Laughing gas - it's not funny!

Irresponsible licensees risk prosecution for selling laughing gas, Winchester City Council's Licensing Manager John Myall has warned.

It has come to the council's attention that some pubs and clubs in the district are selling nitrous oxide to customers which is then inhaled in order to give a "high". One bar has already received an official written warning from the council.

Laughing gas, also known as "hippy crack" or "Nos" is dispensed into balloons and then used to give a disorienting and euphoric result. This has serious health implications and there has recently been one death (not locally) as a result of inhalation for recreational purposes.

The act of supplying nitrous oxide for the purpose of inhalation makes it a medicinal product. Anyone other than a registered pharmacist supplying nitrous oxide for the purposes of inhalation, on any premises, is committing an offence under Section 52 of the Medicines Act 1968, of "selling and/or supplying a pharmacy medicine not under the control of a pharmacist."

Any person in control of premises who either supplies or permits the supply of nitrous oxide is committing the offence of aiding and abetting. People found guilty of these offences could face up to two years imprisonment and/or an unlimited fine.

As well as the legal issues there are serious concerns about health risks to people who misuse it.
- Existing health conditions could be made worse or it may induce adverse health effects, or serious injuries as a consequence of its effects.
- It can cause dizziness, dissociation, and temporary loss of motor control. It is unsafe to inhale while standing up as it could cause the person to collapse.
- Inhaling it directly from a tank poses serious health risks - it can cause frostbite since the gas is very cold when released.
- It drives oxygen out of the lungs and even after it is exhaled, continues to restrict oxygen supply. It can cause unconsciousness with the subsequent risk of falling.
- There are believed to be long term risks to the nervous system. All of these risks are likely to be exacerbated if the drug is combined with alcohol or other narcotics. The risks are particularly severe for pregnant women.

Licensees have duties under the Health & Safety at Work Act 1974 to protect the health and safety of people (including customers) using their premises. Carrying out or permitting activities which put people at risk of injury or harm to health would render them liable to prosecution. Similarly there is a likelihood that people who come to harm in this way may seek to take civil action against them. They could be at risk of being sued and it is unlikely that any insurance would cover the costs involved.

Winchester City Council's licensing manager John Myall said: "If this licensing authority becomes aware that premises are supplying or allowing the supply of Nitrous Oxide we will inform the Medicines and Healthcare products Regulatory Agency and pass on to them any relevant evidence."

The MHRA has indicated that it will prosecute.

Licensees are advised to take all necessary steps to ensure that nitrous oxide is not being supplied on their premises and advised to contact the police, the MHRA, or this authority should they become aware that any group or individual is attempting to use their premises to supply it.

Extra details
Nitrous oxide is an anaesthetic and is a pharmacy-only medicine, meaning that it can only be supplied by a pharmacist. There are two licensed products available which provide medical supplies of N2O in large cylinders for use in a healthcare environment. The gas is also used for boosting the performance of racing cars and as the propellant gas in cream dispensers.

Nitrous oxide can be habit-forming, and death can result if it is inhaled in such a way that not enough oxygen is breathed in at the same time. While the pure gas is not toxic, long-term use in very large quantities has been associated with dangerous symptoms similar to vitamin B12 deficiency, anemia, tinnitus, and numbness in extremities.

The protection of public safety is one of the four Licensing Objectives under which premises are licensed. Concerns about the safety of members of the public arising from activities associated with premises could result in a review of the licence.