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One of my best friends has started hanging out with a new group of people and they are messing around with bulbs - they call it 'nanging'. They say it is the same as 'laughing gas' and is called nitrous. I am worried about her, she says that I shouldn't be worried because it is harmless. Is it dangerous and what does it actually do to you?

Thanks for the question, although it is most probably one of the most difficult to answer as I have to be extremely careful about what I say as I don't want to give anyone reading this any ideas of what to do ...

I have to say that I haven't heard it called 'nanging' for a very long time (if you take a look at the internet it is also sometimes called 'nagging', although I think that is just researchers getting the name wrong!). The term relates to the inhaling of a gas called nitrous oxide (NO) from cartridges ('bulbs' or 'nangs') usually used for making whipped cream. Apparently it's called 'nanging' due to the "repetitive sound distortions induced by its use" according to UrbanDictionary.com. I won't go into how exactly people use these cartridges or bulbs but essentially what they want to do is to get the gas out of the bulb and then inhale it ...

Nitrous oxide has been around for a very long time and is used in surgery and dentistry for its anaesthetic and analgesic (pain-relieving) effects. It is often called 'laughing gas' mainly due to the euphoric effects of inhaling it (even though you may see movies showing people using this gas laughing hysterically, that is not what the gas necessarily does - the term 'laughing gas' relates to the hallucinogenic or euphoric effect). It has been used by some to get intoxicated or 'out of it' for a very long time - with reports of use in this way going back to 1799! In addition to the effects already discussed, users say they experience a lack of coordination and disassociation (feeling separated from their body) when they inhale the drug and that is why it continues to be popular amongst some groups of young people.

If you take a look around the web you will find lots of discussion around the use of nitrous and bulbs. Some people talk about the fact that because NO is used by doctors and dentists then it must be safe, whilst others imply that anyone who inhales this gas is going to drop dead immediately! The reality is somewhere in the middle (as it usually is) but I need to make it very clear that nitrous is not a safe product to play around with. It certainly continues to be used by health professionals to assist them with their patients but is used in a very controlled way to ensure safety. There is recent research, however, to say that even when used in medical procedures NO can be neurotoxic, particularly in the developing brain.

Certainly there have been deaths reported due to 'nanging' and these are usually caused by the user choking on their own vomit after inhaling the gas and passing out or falling asleep. 'Sudden sniffing death' is also a risk, that is, heart failure resulting from an irregular heartbeat usually caused by stress or strenuous activity after sniffing or inhaling the gas. Usually, the user has been startled (possibly because he or she has been caught), or has engaged in rigorous activity following the use of the drug and collapse and death follow.

Is death likely? Most probably not, deaths from nitrous are rare, but is nitrous or 'nanging' risk free? Absolutely not! Nitrous oxide, particularly if used regularly, can be toxic to a number of organs, including the nervous system, blood, heart and immune system. It may seem a bit of harmless fun, but death is possible and there is there is the risk of long-term negative impacts if your friend continues to mess around with it ...