxide was one of the top louver sum totals abused by adolescent inhalant users (Narconon). According to the burden Abuse and Mental Health Services Administration, the rate of inhalant abuse increased steadily from 3. 4 percent at age 12 to 5. 3 percent at age 14, then declined to 3. 9 percent by age 17 from 2002-2006. entropy from this study also showed that adolescents age 12 to 17 represented 48 percent of all substance abuse treatment admissions account inhalants. Among these adolescent admissions reporting inhalant abuse, 45% had a concurrent psychiatric disorder (SAMHSA). Erowid. com, a popular website that provides information on psychoactive drug use, conducted a series of online surveys in September 2009 in a study examining the possible presence of contaminants in nitrous oxide chargers. One of the surveys asked regular nitrous oxide users their preferred method of inhalation 46% preferred using a cracker with a balloon, 34. 4% preferred inhaling directly from a whipped cream dispenser, 11. % percent preferred a whipped cream dispenser with a balloon, 1. 7 % preferred a cracker with a bag, 0. 7% preferred a whipped cream dispenser with a bag, and 5. 0% preferred other methods (Erowid). Nitrous oxide is not physiologically addictive, although certain individuals can use it compulsively. magic s pell psychological addiction is possible, the only symptom of pulling out is the desire to inhale more nitrous oxide (Dartmouth College). Furthermore, statistics on inhalant-related deaths are difficulty to determine, as most deaths are severely under-reported.Most of the time, death is attributed to cardiac or respiratory failure subsequent to inhalant abuse. Studies from the Texas Commission on Alcohol and Drug Abuse between 1990 and 1993 revealed an mean(a) of 15 inhalant abuse-related deaths per year in the state of Texas. Of those deaths, 94% of victims were male, and 91% were Caucasian, on average (National breathing in Pr matterion Coalition). Most recreational nitrous oxide-related deaths are caused by hypoxia when users affix masks without oxygen or place bags over their heads to concentrate the gas (Erowid). EFFORTS TO ADDRESS ABUSEThe radical of inhalants has been addressed by multiple small grass-roots efforts in local communities, but has also seen national discussi on. Although no national legislation is in place constrictive the sale, consumption, and distribution of nitrous oxide, several states and municipalities have passed laws in an attempt to curb usage. Most of these laws specifically purpose underage consumption and sale of nitrous oxide to bush league (Center for cognitive Liberty & Ethics). For example, the Article 34 gentle 7 3380. 5a-5b of the new-sprung(prenominal) York State Controlled Substances Act states a) No person shall use nitrous oxide for purposes of causing intoxication, inebriation, excitement, stupidity or the dulling of the brain or nervous system of himself or another. (b) No person shall sell any canister or other container of nitrous oxide unless give an exemption pursuant to this subdivision. In no event shall any canister or other container of nitrous oxide be sold to a person under the age of twenty-one years. Any person who violates any provision of subdivision four or five of this section shall be gu ilty of class A misdemeanor (New York State Legislature).A number of non-governmental organizations such as the National Inhalant prevention Coalition work to educate the public on the facts and dangers of inhalant abuse. These organizations frequently lobby on the state and federal train in attempt to pass more constrictive anti-inhalant abuse legislature. These preventative efforts have helped to several states mix in inhalant abuse education into primary and secondary winding school health education curricula (National Inhalant Prevention Coalition). Works Cited Alai, Nili N. Nitrous Oxide Administration. Ed. Rick Kulkarni.Medscape Reference, 30 Jan. 2012. Web. 4 Mar. 2013. . Banks, Amelia, and Jonathan G. Hardman. Nitrous Oxide. British Journal of Anaesthesia proceed Education in Anaethesia, Critical Care, and Pain (2005) 1-4. Web. 4 Mar. 2013. . Brecher, Edward M. The Consumers Union Report on Licit and outlaw(a) Drugs. Consumer Reports Magazine 1972. Web. 4 Mar. 2013. . Drug Facts Inhalants. Inhalants. National Institute on Drug Abuse, Sept. 2012. Web. 4 Mar. 2013. . Erowid Nitrous Oxide Vault. Erowid, 21 Feb. 2013. Web. 4 Mar. 2013. . Frequently Asked Questions. Nitrous Oxide Whipped Cream Chargers. Creamright, 2013. Web. 4 Mar. 2013. . Nitrous Oxide (Laughing Gas). Health Promotion. Dartmouth College, 21 Jan. 2009. Web. 4 Mar. 2013. lthttp//www. dartmouth. edu/healthed/groups/dapa/otherdrugs/no. html. Nitrous Oxide. Nitrous Oxide. Narconon, 2013. Web. 4 Mar. 2013. . Priestly, Joseph. Experiments and Observations on Different Kinds of Air. Vol. 2. London n. p. , 1776. 6 vols. Web. 4 Mar. 2013. . Public Health. Laws of New York. New York State Legislature, n. d. Web. 4 Mar. 2013. . Statistics on Inhalants extract Young Teens at Risk. SAMHSA News. SAMHSA, Mar. 2008. Web. 4 Mar. 2013. . US Nitrous Oxide Laws. State Laws Concerning Inhalation of Nitrous Oxide. Center for Cognitive Liberty & Ethics, May 2002. Web. 4 Mar. 2013. . View Point. National Inhalant Prevention Coalition Quarterly Newsletter.National Inhalant Prevention Coalition, 2013. Web. 4 Mar. 2013. . Wagner, Scott A. , Michael A. Clark, David L. Wesche, David J. Doedens, and Alan W. Lloyd. Asphyxial Deaths from the Recreational Use of Nitrous Oxide. Journal of Forensic Sciences 37. 4 (1992) 1008-15. Web. 4 Mar. 2013. . Winter, Mark. Nitrous Oxide. WebElements Periodic Table of the Elements. WebElements, n. d. Web. 4 Mar. 2013. .