It's the most abused drug among 16-24 year olds in England after cannabis and cocaine, but the scourge of so-called laughing gas, aka 'hippy crack', is no joke. 

Doctors have warned of a 'terrifying' epidemic following a rise in patients suffering 'life-changing' nerve damage and even paralysis after inhaling the gas, formally known as nitrous oxide - which can starve users of the vital B12 vitamin and oxygen. 

Also referred to as 'nos', users breathe in the colourless substance through balloons or cannisters - which cost just £25 for industrial-sized containers - causing a feeling of euphoria, relaxation and dissociation from reality. 

But the government is expected to make the sale and possession of the drug illegal - a move that will be welcomed by some of its victims - after medics warned that its rising popularity has seen a spike in serious complications, including spinal cord damage and even death, with dozens of lives claimed in Britain over the past decade.

Meanwhile, thousands of small silver cannisters used to carry the gas are often seen dumped on roads or in parks, contributing to environmental pollution. 

Under the Home Office's proposal, only those with a 'legitimate excuse' for possessing the drug would avoid prosecution - including those who use it in catering equipment such as whipped cream machines, or for legitimate pain relief.

It comes after last year saw much larger cans containing hundreds of litres of gas gain popularity, with four skips' worth being cleared-up after Notting Hill Carnival in central London over the August bank holiday. 

That same month, Kayleigh Burns, 16, died at a house party in Leamington Spa just moments after inhaling laughing gas. 

The exact cause of Kayleigh's death has not yet been reported, but her sister, Clare Baker, 31, said she believed it was caused by the substance as she called for it to be banned. 

Nitrous oxide (N20), commonly known as laughing gas or nos, is an anaesthetic gas

It is used recreationally using metal canisters and whipped cream chargers

The gas dissolves into the bloodstream quickly, reaching the brain in seconds 

The effects, which include laughing and minor hallucination are strong but short-lived

Nitrous Oxide prevents oxygen from reaching the blood, causing a rapid heartbeat and tingling limbs 

The gas is relatively low risk but oxygen starvation can be fatal in severe doses 

Gas being released from its canister can cause freezing temperatures of -40C which can cause frostbite on skin or internally when inhaled directly from the canister 

Source: Drug Science 

People who were at the house party sent Kayleigh's family videos of the asthmatic teen inhaling the nitrous oxide. Later, she complained of feeling 'too hot' before she collapsed and an ambulance was called.

Clare told The Echo: 'I will be missing a huge piece of my heart for the rest of my life now and I don't know how I'm going to go on without her. But I need to because I have kids.

'I want people to think about what they are taking before they take it because they're going to leave people behind who love them. People may think it is a laugh and a joke, but it's not, they're playing with their lives.

'I want it to be banned. They have upped the legal age of buying it in America to 21... I know people use it in the food industry, but I think there should be some sort of ID card or at least an age requirement.

'I don't want this to happen to anybody else. We have lost our Kayleigh forever now.'

It comes as TikTok and other platforms continue to be flooded with videos of young people taking the drug while out partying with friends. 

Attempting to battle the promotion of laughing gas, doctors are also uploading clips of themselves warning of the drug's side effects. 

A doctor from the Sandwell & West Birmingham NHS Trust says in a recent video: 'Whether it's a short binge or chronic use, it's just not safe. We've seen both... and they both end up in hospital.' 

He adds: 'We as doctors are seeing people coming to hospital off their legs, with tingling numbness in the hands and feet, difficulty walking and maybe getting psychosis. 

'I even know of an eye doctor that's seen people who have lost vision because they're not getting enough oxygen to the brain. I know of patients who have had erectile dysfunction... because of spinal cord injury from nitrous oxide use... it's really serious.' 

He also warned people that taking B12 vitamin supplements will not help you avoid the risks of inhaling the gas, as is often believed. 

Other people negatively impacted by the trend have also continuously warned about the risks - including Kerry Donaldson, 25, from Newham in London, who was left in a wheelchair. 

The former receptionist revealed in July 2022 how her 'hippy crack' binges damaged her spinal cord and forced her to rely on her dad for round-the-clock care.

Elsewhere, Alex Littler, from Cheshire, was just 16 when he was rushed to hospital on June 20 last year after complaining of a swollen neck, breathlessness and that his chest felt like 'popping bubble wrap' when touched due to the air leaking from a ruptured lung.

The year 11 student was forced to confess to doctors and devastated mother Cathy McCann, 44, that he'd inhaled nitrous oxide - or 'nos' - over the weekend while at Parklife music festival in Heaton Park, Manchester, on June 11 and 12. 

According to the European Union drugs monitoring agency EMCDDA, the recreational use of nitrous oxide is on the rise in Europe among young people, producing worrying numbers of poisonings.

The growing popularity of the substance stems from its wide over-the-counter availability, low price, ease of use and the false perception that it is safe, the Lisbon-based agency said.

Nitrous Oxide, has been nicknamed 'laughing gas' due to the euphoric and relaxed feeling people who inhale it can sometimes feel.

The substance - also known as 'hippy crack' - is normally bought in pressured canisters, commonly transferred to a container, e.g. a balloon, from which the gas is inhaled.

Although possession of laughing gas is not yet illegal, English law prohibits its sale to under-18s if there is a chance they will inhale it.

The Home Office is currently proposing to make the sale and possession of the drug illegal - unless it is being used for legitimate purposes.  

The effects of nitrous oxide vary depending on how much has been inhaled but they include:

• Feelings of euphoria, relaxation and calmness.

• Dizziness, difficulty in thinking straight and fits of giggles/laughter.

• Sound distortions or even hallucinations.

• In some people, a headache can be an unwanted immediate effect.

Risks include:

• Unconsciousness or death from lack of oxygen. This occurs when the available oxygen for breathing is effectively pushed out by the nitrous oxide.

In the United Kingdom, nitrous oxide is the second most prevalent drug among young adults aged 16 to 24 years, after cannabis, the EMCDDA said. 

It has a legitimate wide range of medical, industrial and commercial uses, particularly as propellant in whipped cream dispensers or water siphons for which purpose it is sold in compact, inexpensive cartridges online or in supermarkets.

In some European countries, particular concerns have been raised since 2017, when larger cylinders of the gas that deliberately target the recreational market appeared, often luring teenagers inexperienced with drug use.

The cartridges are normally consumed by filling party balloons, from which the gas is then inhaled, but more recently users have been inhaling directly from dispensers or cartridges, which poses a high risk of severe cold burns and lung injury. It also affects several brain and spinal cord networks.

Smaller nitrous oxide canisters - which are legitimately used in the catering industry - have been widely used for recreational drug-taking for at least a decade.

The small, silver cartridges contain four litres of the colourless gas, but the larger types - which cost just £25 - can hold between 322 litres and 5,500 litres.

Large canisters have become commonly littered in British streets in the last year. 

One in 11 people aged 16 to 24 said they had taken laughing gas in 2019-20, according to the Crime Survey of England and Wales.

Amid mounting concerns, the Government's Advisory Council on the Misuse of Drugs was asked to review the harm caused by the drug last autumn. It has yet to report.

In August, medics warned that as the substance's popularity has skyrocketed, so have cases of spinal cord and nerve damage, including paralysis.

Dr Mark Ellul, a specialist registrar in neurology in Liverpool, claimed youngsters are coming into hospital with 'severe and long-lasting' damage after using the drug.

A drug known as 'hippy crack' is banned in the Netherlands in a world first.

Since January 2023, the gas nitrous oxide has been illegal to buy, sell or own except for legitimate uses in medicine and catering.

In the UK it is the second most commonly misused substance after cannabis among 16 to 24-year-olds, but only possession with intent to supply is currently illegal.

The Home Office is considering a stricter ban. Inhaling the gas can induce heart attacks, fainting, nerve damage, vitamin deficiency, anaemia and weakness in the legs.

Dutch road safety campaigners say it has also played a role in 1,800 accidents across the country over the past three years.

Nitrous oxide users buy the gas in small metal canisters, sold legally to dispense whipped cream.

But they then empty the gas - known in Dutch slang as 'nang' - into balloons and inhale it.

Announcing the decision, State Secretary for Health, Welfare and Sport Maarten van Ooijen said: 'The recreational use of nitrous oxide leads to enormous health risks.'

Nos can starve the body of a crucial vitamin and oxygen, which can lead to life-changing nerve damage and suffocation.

Official figures show the number of young people in England and Wales using the drug has soared 50 per cent in the last decade.

Just six per cent of the millennial generation, who were aged 16 to 24 a decade ago, reported taking the drug, compared to nine per cent of the Gen Z age group.

At least 45 people have died after taking the drug since 2010, with many more hospitalised.

Dr Nikos Evangelou, a neurologist at Nottingham University Hospital, tweeted that there is an 'epidemic' of spinal cord and nerve damage due to nitric oxide. 'Terrifying to see paralysed young people from laughing gas canisters,' he said.

The phenomenon was 'almost unknown' last year but medics now see cases weekly, Dr Evangelou said. 

Dr David Nicholl, a consultant neurologist at University Hospital in Birmingham, took to TikTok to share concern about the 'epidemic'.

'This stuff is dangerous. Seven years ago, this was a neurological rarity, even a couple of years ago I was seeing cases maybe once a month, now I'm seeing them every week,' he said.

Dr Nicholl urged medics to ask young patients with unexplained neurological symptoms whether they use nitrous oxide and where they get it, so suppliers can be reported.

He called for the age limit for buying nitrous oxide canisters — which cost just £25 compared to £50 a year ago — to rise to 25. 

Dr Ellul previously told The Guardian that his team treats one case every few weeks. 

He said: 'Most are young people, and many were previously unaware that the substance could be harmful. In some cases the effects can be quite severe and long lasting.'

The 'high' kicks in immediately, causing users to feel dizzy, relaxed and giggly, and lasts one to two minutes, on average. 

Having too much, however, can make users faint or suffocate due to a lack of oxygen to the brain if they inhale highly concentrated forms of the gas. 

Heavy and regular use can cause a vitamin B12 deficiency and anaemia. 

B12 is essential in the body's production of myelin — the fatty sheath around nerves in the body.

A lack of myelin can trigger nerve damage, leading users to suffer painful tingling and numbness in their fingers and toes that makes walking difficult, as well as spinal cord damage. 

Figures taken from an ONS survey in December 2022  

- 6 per cent of millennials, who were aged 16 to 24 a decade ago, reported inhaling the drug

- 9 per cent of Gen Z reported inhaling the drug 

- 45 people are known to have died after taking laughing gas since 2010

-  50 per cent increase in young people using 'hippy crack' in England and Wales over the last decade 

-  16.2 per cent of 16-24 year olds admitted using cannabis at least once during the year

- 4 per cent admitted to using cocaine and 3.9 per cent to laughing gas  

In June last year, a 16-year-old boy almost died after taking laughing gas at Parklife festival, in Heaton Park, Manchester caused his lung to burst.

Alex Littler, from Ellesmere Port, Cheshire, was rushed to hospital after complaining of a swollen neck, breathlessness and that his chest felt like 'popping bubble wrap'.

The year 11 student confessed to doctors and that he'd inhaled nitrous oxide while at the festival on June 11 and 12. He was diagnosed with a ruptured and leaking lung and told he was lucky to be alive.

Meanwhile, a young woman named Kerri Anne was left partially paralysed after consuming too many small canisters containing nitrous oxide; the containers are readily available online and on social media.

'In a week, maybe I would do about 600 canisters,' she told the BBC. 'For the next week I wouldn't be able to do anything, I would be sleeping 12 plus hours and I would be vomiting. I'd be having sweats, I couldn't eat, I couldn't drink water. I couldn't walk or use my hands.'

The frequent and heavy use of the drug left her with no sensation in her legs and in the constant care of her dad.

She added: 'I can't do anything for myself at the moment. It's not like I can get up and walk out of my house, which is why I have my dad. I have to use a commode. He does literally everything for me.'

A dealer of the drug said it was 'a walk in the park' to find users on social media who wanted to buy the larger canisters.

'It's dangerous. I don't think people should do it, but as long as they do I am going to sell it,' the anonymous dealer said.

Harry Sumnall, a Professor in Substance Use at Liverpool John Moores University, said: 'The concern is over the availability of much bigger canisters, potentially delivering 80 maybe even 90 times the amount of nitrous oxide. There's real concern over those much larger volumes.'