PARLIAMENTARY DEBATE
Misuse of Nitrous Oxide - 23 November 2022 (Commons/Westminster Hall)

I beg to move,

That this House has considered the matter of the misuse of nitrous oxide.

As many people will know, nitrous oxide is a substance that has been available for many years. Known more familiarly as laughing gas, it has been used by the medical profession for some time, and in its form of gas and air it is used as a mild anaesthetic by both dentists and doctors—I believe I first came across it during the birth of my eldest son, when it was used to ease the pain of childbirth. It is also used to give a bit of extra whoosh to drag-racing engines: nitrous oxide systems designed to boost power outputs are used for competitive motor events, and of course, it is used in catering for both frothing whipped cream and frothing coffee in home appliances more usually found outside the UK. In that form, it is sold in 8-gram mini-cylinders.

Increasingly, however, nitrous oxide is used for recreational highs. Back in my day, solvent abuse was a problem; today, nitrous oxide—NOS, whippits, hippie crack, balloons; call it what you like—is being used for short-term highs by a new generation. It may be referred to as laughing gas, but in reality, it is no more glamourous than glue sniffing. This is not a new phenomenon. The Misuse of Drugs Act 1971 lists specific substances that are illegal; nitrous oxide is not listed, but it is covered by the Psychoactive Substances Act 2016. That Act, while not listing specific substances, covers those that fit specific characteristics and definitions. To fall within the remit of the Act, the substance must be capable of having “a psychoactive effect” that affects someone’s

“mental functioning or emotional state”

by stimulating or depressing their nervous system. Specifically, this includes effects that we associate with controlled drugs under the 1971 Act such as hallucinations, changes of alertness, changes of perception of time and space, changes of mood and empathy with others, and drowsiness.

The wide definition under the 2016 Act is intended to pre-empt new substances emerging in the drugs market by defining their effects, as opposed to their chemical structure. The Act is good news: it makes it an offence to produce, supply, offer to supply, or possess with intent to supply any psychoactive substance, with a maximum penalty of seven years’ imprisonment. In short, it makes it illegal to sell nitrous oxide for recreational use. The available data tell us that there were 152 convictions in 2017, 107 in 2018 and 52 in 2019 under the Act, but we are trying to find more recent data. Slightly alarmingly, however, West Midlands police got in touch with me only this morning to tell me that since 2015, it has prosecuted only four people under the 2016 Act.

The Act was formally reviewed in 2018, and the review concluded that

“the use of nitrous oxide…does not appear to have been affected by the Act”,

with use by adults increasing to around 2.3% of the adult population, while use by 16 to 24-year-olds stayed steady at just under 9%. Indeed, nitrous oxide is now the second most commonly used drug in that age group, coming a close second to cannabis, but, as I say, the data are old.

Anecdotal evidence from the medical profession in the west midlands suggests that usage of nitrous oxide has increased markedly since lockdown. The medical profession is picking that up because of the appalling effects that it has on users. Its attractiveness is that it is easy to use. Historically available in small 8-gram cylinders—mini-cylinders—it is inhaled using, commonly, a balloon. Its effects are immediate and include euphoria, giggling, distortion of sound, and hallucinations. Those peak after 20 seconds and resolve after a couple of minutes. It is a quick high and leaves no immediate after-effects. Someone using it once would be able to sit down with, for example, their parents with no evidence that they had been using it in the minutes before. It appears to be harmless, but that is not the case. The reality is that people use it not just once, but for long periods. It used to be available in small 8-gram mini-canisters, similar in size to those of sparklets bulbs—

I thank the hon. Member for securing this really important debate and for making such a significant and poignant speech. I find it very distressing to know that young people are able to access these silver cylinders and that they have such a harmful effect on them. In my constituency, I have seen pockets of those cylinders in various places, and I am pleased that he has brought the matter to the Government’s attention. Does he agree with me that we need more work to be done on health and education as well as on enforcement to make sure young people are not able to purchase them?

I completely agree. I will be coming on to that, but the hon. Lady is absolutely right. With any legislation, part of it has to be to do with education, and it is important that people recognise that the high is insidious and not without consequences. The fact that it is called laughing gas means that it trivialises what is not a trivial thing.

I am really interested in the hon. Member’s speech and in the harms from nitrous oxide that he raises. As somebody whose lung was punctured as a result of using nitrous oxide during childbirth, I am keen for what he says about education to be at the heart of the proposals that he is making so that we tell people about the very real dangers they face if they misuse nitrous oxide. The only reason I came through it safely was because I was using it in a medical setting with medical professionals who could look after me.

That is an incredibly alarming story, because it was being prescribed presumably by an anaesthetist who knew exactly what they were doing. That was in the form of gas and air, but the people who misuse the drug use it neat, which is much more powerful and dangerous.

What used to require some effort to transfer smallish amounts from a canister to a balloon so that it could be used in a simple way is now something that can be inhaled all evening, sucking in huge quantities of nitrous oxide. Instead of being available in 8-gram canisters, it is now typically in canisters of up to 600 grams, which allows someone to sit there using it all night. The result is that doctors are now seeing an increase in cases of people being admitted to hospital with serious side effects.

Dr David Nicholl, a campaigner in my region of the west midlands—a local doctor and significant campaigner—tells me that he sees at least one new case every fortnight. Misuse of nitrous oxide creates a vitamin B12 deficiency. That is a vitamin vital for nerve function for both periphery in the hands and feet and in the spinal cord. Practical effects are numbness of the hands and feet and pins and needles, but longer-term use results in people being unable to walk and talk properly, relying on crutches and, in some cases, wheelchairs for, potentially, the rest of their life.

I add my thanks to my hon. Friend, who is also a Member of Parliament in Worcestershire. I have canvassed my local police force to understand the impacts on my constituency, as he has done. Is he aware that as well as the health impact that he is discussing, there is also the impact of anaemia in some users? Does he agree that that is a matter of resources for our NHS? We know that in Worcestershire we have problems with our NHS acute trust, so we should educate people not to engage in optional activity that burdens an already overstretched trust.

I completely agree. My hon. Friend will be delighted to hear that I spoke to our local police and crime commissioner only this morning about the issue. I have engaged with him over a number of weeks, and he is acutely aware of it, but there are problems.

On the issue of crime, my constituents in Worcester have been inundated with concerns about Astwood cemetery, where vandalism and theft from graves has been taking place. One of the constituents who came to see me about it, Mrs McAuley, mentioned that the ground around the graves was littered with gas canisters. Is my hon. Friend concerned about the behavioural effect? People have these short-term highs, then carry out foolish and stupid activities, which can be deeply hurtful to people if it is something such as desecrating a grave in a churchyard.

My hon. Friend is absolutely right. Desecrating a grave is absolutely appalling. The last time I saw a pile of empty NOS canisters was outside the Royal Society on Carlton House Terrace, which is an unexpected place to see them. I am sure the members were not using it themselves. My hon. Friend is right that it brings about behaviour that, at the time may seem highly amusing to the person affected by it, but has incredibly profound long-term effects to other people around them. I will come to that later. The important point is that something that is used by trained medical professionals for beneficial medical outcomes, although not always without risk, is being misused to the level that it destroys the lives of the users and those around them.

How is nitrous oxide becoming so prevalent? The reality is that there seems to be no one controlling the selling of it. The Act is being ignored at worst, and at best it is very difficult to enforce. Users say that nitrous oxide is incredibly easily to get hold of, as it is freely available in corner shops. Moreover, it seems to be getting cheaper while everything else is getting more expensive. The 600 gram canister that I mentioned earlier has dropped from £50 to just £25, bucking the trend of the cost of living crisis. For communities that tend to avoid alcohol, it is an apparently guilt-free alternative.

The availability of nitrous oxide is extraordinary, given that it is being used as a psychoactive drug and is therefore controlled by the 2016 Act. You can google this should you choose to, Sir Christopher. There are websites that sell it nominally as a whipped cream additive, but brazenly give advice on its psychoactive effects and its legality or otherwise as a recreational drug. There is even one website that offers vitamin B12 supplements to counteract its effects. More alarmingly, one website that I looked at offers nitrous oxide not just in quantities for personal use—six 600-gram canisters can be bought for an attractive £130—but by the pallet load. Seventy-two cases of canisters cost an impressive £8,150, which will be delivered to the buyer’s door. Remember that the website starts by talking about it as a whipped cream additive but quickly goes on to its misuse. That is either an awful lot of whipped cream, or this is a wholesaler of misery for any number of people.

I am incredibly grateful to my hon. Friend for bringing this debate to the House. The use of nitrous oxide in the community and the litter that comes from the canisters are constituency issues of great concern to me. I met my police and crime commissioner this morning, and we had a discussion about this. She is concerned about the impact on people driving following the use of these canisters. Would my hon. Friend comment on that?

Absolutely. There is definite evidence that people have been killed driving under the effect of nitrous oxide. Although it takes 20 seconds to kick in, and after a couple of minutes it resolves itself, we do not know what the long-term effects are on people’s acuity and ability to drive. I suspect that if someone has been taking the stuff all this evening and then gets into their car, even if they have come off the immediate high it surely has some longer term effect on their ability to check traffic lights and all the rest of it.

The website I was referring to looks like a wholesaler of illegal drugs under the 2016 Act. Importantly, the bottles that the nitrous oxide is being offered in suit neither the catering industry nor the medical profession. The medical profession buys it in very large quantities for its important uses. Those bottles can therefore only be being made for misuse.

Back in 2015, the Advisory Council on the Misuse of Drugs provided advice on the harms of nitrous oxide and public health and safety. It conclusion was that, although its harmfulness did not warrant control under the Misuse of Drugs Act 1971, it was important that it came under the 2016 Act. Back in September 2021, thanks to the British Compressed Gases Association—the trade association that covers the legitimate use of nitrous oxide—the then Home Secretary wrote to the advisory council asking it to review its finding. In her letter, the Home Secretary cited statistics showing that 550,000 16 to 24-year-olds had used nitrous oxide in the previous 12 months—that is significant use. The advice would inform the Government’s decision on whether nitrous oxide should be controlled under the Misuse of Drugs Act 1971 due to the long-term effects that its misuse can have, which, in theory, was quite a good move forward.

I understand, however, that the Home Office is still waiting for a reply. I would be grateful if the Minister could confirm what progress the Home Office has made in chasing up a response to that letter. I have learned from the British Compressed Gases Association that it has raised this again with the current Home Secretary, who has also written seeking guidance from the organisation in question. I gather that the Home Office is on to this, but it seems to be taking some time to get a response.

This issue was brought to my attention by the frankly brilliant campaign being run by BBC Hereford & Worcester—my local radio station—which has been working hard with local campaigner Dr David Nicholl, whom I have already referred to. It is just not David and BBC Hereford & Worcester who are on to this: not only have we had a petition in Parliament that has achieved more than 11,000 signatures, but the European Monitoring Centre for Drugs and Drug Addiction published a report on Monday that highlights all the points raised here and more. The report, which lists seven case studies from Denmark, Ireland, France, Lithuania, the Netherlands, Portugal and the UK, absolutely reinforces the concerns raised by Dr Nicholl, BBC Hereford & Worcester and my colleagues present.

Does my hon. Friend agree that, at a time when the BBC appears to be considering cutting back on local radio, this is an excellent example of the public service and duty that our local radio provides? The BBC should really reconsider its decision to target local radio for its cuts.

I could not agree more. I was going to come to this later, but my hon. Friend has raised it now: he is absolutely right: local radio is fantastic at every level. My hon. Friend and I both know what it is like trying to get around Worcestershire when flooding is coming in; were it not for BBC Hereford & Worcester providing that brilliant support, as other radio stations do, we would not have that help. He raises a brilliant point.

The report moreover reinforces the call by the British Compressed Gases Association for consumer sales to be banned in the UK. This advice has been followed by the Netherlands, which will introduce a ban in January 2023. It seems that anybody who knows anything about this is keen to tackle the problem, but there seems to be a problem with the Government and their agencies.

With all this official information, it is sometimes more meaningful to hear the views of those who have been affected. Earlier this week, I received an email in anticipation of this debate, which, I think, is worth reading out in full:

“Around 5 years ago, I found out that my brother had become addicted to nitrous oxide. He had been introduced to it as a party drug by a friend at university but soon became heavily reliant on it, to the point where he would do it all day, every day. Unfortunately, it turned him from a really kind, intelligent, outgoing and sociable person to a depressed recluse. He developed Psychosis, suffered from hallucinations and became confused. In one incident, he was convinced that I was impersonating his sister. He subsequently became violent towards my parents and me, and one Christmas tried to kill my father by repeatedly bashing his head with a portable speaker. We were all terrified of him. His nitrous oxide abuse led to him drinking alcohol heavily and gambling, and, two years after we learned of his addiction, he took his own life at the age of 25.

I am so angry that someone who had so much potential—he was an elite athlete, had won a scholarship to a top university in the USA and had just started a great job in finance—had his life destroyed by a drug, which many still consider harmless. We really need greater awareness of the harmfulness of the drug, especially amongst young people. Despite how damaging it can be, you will also know that it is freely available with no checks necessary. Indeed, my brother was able to purchase boxes of it on Amazon with next day Prime delivery and it was being openly sold by a shop around the corner from where he was living.”

We all know that drug use is not free from consequences, which vary from misery for users to misery for all the people, family and loved ones around those who have become addicted. If we agree that nitrous oxide is a drug under the 2016 Act, how on earth is it possible that Amazon can deliver large quantities of it and corner shops can sell it to kids? How is it possible that I can go to a freely accessible website that not only offers it by the pallet load, but provides advice on how to use it as a recreational high? How is it possible that the police are apparently not able to tackle this issue? As I say, my PCC is definitely on to it, but it is a problem.

I thank my hon. Friend for highlighting that awful case, and our hearts go out to the family of those affected. The suggestion from Inspector Rich Field, my local police lead, is that it is very difficult to ban the sale of those sorts of things because, as has been pointed out, they are easily available on Amazon and eBay. The police are suggesting that it be made illegal to have possession of nitrous oxide in a public place for under 16s. What does my hon. Friend think of that idea? I hope the Minister has also noted that and will address it in his final remarks.

The answer to my hon. Friend is I think that is exactly the right idea. I have already spoken to the Minister about that, and I know that he is open to ideas—perhaps we will hear his thoughts on that when he makes his response. Importantly, why are we still waiting for an answer to two Home Secretaries’ request for more information from the Advisory Council on the Misuse of Drugs? That is where a lot of the answers will come from.

I am grateful to the Minister for his time, and I look forward to hearing what plans he has to deal with this 21st century version of glue sniffing. We have already heard of the tragic consequences for somebody who became addicted. The Minister potentially has in his hands the ability to prevent further unnecessary misery. Finally, I congratulate David Nicholl and BBC Hereford & Worcester on their work. As we have heard, the BBC are introducing changes to local broadcasting that fly in the face of all logic. I will end on a point that is slightly unrelated to the main debate, but the work done by local radio is so important, and BBC Hereford & Worcester is such a good example of that.

This is a slight change of topic, but in Coventry we have had young people paralysed due to the neurological effects of this particular drug. Would the Minister speak to his counterpart in the Department of Health and Social Care about running a public health campaign to raise awareness about the effects of this drug?

That is absolutely the right suggestion. With the public health campaign, could the Minister also speak to his counterparts in the Department for Education to make sure there is that connection between health and education, so that young people are receiving that information early?

I am very grateful to the Minister for making that clear. He is right. Where there is concern about these things, the website should be referred. I have come across similar cases in relation to even more dangerous substances. He will know about some of the debates we have had previously about DNP—or 2,4-Dinitrophenol—which is a highly toxic and deadly substance, sometimes mis-sold as a slimming aid or exercise supplement. Does the Minister agree that we need stronger powers to ensure we can take action against websites that sell these substances, because I am concerned.

I have seen cases and cases have been raised by my constituents where drugs that can literally kill people, simply through being ingested, are being mis-marketed, or marketed in a way my hon. Friend the Member for Wyre Forest (Mark Garnier) described—where it explicitly says, “This is not the use for it,” but then goes on to imply that someone can buy it and use it for all those things. That is very, very dangerous, particularly for young people to whom these things are targeted. Can I urge him to take more action?

It is always pressing.

This debate can go on until half-past eleven, but not beyond, if that is the question the Minister is asking.

Will the Minister enlighten us, for the benefit of those of us not quite familiar with the role of this body? Does its recommendations include providing changes to the law and legal frameworks such as making it illegal to possess those substances in a public place, as I referred to earlier? How would that be enforced, based on those recommendations?