By Mary Ward
Thousands of nitrous oxide bulbs – or nangs – are being delivered to customers in Sydney and Melbourne within minutes of being ordered with the rising popularity of 24/7 Uber Eats-style businesses, leading doctors to call for tighter sales restrictions to prevent dangerous misuse.
The cartridges are used to aerate cream and other food, but have gained popularity in recent years as a party drug, inhaled by first trapping the gas in a balloon or, with a higher risk of injury, directly from the bulb.
Nitrous oxide is often sold in small metal canisters and inhaled out of balloons.Credit:
Since October 1, the Therapeutic Goods Administration (TGA) has required cartridges to carry the warning label “do not inhale”, following consultations last year about regulating the drug.
NSW and Victorian laws prohibit the sale of nitrous oxide to someone a person suspects will inhale it. But with 24/7 nang delivery services re-emerging in Sydney and Melbourne this year, some experts say more should be done to prevent excessive use.
Western Australia prohibited the sale of nangs to under-16s from September, while South Australia has banned retail sales, such as at kitchen stores, between 10pm and 5am since 2019.
The European Union drugs monitoring agency is considering banning sales to under-18s or during night hours, citing UK data showing nitrous oxide is the second most prevalent drug among people aged 16 to 24, after cannabis.
“It’s pretty unlikely anyone would need 2000 bulbs for baking in the middle of the night.”
Dr Nicole Lee, drug and alcohol researcher
UNSW’s National Drug and Alcohol Research Centre (NDARC) has called for tighter restrictions and better education about the harms of inhaling nitrous oxide.
“We don’t know if people who are using nitrous oxide, particularly at a high level or frequency, are aware of the associated neurological risks,” said Dr Rachel Sutherland, deputy program lead of the centre’s drug trends unit.
While one-off recreational use was “relatively low-risk”, Associate Professor Darren Roberts, medical director of the NSW Poisons Information Centre, said extensive inhalation can lead to irreversible nerve damage, the first signs of which is usually tingling or numbness, followed by problems with movement.
“The group we are most concerned about are people who use daily, and as a self-treatment for mental health issues,” he said.
The number of calls about suspected nitrous oxide poisoning in Australia increased from 42 and 45 in 2018 and 2019, respectively, to 111 in 2020, according to data provided as part of the TGA’s submissions process.
At least 43 users were hospitalised across four Sydney metropolitan hospitals between January 2016 and October 2020. The patients were using an average of 171 bulbs daily and presented with severe disabilities which required extensive rehabilitation.
Nang delivery businesses advertise on Instagram and TikTok, as well as through websites easily found through a Google search.
Accepting payment through cash or bank transfer, they promote nangs as baking supplies, often using images of desserts and, in one instance, including recipes for whipped cream.
However, most also hint that bakeries are not their primary clientele.
For example, the product description of a tank on one website said the purchaser would not “need to waste [their] time just cracking the nangs”. Most also sell balloons.
The wholesaler who answered the phone number of one Sydney-based service confirmed that business had increased this year, with most clients being university students.
Screenshot of a text exchange with a nang delivery business. Credit:
But the man denied he was flouting state rules, saying delivery drivers would refuse sale if they suspected the products were being “misused”.
These processes were not present at some other businesses contacted. One agreed to leave a delivery outside a Sydney or Melbourne home after only communicating via text message, ignoring questions about whether they would require evidence the cartridges were being used for whipping cream to make the sale.
A texted price list included boxes of 2000 nangs for $750, with delivery promised within 30 minutes.
In a statement, the TGA said it had not received any direct reports of nangs being sold without the required warning, although it had received enquiries about businesses’ new obligations.
Roberts said easy access to nitrous oxide in such large amounts could increase harm for people using nangs frequently. He observed a peak in cases of nitrous oxide poisonings admitted to hospital before the pandemic, but said cases were again being seen.
“A common reason people come into hospital is because a welfare check was done on them at home, which showed a significant deterioration in their health,” Roberts said, adding many patients had been found in an apartment littered with used cartridges, with a new pallet recently delivered.
He supported restricting the sale of nangs to adults, as well as limits on the quantity able to be delivered.
In the 2021-22 financial year, there were four convictions for knowingly or recklessly supplying a psychoactive substance for human consumption in NSW, the law limiting the sale of nangs and other substances in the state, up from none the previous year and one two years prior, according to data from the NSW Bureau of Crime Statistics and Research.
Current demand for nangs is likely a continuation of what was being seen before the pandemic, said Curtin University drug and alcohol researcher Dr Nicole Lee.
“The party season is up and running now and that tends to be where people use those drugs,” Lee said, adding it was difficult to get good statistics about how many people in Australia used nangs.
NDARC’s Ecstacy and Related Drugs Reporting System shows nang use increased from about a quarter of regular users of other drugs in 2015 to half of this cohort in 2022, but little is known about use among the general population, with the Australian Institute of Health and Welfare’s drug household survey only asking about inhalants generally.
The TGA said it would consider imposing further restrictions on the sale of nitrous oxide in future “should sufficient evidence come to light to show that it is necessary to do so”.
Lee said she supported the regulator’s “watch and wait” approach, expressing concern restrictions on nangs could push people to harder party drugs. However, she said purchase limits and age restrictions would be reasonable.
“It’s pretty unlikely anyone would need 2000 bulbs for baking in the middle of the night,” she said.
Sydney GP Dr Michael Bonning, president of the NSW branch of the Australian Medical Association, said the rules introduced in South Australia and West Australia were “pretty fair minded”.
“Nang use did go away for a while during COVID, and now it is cropping up again,” he said.
“These services are profiteering off young people, preying on risk-taking behaviour. And I don’t think there’s anything about the rules being implemented elsewhere that would restrict legitimate use.”
Lifeline 13 11 14
The Morning Edition newsletter is our guide to the day’s most important and interesting stories, analysis and insights. Sign up here.