Nitrous oxide, commonly known as laughing gas, whipping gas, or galaxy gas, has become a popular recreational drug due to its easy availability. In 2024, Rambam Health Care Campus (Rambam) in Haifa, Israel, recorded a sharp rise in patients requiring medical care after using the drug.
Nitrous oxide (N2O) is used legally in the food industry to produce whipped cream; in healthcare it is diluted and used as an anesthetic, sedative, or pain reliever. However, it is increasingly being misused. People can experience oxygen deprivation, dizziness, visual disturbances, memory loss, and ringing in the ears when inhaling undiluted N2O. Long-term misuse can lead to vitamin B12 deficiency, neurological and nervous system damage, and even death. Chronic use poses the risk of irreversible damage.
The number of N2O-related hospitalizations at Rambam has risen sharply, from one patient in 2023 to seven in 2024. Nationwide, the full scope of the problem is unclear due to limited data collection. But Dr. Moshe Herskovitz, director of the Video-Electroencephalogram (Video-EEG) Service in Rambam’s Department of Neurology, cautions, “What we are seeing is just the tip of the iceberg. There are likely many more unreported cases.”

Photo: Dr. Moshe Herskovitz Photography: Rambam HCC
Herskovitz, highlights two recent cases of N2O-related complications. “A patient in her 20s arrived at Rambam with walking difficulties, neurological impairment, and severe memory issues. Her B12 levels were undetectable. She had been hospitalized previously for the same condition indicating she was a chronic abuser. The other patient, in her 30s, reported worsening leg weakness and mobility problems.”
The gas is sold in small canisters filled with compressed N2O. Users inhale the gas straight from the container or transfer it into balloons. Breathing in the gas gives a sense of euphoria and relaxation but that sensation ends quickly and the user needs to breathe in more and more gas to maintain the effect. What began as a one-time use at a social gathering can escalate, leading to addiction. Herskovitz points out, “The country has faced significant trauma over the past year, and some people are trying to escape the harsh reality in problematic ways without fully understanding the risks.”
Addressing this growing public health concern requires stricter regulations and increased public awareness. To curb misuse, Knesset member Yonatan Mishraki has proposed legislation to restrict nitrous oxide sales including the limiting of sales to 11:00 AM–11:00 PM, prohibiting sales to minors, and imposing significant fines on violators. He hopes that these restrictions will reduce the temptation for dangerous use of the gas and protect public health.