Wesley Grover looks at a disturbing new trend in Ho Chi Minh City, nitrous oxide. Photo by Romain Garrigue.

Of the many vices to be found on Bui Vien, balloons filled with nitrous oxide, or laughing gas as it’s commonly referred to, are among the most easily and affordably attained. Some bars will use it to lure passersby in and vendors can be seen along the street with canisters of gas, ready to hock balloons for VND40,000, or roughly the same price as a beer.

On any given night, one can hear the distinct hissing sound as locals, expats, and backpackers alike inhale the intoxicating gas – dazed, wobbly, and, of course, laughing hysterically – but what risks are they taking?

Due to the fact that the inhalant is both legal and used medicinally, there’s a widespread belief that laughing gas is harmless. After all, it’s relatively non-toxic; it’s been used recreationally since the 1800s (“laughing gas parties” were reportedly a thing among the upper class in the Victorian era); and most people have probably experienced the euphoric effects of nitrous oxide as an anesthetic administered by a doctor or dentist at one point in their life.


However, use of the depressant-type drug outside of a professional setting does pose serious risks that people should be aware of it they’re going to try it, especially when it’s used repeatedly and under the influence of alcohol.

“Chronic exposure to nitrous oxide is very dangerous and can produce significant damage to brain cells, nerve fibers, the heart, red blood cells, and induce vitamin B12 deficiency, which can lead to neurologic deterioration if undetected,” shares Dr. Marie-Laure Bry, a general practitioner specialising in psychiatry and addiction rehabilitation at FV Hospital.

She warns that adolescents in particular, whose brains are not yet fully developed, are most susceptible to damaging the prefrontal cortex of the brain, a region that plays an integral role in decision making, planning complex cognitive behavior, and personality expression.

Can Be Deadly

“At a high dose, nitrous oxide can cause lethargy, general muscle weakness, slurred speech, hallucination, irregular heartbeats, and sometimes convulsions. Using inhalants as a recreational drug can even cause death due to lack of oxygen to the brain, asphyxiation, and heart failure,” Dr. Bry tells us.

Additionally, users face the risk of injuries that can occur from a loss of motor function, such as falling down, passing out, or driving impaired.

The fact that laughing gas is legal in many places can be misleading. As an aerosol propellant, it has a variety of legitimate uses and is commonly found in whipped cream canisters, known as whippits, and cooking sprays, which account for why the gas is so easy to obtain at a low price.

However, the legality of recreational use varies around the world and a few years ago it was banned in the United Kingdom under the 2016 Psychoactive Substances Act (though, interpretation and enforcement of this law remains heavily debated).

Here in Vietnam, the Hoi An City People’s Committee made a recent effort to crack down on the debauchery that comes with late night inebriation and banned buying and selling all forms of laughing gas, Viet Nam News reported in February, a move that could follow in other parts of the country.

While use of nitrous oxide is unlikely to lead to addiction issues or habit-forming tendencies, it’s important to have all of the facts if you are going to indulge in a high that lasts about as long as it’s taken you to read this sentence. After that, the decision is yours.