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Government Ignores Scientific Advice with Plans to Criminalise Nitrous Oxide

The Government has been warned that plans to make possession of nitrous oxide a criminal offence in England has no basis in scientific evidence and was likely to prove unenforceable.

Cabinet minister Michael Gove confirmed the move on Sunday, saying that nitrous oxide, also known as laughing gas, had "a potentially damaging effect on young brains and young nervous systems", whilst its use was turning public spaces into "arenas for drug taking".

According to Mr Gove's Department for Levelling Up, Housing and Communities, nitrous oxide is now the third most used drug among 16- to 24-year-olds in England, and both the police and public have linked its use to nuisance or anti-social behaviour.

Using Misuse of Drugs Legislation

Use of nitrous oxide as an anaesthetic in healthcare settings and in industrial processes will be unaffected by the proposals.

Nitrous oxide currently falls under provisions in the Psychoactive Substance Act 2016, making it illegal to produce or supply the gas for its psychoactive effects. But the Government has signalled its intention to extend control using the Misuse of Drugs Act 1971, making possession a criminal offence, despite being advised recently not to do so by an independent committee. Earlier this month, the Advisory Council on the Misuse of Drugs (ACMD) concluded that current evidence suggested that the health and social harms of nitrous oxide were "not commensurate" with bringing it under the scope of that legislation.

The ACMD acknowledged that nitrous oxide was widely used in non-legitimate settings outside healthcare and industry, particularly by young people, but said that the number of deaths and demand for treatment for problematic use remained low compared with other drugs.

Health concerns around the drug centre on a severe vitamin B12 deficiency from heavy use that can damage nerves in the spinal cord. A guide published in February by the British Association of Neurologists (BAN) pointed to increasing cases of nitrous oxide-induced subacute combined degeneration of the cord (N2O-SACD). The BAN differed slightly from the Government over the extent of nitrous oxide use, saying it was the second most commonly used drug among young people, not the third as the Government claimed.

A Zero Tolerance Government Approach

The Government's plan to tighten the law on nitrous oxide use came as part of a "zero tolerance" pledge to crack down on anti-social behaviour in England, which would include "increased fines and enhanced drug testing". 

Commenting to the Science Media Centre on the proposals, Dr David Caldicott, senior lecturer at the Australian National University ANU Medical School, said his international perspective was that the Government's policy was "less about 'medical concern', than it is about 'social control'". He argued that "any drugs policy associated with the term 'zero tolerance' should be viewed as being a 'red flag' to the society to which it is being pitched", and that such policies were "generally associated with failure".

Professor David Nutt, head of the Centre for Neuropsychopharmacology at Imperial College London, said scientific evidence suggested there was "around one death per year in the UK from around one million nitrous oxide users" and that "a comparison with alcohol would be that around 28,000 deaths happen per year in around 40 million users of alcohol".

Dr Caldicott said that a ban on nitrous oxide use could have unintended consequences. "There is a clear danger that those whose choice was once nitrous oxide will look elsewhere, to something that is of greater medical concern to healthcare providers," he warned.