At least two cases of nerve injury from chronic nitrous oxide use have been seen at Hawke’s Bay Hospital’s emergency department.
The cases were revealed by Hawke’s Bay medical officer of health Dr Nicholas Jones, who attended a community leaders meeting a fortnight ago to discuss increasing recreational use of “nangs” in the region.
They came from “informal reporting” at the emergency department, he said, but no other details were available.
Jones said Health NZ is continuing to gather intelligence from key partners, such as Hato Hone St John, to better understand any harms and impacts associated with non-medical nitrous oxide use in the region.
“While nitrous oxide has legitimate medical and catering uses,” he said, “inhalation of the gas for non-medical (recreational) use can pose significant health risks particularly if that use occurs over a long period of time.”
The risks include long-term chronic harms including permanent brain damage or nerve damage.
He said they can be short-term, acute harm in the form of frost burns to the mouth and throat or injury due to loss of consciousness.
Long-term effects can include chronic harms including permanent brain damage from hypoxia (lack of oxygen), or nerve damage which can cause ongoing numbness or tingling in the hands and feet, weakness, difficulty walking, or problems with balance and co-ordination.
“Nerve damage can be permanent,” he said.
Alarm has escalated in Hawke’s Bay with evidence of possible widespread use by young people getting access to large canisters, as big as dive tanks, or large thermos flasks designed as cream chargers for the catering and baking industry.
A Hastings agency for collection and disposal of tanks and canisters says it now gathering 60 to 70 examples a fortnight, thought to be considerably greater than what would be collected if they were being used for their intended use.
There are concerns they are being sold from sites other than catering supplies outlets, such as at some vape shops and dairies.
It led to the Hastings meeting, attended by about 40 people representing health, police, councils, youth councils and other interested parties.
Jones said it offered an important forum for public health in Hawke’s Bay to hear directly from community groups about recreational use of nitrous oxide.
“Any serious harm from psychoactive substance use is a concern,” he said.
Health New Zealand has a responsibility to respond to emerging health concerns, and he said its focus at the meeting was on “listening, understanding local experiences, and ensuring people had clear, accurate information about potential health risks”.
He said where concerns are raised about sale or supply, we will help ensure those concerns are “appropriately escalated to the regulator”.
Medsafe is the regulator responsible for psychoactive substances, including product approvals and licensing.
Police are responsible for enforcement matters relating to unlawful activity, including supply.
The annual New Zealand Drug Trends Survey, an anonymous online survey run by Massey University’s Shore and Whāriki Research Centre asked 5000 respondents about a full range of negative experiences they’d had from alcohol or drug use in the previous six months.
Professor Chris Wilkins said of particular interest are the various components of harm in the data.
The data is summarised in the Substance Outcome Harm Index, which has heroin/morphine (9/10) at the top, followed by methamphetamine (8.21) and GHB/GBL (8), also known as fantasy.
These were significantly higher in cumulative harm than the rest and roughly twice as harmful as alcohol (4.2), which was ahead of cannabis, tobacco, nitrous oxide (nangs) and vaping. The least harmful was LSD, followed by cocaine and then MDMA (ecstasy).
An important caveat is the methodology is still being developed, with the data and findings – shared exclusively with the Herald – in only a preliminary stage.
It’s also a measure of acute harm rather than something that might emerge years or even decades later.