Extreme, Extreme! The literature of laughing gas. (2014)
theparisreview.org
theparisreview.org
Looking the mechanism of action - that it replaces oxygen in the brain - it’s pretty obvious why long term use can be so damaging to your brain. It might also contribute to how crazy Crowley gets in his later years.
I've been under the impression that biggest risk of long term use of nitrous is that it causes b12 deficiency which is really bad for your nervous system. Wikipedia also mentions that NMDA receptor antagonist in general are neurotoxic and studies in mice suggest that nitrous has this neurotoxicity.
There's a point where you "pass in" instead of passing out. Just don't try it standing up. You'll try to brush something off your shoulder, then come to the profound realization that it's the floor.
Here's a classic book all about it, "Laughing Gas: Nitrous Oxide" ("HILK HILK"), which goes into much more detail than the article:
https://archive.org/details/isbn_9780914171522
Look for the hissing U-Haul in the parking lot of a Grateful Dead concert.
There's a reason it's called "Hippie Crack".
By the time you notice the peripheral neuropathy, it's probably too late. Note: to get to this point, you would be doing quite a lot at a time.
Be careful with nitrous and take your B12.
https://www.rch.org.au/clinicalguide/guideline_index/Nitrous...
Checking your B12 levels is not a guarantee either, since the mechanism of deactivation still makes the B12 detectable in a blood test. The inactivation can last for a few days.
For frequent users, getting pins and needles in your feet is fairly common, and with prolonged use it can lead to "subacute combined degeneration of the spinal cord". The good news is the effects are mostly reversible if you aggressively supplement with B12 and perhaps the B12 cofactors, and stop using nitrous.
If you do a search (https://pubmed.ncbi.nlm.nih.gov/?term=%22Nitrous+Oxide%2Fadv...) neuro effects are most common, but but there are also reports of thrombosis, bladder issues, and sexual disfunction.
Some decent papers are https://pmc.ncbi.nlm.nih.gov/articles/PMC10447413/ and https://pmc.ncbi.nlm.nih.gov/articles/PMC10442242/
I'm not a medical doctor, but the metabolic processes are fascinating, akin to background garbage collection or other maintenance processes in software. And like those, they are subject to bugs or other interruptions.
I've certainly enjoyed a huff or two in my day, but learning someone could become dependent was news to me. And then last year a close friend had to go into residential rehab for nitrous issues. Who knew?