Sharp rise in clinicians seeking poisoning information about nitrous oxide and ketamine

There has been a 175 per cent increase in clinicians consulting the National Poisons Information Service (NPIS) about nitrous oxide in a year, says the latest NPIS report, with a 25 per cent increase related to ketamine over the same period. 

nitrous oxide users with balloons
There have been reports of increasing levels of neurological harms associated with heavy nitrous oxide use. 

NPIS is an expert toxicology advice service with 24-hour telephone support commissioned by the UK Health Security Agency (UKHSA), as most UK hospitals do not have specialist clinical toxicology services in-house. Its annual report sets out how often it was consulted by clinicians, and for what reason. NPIS also operates an online database and app for healthcare professionals called TOXBASE, providing general information and advice, enquiries to which are included in the figures.  

There have been reports of increasing levels of neurological harms – including nerve and spinal cord damage – associated with heavy nitrous oxide use. The government’s controversial ban on the substance came into force late last year (, despite the ACMD advising not to schedule it under the Misuse of Drugs Act. 

According to the latest treatment figures from OHID, more than 2,000 people entered treatment for problems with ketamine in 2022-23, five times the total from less than a decade ago ( 

‘The NPIS annual report serves as a comprehensive statement of NPIS’s activities, emphasising its pivotal role in managing poisoning cases, offering expert advice, and contributing to public health efforts,’ said Professor Raquel Duarte-Davidson of UKHSA’s Radiation, Chemicals and Environmental Hazards Directorate. ‘The rise in nitrous oxide and ketamine-related activities underscores the need for targeted interventions to protect public health and prevent further harm.’

Meanwhile, a YouGov survey commissioned by alcohol industry-funded body the Portman Group found that almost half of 18 to 24-year-olds now considered themselves occasional or regular drinkers of low- or no-alcohol alternatives, up from a third on the previous year. Almost 40 per cent drink no alcohol at all, making them ‘the most sober age group overall’, the Portman Group states. 

National Poisons Information Service – report 2022 to 2023 at

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