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Misuse of Nitrous Oxide

Volume 723: debated on Wednesday 23 November 2022

[Relevant document: e-petition 301247, Stop nitrous oxide (N2O/laughing gas) abuse in our communities.]

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.

It is a pleasure to serve under your chairmanship, Sir Christopher. I thank my hon. Friend the Member for Wyre Forest (Mark Garnier) for securing this important debate. I put on record my thanks to his local radio station, BBC Hereford & Worcester, for its tireless and energetic campaigning and investigative journalism in this area. As my hon. Friend said, work by local radio stations, such as BBC Hereford & Worcester, is extremely important in raising those issues and drawing them to the attention of local Members of Parliament, and, through them, the Government.

The Government share the concerns that hon. Members have raised about the use of nitrous oxide. We are very conscious about its growing levels of use recreationally, particularly by younger people aged between 16 and 24. We are concerned about the effect it has on people’s physical and mental wellbeing. Often, drug consumption can have effects that take quite a long time to manifest For example, we know long-term cannabis consumption can lead to psychosis and psychotic episodes, but it takes quite a long time for that to manifest. With any sort of psychoactive substance there can be effects that are not immediately obvious, and only after the passage of time do they become clear.

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?

The hon. Lady is right to point to the need to elevate public awareness. All too often we find that people make an assumption about something that, on the face of it, appears relatively innocuous but can in fact have serious effects, either over time, as in the case of cannabis and psychosis, or if consumed in excessive quantities. The point my hon. Friend the Member for Wyre Forest made about very large cannisters is concerning. The point she makes about people ending up paralysed by consuming huge amounts of this stuff is deeply concerning. I will write to my colleagues in the Department of Health and Social Care conveying exactly that suggestion. I think it is a good idea. It may be worth her raising it directly with Health Ministers, but I will certainly write on that point.

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 can see my job list growing with every passing minute of this debate. I am happy to raise that with Department for Education colleagues. Education is important so that young people understand the risks they are running when they take nitrous oxide. We support an organisation called Every Mind Matters, which is an online resilience-building resource aimed particularly at 11 to 16-year-olds and provides them with information to make informed choices. Raising concerns about these drugs is important. Children obviously get taught about it in schools through relationships, sex and health education. That teaching became compulsory in schools from September 2020, so part of the curriculum is set aside for messaging of the kind that the hon. Member for Lewisham East (Janet Daby) pointed to.

Let me turn to some of the questions raised by my hon. Friends the Members for Wyre Forest, for Redditch (Rachel Maclean) and for Worcester (Mr Walker) about the legal framework and where we are with that. As my hon. Friend the Member for Wyre Forest said, nitrous oxide is currently controlled under the Psychoactive Substances Act 2016 rather than the Misuse of Drugs Act 1971, and there are provisions in the 2016 Act that control the supply of it but do not criminalise possession. It is an offence to supply nitrous oxide if the person supplying it knows or is reckless as to whether it will be used for its psychoactive effect. There is a legal duty on the supplier not to act recklessly in supplying it.

I was very interested by the example my hon. Friend the Member for Wyre Forest gave about an online company who were in his words acting as a “wholesaler” of this drug. He thinks it is not for legitimate purposes to do with whipped cream or other related commercial applications, but for use in a psychoactive context. He says the website sells it in forms of packaging that would appear to suggest it would be used for psychoactive effect, and there is content on the website pointing in the same direction, including suggesting people can take vitamin B12 supplements to counter the effect the nitrous oxide has. That all points to the fact that they may be supplying it for psychoactive purposes, not legitimate commercial purposes.

I have not seen the website, but were that the case, it would strike me that it probably would be reckless. The company acting in the way he describes would be acting recklessly as to whether or not it is being use to psychoactive effect. In fact, in some ways, the company might be implicitly encouraging it, considering the content he describes. I think my hon. Friend would have a case to refer that website to the police, drawing their attention to the provisions I pointed to. There might be grounds for investigation and prosecution under the law as it stands today for the reasons I just set out.

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?

Yes, I think that is a very important point. Where the substance concerned has a psychoactive effect, it will fall under the Psychoactive Substances Act 2016, and where people are supplying it recklessly in the way that my hon. Friend the Member for Worcester just described, there is basis for action. If there is no psychoactive effect but the substance has some other adverse medical effect, that would obviously not fall within the purview of that Act, but such substances are regulated separately through the Medicines and Healthcare products Regulatory Agency and other regulators, who can make regulations to restrict supply. If there is evidence that there is misuse of substances that are legal, either tightening that regulation or having them reviewed by the Advisory Council on the Misuse of Drugs is the right way to go. If my hon. Friend has particular examples, he should write to me and I would be happy to take them up.

I am conscious that time is pressing upon us.

Thank you. That is very helpful, Sir Christopher; that was the clarification I was seeking, alongside your more metaphysical point about the pressing nature of time in general.

I return to the questions on the Advisory Council on the Misuse of Drugs. As my hon. Friend the Member for Wyre Forest eloquently and accurately put it, this matter was referred to the ACMD by the Home Secretary in September of last year, 12 or 13 months ago. We have not yet received its report. The Home Office has raised the matter. The ACMD is independent of Government so cannot be compelled, but it would be proper to draw its attention to this debate and the concerns that have been expressed from both sides on the issue, to make sure that it is aware of the strong parliamentary interest in this matter. That would be a proper and reasonable thing to do without trespassing on its independence. I agree with my hon. Friend that the issue needs to be looked at urgently.

Generally, the Government follow the advice of the ACMD because it has the medical expertise, although we are not obliged to do so. It is within that organisation’s power to make a recommendation on how the drug should be classified. If it were to give advice that it thought the drug sufficiently damaging, it would be open to the Government to reclassify and bring it within the remit not of the 2016 Act but of the Misuse of Drugs Act 1971, at which point it would become a prohibited drug and would fall into class A, B or C. The Government take the ACMD’s recommendations very seriously because it is the expert in this area.

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?

The Advisory Council on the Misuse of Drugs principally makes recommendations about how harmful a particular drug is and therefore how it should be classified under the Misuse of Drugs Act 1971. That is the advice we have sought in this case. The consequences that then flow from classification are matters for Parliament to legislate; they are set out in law. There are obviously different criminal penalties depending on whether a drug is in class A, B or C, and there are different penalties for possession versus supply. The advice we are seeking is essentially medical advice on just how damaging the drugs are and therefore which regime they should fall within. I will convey to the ACMD how pressing Members of Parliament feel the issue is, quite rightly. The points raised have been very powerful and well articulated. I will undertake a third action to go and do that. This is an important issue, about which we are concerned.

I add a point before closing about the powers that local authorities have. One or two Members mentioned the associated antisocial behaviour and littering. There are powers available under the Anti-social Behaviour, Crime and Policing Act 2014 and other legislation to make various forms of order in this area, including orders on antisocial behaviour and dispersal. We also have public space protection orders, which are available to local councils to stop individuals or groups committing antisocial behaviour in a public space; such behaviour would clearly fall into that remit. Following consultation by councils with the police or the local PCC, councils can issue a PSPO, which would effectively prevent the activities taking place in a particular area. If there are Members who feel there is a problem in a particular location, I would suggest they get their local council to use PSPOs as an immediate measure and way of taking action. I thank my hon. Friend the Member for Wyre Forest for the opportunity to speak on this important issue.

Question put and agreed to.


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

Sitting suspended.