Posted on: 4 April, 2023
Last week the Prime Minister Rishi Sunak announced that Nitrous Oxide, commonly referred to as laughing gas, would become illegal under the Misuse of Drugs Act 1971, with the substance set to become a Class-C drug.
The recreational use, sale and possession was already illegal under the new Psychoactive Substances Act of 2016, although illicit supply direct to consumers has been difficult to enforce, due to nitrous oxide having legitimate purposes within the catering the industry.
Nitrous oxide is frequently used for whipping cream in high-street cafes, the catering sector and has several medical benefits, often being used during labour and sometimes in dentistry.
Nitrous oxide use for recreational purposes is commonplace, particularly with young people, and is the second most used illicit substance for this cohort, behind cannabis. Since 2010, 45 people of all ages have died from issues related to nitrous oxide in England and Wales.
Some of these deaths are caused by asphyxiation, resulting from inhaling a freezing substance straight from a cannister rather than secondary inhalation via a balloon.
Other asphyxiation deaths are thought to have been caused by using nitrous oxide in a confined space (such as a car with windows closed or from underneath bedcovers). These tragic outcomes point to the need redeploy aspects of the harm reduction advice similar to advice given to people using solvents in previous generations.
This advice includes not using alone, in confined spaces, or in high-risk environments (near roads, canals, bridges etc.), as well as avoiding direct inhalation of propellants. Ironically the presence of nos litter in public parks and other places points to users avoiding these risks.
We must invest in education and support, not increase the risk of by banning nos. A further ban will drive use into those secretive and riskier locations. It is also likely to make users take nos more quickly in order to remain undetected – similar to overdoses among people who inject drugs in risky areas to avoid detection from law enforcement.
Generally, harms associated with nitrous oxide are relatively small, but excessive use, or long-term use, of the substance can carry risks including Vitamin B12 deficiency and has been linked to neurological damage. The recent emergence of larger canisters (as opposed to smaller whippets) could be a prevailing factor for increased harms.
Larger cannisters allow a person using to inhale more gas, whilst not taking in oxygen, whereas previously, smaller whippets would only allow for a smaller amount of gas before the ‘buzz’ would wear off. Larger canisters which have become more prevalent, are often imported from the Netherlands, and have no legitimate medical or catering benefit.
The Advisory Council for the Misuse of Drugs (ACMD), which is the expert body that the government should refer to on issues related to substance use recently published a review, where they advised against incorporating nitrous oxide within the Misuse of Drugs Act. The Review stated that “the health and social harms of nitrous oxide are not commensurate with control under the Misuse of Drugs Act 1971.” In short, the risks associated with the use of nitrous oxide is not proportionate to the further criminalisation of the gas.
This is not the first time that the government has been accused of ignoring the evidence from the ACMD, with a Times piece recently revealing that a government department had ‘covered up’ the findings of a paper from the body, as the results did not chime with the government line.
When questioned on why the government chose to ignore the advice, they stated that the guidance and expertise within the ACMD did not account for the wider social and criminal elements for which this ban was being proposed. This is widely seen as incorrect given the scope of expertise in the ACMD, and the constant consideration on wider societal impacts including crime.
Despite this, both the Government and the Opposition have endorsed the change to make nitrous oxide a Class-C substance, which will likely lead to further criminalisation. This shift in approach goes directly against the scientific guidance from the ACMD, and is an example of political will usurping evidence when it comes to making policies on drugs. Severe harms such as neurological damage, fatality and B12 deficiency are thought to affect less than 0.05% of people who use nitrous oxide for recreational purposes, yet the media focus is on the most severe consequences affecting a tiny minority.
Cranstoun firmly believes that policies related to substances must always be evidence-led, and not guided by political ideology. There is no coincidence that this policy is being proposed just two months ahead of the local elections, with both main parties focusing campaigns on anti-social behaviour, and being tough on crime. The evidence that this will tackle crime or anti-social behaviour however, is seriously lacking.
The narrative surrounding the banning of nitrous oxide is rooted in anti-social behaviour, namely the littering of cannisters in public. Whilst littering is an unpleasant nuisance, this is already a crime and criminalising nitrous oxide will not decrease litter. It could be argued that the littering of cigarette butts, alcohol bottles and cans, and fast food packaging is far more of a prevalent littering issue than paraphernalia related to nitrous oxide.
Changing legality surrounding nitrous oxide could lead to more blighted lives for young people, who will receive a criminal record for behaviour that – whilst not risk-free – is common and not life-threatening. The vast majority of people who use nitrous oxide will not develop a dependency or use it excessively, but may suffer grave consequences as a result of a criminal record.
Substances like cocaine and cannabis, which are more widely used in young people, cause greater cause for concern given the short-term, long-term, mental and physical risks associated with both substances. The proportionate risk for young people, and risk of dependency is far greater with these two substances than nitrous oxide.
Given that people of colour, namely young black men, are overrepresented in regards to stop and search and subsequent representation within the criminal justice system, Cranstoun fears that nitrous oxide becoming a class-C drug could exacerbate this issue. This is particularly pertinent that young people’s use of nitrous oxide is more likely to be public and visible, leading to a greater chance of criminalisation.
For the small percentage that do develop a problematic relationship with nitrous oxide, criminalisation will only further lead to cycles of crime and addiction. This change will do nothing to address the root cause of why people use or become dependent on a substance, and will not help anyone overcome addiction. Particularly for young people, this will have grave consequences.
Potential solutions to emerging issues related to nitrous oxide include the improvement of education for young people in relation to substance use, improving social conditions for young people through services and youth clubs, a focus on enforcement on larger canisters which are only used recreationally at the point of wholesale supply, and a deposit scheme to counter nitrous oxide related litter.
Overall, it is impossible to countenance that this change is rooted in anything other than short term political gain, against longer term salient policy making that reduces harm. This will increase harms for people who nitrous oxide, as well as providing the police and criminal justice system with another issue in relation to time and punishment, for a ‘crime’ that the ACMD view as disproportionate to the harms caused by the substance.
Meg Jones, Cranstoun Director, said: At a time where culturally similar countries to our own move away from the reactive criminalisation of people who use drugs, it is disappointing that the two main political parties have chosen to ignore their expert bodies and push ahead with a move that will do nothing but increase harm, suffering and cost to the taxpayer. We strongly urge a rethink to protect young people and address the root cause of substance use.
Vicky Branch, Cranstoun Head of Young Persons Services, said: I’m concerned about the unintended consequences this ban will have for our young people. It potentially increases their risk and vulnerability by accessing nitrous oxide from street dealers/criminal gangs and the likelihood of receiving a criminal record. Neither of these will decrease their health or social harms exposing them to further injustices. The recommendations which have been ignored from the ACMD, provided a proportionate and sensible way forward to tackle non legal supply and reduce associated harms.