This briefing explains the law on assisted suicide in England and Wales. It examines recent parliamentary activity, developments in other legal jurisdictions, human rights challenges, and stakeholders' views.
On Tuesday 21 July MPs will discuss the misuse of nitrous oxide (commonly known as laughing gas) in an adjournment debate. This Insight explains what nitrous oxide is and how its use as a recreational drug is currently policed.
Legitimate uses of nitrous oxide
Nitrous oxide (N2O) is a colourless gas discovered by Joseph Priestly in 1772. In human and veterinary medicine, it is used with oxygen as an anaesthesia due to its pain-relieving effects. It is often referred to as ‘laughing gas’ because it can give those who inhale it a euphoric mood.
Other legitimate uses of nitrous oxide include as a fuel additive and as an approved food additive when used as a propellant for whipped cream.
Use as a recreational drug
Recreational users typically inhale via a balloon inflated with the gas. There are health risks associated with the recreational use of nitrous oxide.
The Government-funded drugs advice service FRANK emphasises that inhaling nitrous oxide directly from the canister is “very dangerous because the gas is under such high pressure. It can cause a spasm of the throat muscle and stop a person breathing.”
FRANK also says that nitrous oxide can cause:
- severe headache
- stop people thinking straight
- short-lived but intense feelings of paranoia.
The Advisory Council on the Misuse of Drugs advises the Government on the control of dangerous drugs. It says that long-term use of nitrous oxide can lead to vitamin B12 deficiency. In severe cases this can lead to neurological changes.
Nitrous oxide is normally treated as a “psychoactive substance” under the Psychoactive Substances Act 2016. Producing, supplying and importing/ exporting psychoactive substances for human consumption is illegal. It’s not illegal to possess psychoactive substances unless it’s with intent to supply. Possession of such a substance in prison is also an offence. However, the application of the 2016 Act in cases involving nitrous oxide has not always been straightforward.
A psychoactive substance is anything capable of producing a “psychoactive effect” in those who consume it, assuming it’s not exempt. Illegal drugs, alcohol, tobacco, caffeine, medicine and food are all exempted under the 2016 Act.
Last year two nitrous oxide “intent to supply” cases collapsed when questions were raised as to whether the gas is exempted because it is consumed as food in whipped cream. In 2017 an appeal against a conviction for intent to supply nitrous oxide was denied when the court decided nitrous oxide wasn’t exempted as a “medical product.”
Police have a range of powers which help them enforce the law. They can stop and search those they suspect are committing an offence under the 2016 Act. Police can also get a warrant to search premises for psychoactive substances. Finally, they can seize substances they find if they suspect they are drugs meant for recreational use.
Supplying nitrous oxide
Those selling psychoactive substances can be found guilty of supplying the drug when they are “reckless” as to whether it is being consumed by people. Even if someone advertises the sale of a psychoactive substance for a legitimate purpose, if they know (or ought to know) it is being bought for recreational purposes they can be found guilty. Those found guilty could face up to six months in prison or an unlimited fine.
The 2016 Act was formally reviewed in 2018. The review found:
the use of nitrous oxide (among all adults) does not appear to have been affected by the Act, although there are limited time series data to draw comparisons from.
Data for 2018/19 shows that 2.3% of adults aged 16-59 had used nitrous oxide in the last 12 months (around 763,000 people) up from 2% in 2012/13. Nitrous oxide use is more prevalent in young people. 8.7% of 16 to 24-year-olds had used the drug in 2018/19 down from 9% in 2016/17 but up from 6.1% in 2012/13.
A one-off data release from the ONS shows the number of deaths associated with nitrous oxide between 1993 and 2017. Although the numbers are very small, there are signs of an increased trend. If we examine the rolling average number of deaths for 5-year periods, the average number peaked at just below 5 deaths per annum on average for 2013-2017.
There are concerns about the health impact of recreational nitrous oxide. There are also concerns about anti-social behaviour associated with the drug’s use. Some are worried about the disturbance caused by those using the drug in public. Littering of empty cannisters on the street is also a problem. Local authorities, like Middlesbrough and Tower Hamlets, have stepped up their efforts to discourage the use of the drug in response to these concerns.
Local authorities can prohibit people from taking psychoactive substances in a specific place by making a public space protection order (PSPO). In order to do so they must show that the persistent use of psychoactive substances is causing a “detrimental effect on the quality of life of those in the locality.”
Those who break a PSPO could be issued a ‘fixed penalty notice’ fining them up to £100. Scarborough and Lambeth have both made PSPOs banning the consumption of nitrous oxide. It’s hard to assess their impact because we don’t have enough data about them.
The proposed solution
A petition currently before Parliament asks the Government to make the recreational use of nitrous oxide an offence. Given its widespread use for legitimate purposes, such a prohibition might be difficult to police. The Government says it has no plans to change the criminal law regarding to nitrous oxide. The Royal College of Nursing have called for better public information about the dangers of nitrous oxide misuse.
About the authors: Jennifer Brown is a researcher at the House of Commons Library specialising in policing and crime. Elizabeth Rough is a medical and health specialist at the House of Commons Library.
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