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Warning of frostbite injuries from nitrous oxide misuse

Doctors at a Dublin hospital have said they are worried about the number of teenagers presenting with frostbite injuries associated with the inhaling of nitrous oxide, commonly known as laughing gas.

The gas is primarily used in the catering industry and is not a controlled substance under the Drugs Act.

It is, however, illegal to sell nitrous oxide for human consumption.

On a housing estate in Clondalkin in Dublin, the issue is clear to see.

RTÉ News came across around ten canisters of “Fast Gas” discarded and empty. One of them was close to the gates of a school.

Local Sinn Féin TD Mark Ward said it is a common sight and evidence of a big problem.

He said: “They’re everywhere. They’ve changed there from the last number of years from the small kind of silver bullets, ‘one hit wonders’, to these large canisters which are absolutely frightening to know that young people are taking these.

“It’s like playing Russian roulette, I was speaking to a neurologist in the Mater Hospital who was saying there were young people who were turning up at the Mater with dizziness, nausea with mental health problems.”

“Problems with balance, with respiratory problems, there’s a whole multitude of problems,” he said.

Dr Catherine de Blacam said there is an additional problem of youngsters delaying going to hospital

Attention has also been brought to another problem with doctors in Children’s Health Ireland at Crumlin warning of a cluster of frostbite injuries.

Consultant Paediatric Surgeon Dr Catherine de Blacam said: “We have seen a number of teenagers who are using nitrous oxide for recreation and as part of the process where they’re inhaling it.

“It has to be an transferred from a canister into a balloon and the process of doing that cools the canister and the solution to really low temperatures (as low as -50C).

“So the liquid can spill onto the skin or the canisters touch off the skin, causing really quite deep severe frostbite burns.”

Dr de Blacam said: “Scarring is a really significant thing. Some of the patients that we’ve had with even superficial burns around the lips and fingertips, they’re really sensitive areas, so they can end up with hypersensitivity in those areas which can take some months to resolve.”

Doctors have seen around 13 frostbite cases over a ten-month period, among them was a 19-year-old man who was left with severe scarring to his thighs.

“It is a worry,” said Dr de Blacam.

“Anytime that we identify a spate of these kind of injuries, I think it is worth definitely highlighting because … it is a concern for sure.

“These are painful injuries and can result in deforming scars which is all really unfortunate in young people,” she said.

At the moment, nitrous oxide, because of its legitimate uses in industry, is not regarded as a controlled substance

Dr de Blacam said there is an additional problem of youngsters delaying going to hospital.

“There’s a tendency to delay in presentation because obviously by the nature of the injures, it’s a sort of, I guess, an illicit thing that these kids are doing and they might not want to let their parents know.

“They often end up presenting late in a compromised condition already … if patients present late, they’re more susceptible to the wounds becoming colonised with bacteria, which can potentially lead to them being systemically unwell, or the wounds progressing without the correct care,” she said.

Mark Ward is preparing to bring the issue to the Dáil in the coming weeks and has a set of proposals aimed at curbing the problem.

Nitrous oxide, because of its legitimate uses in industry, is not regarded as a controlled substance.

It is though, illegal to see knowingly for human consumption.

Mr Ward said: “In terms of regulations it’s very grey area so there doesn’t seem to be any regulation whatsoever when it comes to nitrous oxide.

“It does come under the Misuse of Solvents … but outside of that there is very little control whatsoever for it. As you can see from walking around the area, they’re discarded everywhere. Whatever rules are out there, they’re not working.”

“You can buy it on the internet. We’ve reports of young people getting them on Snapchat, we’ve young people getting them through TikTok, we’ve got people getting them online left, right and centre,” he said.

Mr Ward added: “‘The plan is to regulate it so it will stop the sale of it so easily online so it will stop the young people getting their hands on it.

“One of the things in our legislation as well, it doesn’t criminalise the end user but it does give the gardaí the right to confiscate them because at the moment the guards don’t have the right to confiscate these nitrous oxide from young people.”

In a statement, the Department of Health pointed out the current laws in place surrounding the supply of the gas for human consumption and said the Minister for Health is “fully supportive” of the work of An Garda Síochána, whose responsibility it is to enforce the legislation.

It also said in line with recent recommendations from the European Drugs Agency, along with the Health Service Executive continue to monitor the use of nitrous oxide and to “tailor appropriate and targeted messages” to address its use.

It said an important goal is to ensure that parents are well-informed and said there was specific information available on and through a parent factsheet.

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