Adapted with permission from ABC News | Antonia O’Flaherty

Abusing nitrous oxide can cause irreversible brain and spinal damage, psychosis, incontinence and in some cases, even death.

Director of toxicology at Princess Alexandra Hospital, Dr Katherine Isoardi is imploring people to heed the warning that abusing the gas from canisters, known colloquially as ‘nangs’, has the potential for serious health consequences.

Nitrous oxide can cause subacute combined degeneration of the spinal cord which affects sensation and proprioception, which refers to knowing where your legs are positioned.

“What we see is a few different presentations related to nitrous oxide misuse. The most concerning is what we see from people who have misused it over a long period of time,” Dr Isoardi said.

“They have difficulty walking because the nitrous oxide can affect the Vitamin B12 in your body and that can lead to the nervous system getting damaged and they have difficulty with their spinal cord which leads to trouble walking,” she said.

Nitrous Oxide is a colourless and tasteless gas that has legitimate uses in baking for whipped cream and by doctors and dentists in sedation.

When misused through inhalation in large quantities over an extended time, nitrous oxide can lead to paralysis and other complications like tingling and numbness in their hands and loss of function of the bladder and bowel.

“People can also get psychotic which is really disturbing and distressing with really intense and delusional content. Other physical complications from the nitrous use includes frostbite to their face, their nose, their lips which needs to be debrided.”

In ‘very severe’ cases, it can also cause suppression of the bone marrow.

"Theoretically, you could get so unwell that you could get an opportunistic infection or you could have such low blood counts that this is something you could die from," Dr Isoardi said.

Despite the serious health concerns, it can be ordered online from companies promising to deliver the gas 24/7.

Dr Isoardi recounts one harrowing tale from a paramedic who had to "wade through thousands of nangs on the ground" to get to a patient who realised they could no longer walk properly.

"You can order it straight to you using a delivery app — you can get it at three o'clock in the morning," she said.

"I've had a patient [who couldn't walk anymore] who's been able to order it online and get it delivered directly to the hospital ward."

There is no effective medication to treat damage from nitrous oxide misuse other than B12 supplements, but some damage can be permanent.

Dr Isoardi believes laws should be introduced in all states to crackdown on nitrous oxide abuse, pointing to mounting concerns over the increasing availability of larger canisters, which increase the risk of nitrous misuse exponentially.

"I think that because it's legal people think that it's safe, but it's not at all safe; certainly not in large quantities and over long periods of time," she said.

You can read the full ABC story online.