Nitrous oxide (N₂O) or laughing gas is legally used for medical purposes and the food industry, but its recreational abuse now poses a serious threat to public health. Inhaling this gas can cause acute hypoxia, which can lead to sudden death, and damage vitamin B12, leading to neurological disorders and permanent disability. Ironically, because this substance is not classified as a narcotic or psychotropic, its abuse falls into a regulatory gray area, so governments tend to only react after the adverse effects have occurred.
In healthcare facilities, the effects of this gas poisoning are often difficult to detect immediately because patients typically present with nonspecific complaints, such as shortness of breath, dizziness, or decreased consciousness. The long-term consequences of this neurological deficiency affect many productive-age individuals, ultimately burdening the national health and rehabilitation system. This situation is further exacerbated by Indonesia's lagging regulations. The sale of laughing gas is relatively unrestricted, there is a lack of adequate hazard warning labels, and exposure to this substance has not been integrated into the national poisoning surveillance system.
To address this gap, Indonesia is deemed necessary to shift from a reactive approach to a comprehensive preventive strategy. Recommended strategic steps include establishing nitrous oxide as a high-risk substance with proportional distribution regulations, mandatory health warning labels, and education for the public and medical personnel. As a long-term solution, the establishment of a National Poison Center is crucial to serve as a clinical reference and strengthen the surveillance system to protect the public from the threat of abuse of legal substances.
Abstracted from an article with the same title by Dr. dr. Tri Maharani, MSi, SpEM(K), FICEP, FIMMA (Policy Analyst at the Ministry of Health's BKPK). Published on the BKPK Website (February 13, 2026)
Design: Timker HDI Setban
