Young people who chronically inhale nitrous oxide, known as nanging, are at risk of neurological damage, a study suggests.
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Nanging involves inhaling nitrous oxide through whipped cream bulbs.
Doctors have seen an uptick in young people presenting with adverse effects because of chronic abuse.
Nanging gives a euphoric high, which lasts for minutes after a 20-second rapid onset of action.
Many users inhale hundreds of bulbs a day to maintain the effects, according to physicians.
Of 22 young people who turned up at hospital because of nitrous oxide abuse, the peak median number of bulbs inhaled per day was 300, according to a study to be published in the Royal Australasian College of Physicians' Internal Medicine Journal.
Of those, 15 had decreased mobility or an unsteady gait despite an average age of 22 and nine needed walking aids once they were discharged from prolonged rehabilitation.
Five participants had psychiatric symptoms such as hallucinations, paranoid thoughts and depression.
Eleven experienced decreased sensation in their limbs.
Of 18 participants who had medical imaging, 10 were found to have degeneration of the spinal cord, and all seven who did nerve conduction studies had dysfunction in small nerve fibres.
"The statistics are worrying and highlight an urgent need to ensure young people are properly informed of the effects of nanging," clinical toxicologist and study author Dr Angela Chiew said.
Young people can easily buy nitrous oxide bulbs over the internet, given they are legally sold for food preparation.
Internet searches for nitrous oxide had increased rapidly since 2017 and the lack of education among young people about the dangers of nangs needed to be fixed, Dr Chiew said.
"Education is vital to mitigating risks of further students suffering the after effects," she said.
"This includes targeted public health messaging, identification of high-risk groups, alongside restrictive policy measures that better regulate the selling and distribution of (nitrous oxide) cannisters."
Other symptoms detected among the 22 participants were problems with urine retention and incontinence and Vitamin B12 deficiencies.
The National Coronial Information System officially attributes a total 36 deaths on record to nitrous oxide inhalation.
The Internal Medicine Journal will be published later this month.
Australian Associated Press
