Pubdate: Sun, 31 Jan 2021
Source: New York Times (NY)
Copyright: 2021 The New York Times Company
Website: http://www.nytimes.com/
Details: http://www.mapinc.org/media/298
Author: Ezra Klein

US: NITROUS NATION

For decades, nitrous oxide has been widespread at raves and music
festivals, used as a quick buzz. The drug doesn't have the death toll
of the opiate disaster or the widespread popularity of marijuana, but
it's widely sold - legally - all over the country, though its
consumption outside medical facilities is illegal in many states.

But the inhalant's use and misuse seems to be on the rise, fueled by
the stress and isolation of the coronavirus pandemic. It's also in the
spotlight this week after the death of Tony Hsieh at 46, the former
chief executive of the online shoe empire Zappos, in a house fire in
November.

On Tuesday, a report from fire investigators, said that Mr. Hsieh may
have been intoxicated when the fire started, noting that he was found
in the presence of "several Whip-It brand nitrous oxide chargers" and
a "whipping cream dispenser," along with liquor bottles and marijuana
paraphernalia.

In the tech business community, he was remembered as a brilliant
business leader who also frequently misused drugs and alcohol. This
was not a secret. According to Forbes, one of Mr. Hsieh's friends, the
singer Jewel, sent him a letter last year. "I need to tell you that I
don't think you are well and in your right mind," she wrote. "I think
you are taking too many drugs that cause you to disassociate."

And while opiates and cannabis do get most of our attention in the
drug world, nitrous oxide use is widespread. A British government
report in December found that nitrous was second only to cannabis in
use among those aged 16 to 24 in Britain. According to the 2019 Global
Drug Survey, it is the 10th most popular drug in the world.

In 2018, The Journal of Neurology said nitrous "abuse is rapidly
rising" in the United States. A 2020 study linked growth in nitrous
use in the Netherlands to an "upsurge in young people presenting to
the hospital with neurologic complaints."

Now, the coronavirus pandemic may be driving its popularity. Dr.
Michael McCormick, the medical director of the Healthcare
Professionals Program at Caron, a prominent rehab facility, said he
had seen an uptick in patients abusing nitrous over the past year.

It makes sense for the current moment. "Some of our patients that
we've had, they use it to dissociate," Dr. McCormick said.

'It's All Funny Until You Go to the Hospital'

Like cannabis, nitrous oxide is responsible for almost none of the
overdose or misuse drug deaths each year, but its use can lead to death.

Opiates have been the leading menace in drug deaths for a while,
resulting directly in about 48,000 overdose deaths in the United
States in 2019 alone. In Britain, just 23 deaths between 2010 and 2016
were attributed to nitrous oxide. The danger of nitrous is more
serious for medical workers, who face serious health hazards for
overexposure in their workplaces.

Nitrous oxide was first synthesized by the English chemist Joseph
Priestley in 1772, and in the late 18th century, it had a brief vogue
as a recreational drug. (A group of scientists and artistic types,
including the poet Samuel Coleridge, experimented with it at parties.)
Its primary medical uses are in dentistry and in childbirth, but its
recreational use came back into fashion centuries later; the Grateful
Dead were fans, and it made appearances in 1970s Hollywood.

There are "stories of pool parties, people filling inflatables in the
pool with nitrous oxide, so you could be just floating on it and
huffing on it," said Mike Jay, the author of "The Atmosphere of
Heaven," a book about the origins of nitrous.

Decades later, a 2010 Village Voice article chronicled the Nitrous
Mafia, a coalition of dealers who sold nitrous-filled balloons from
gas tanks at raves and jam-band concerts, using violence to maintain
their dominance. Concertgoers would consume so much nitrous they would
pass out. ("I've watched so many young people crack their heads and
faces open that I have personally stopped providing emergency first
aid," an emergency medical technician told The Village Voice.)

Stephen Gilchrist Glover, the former "Jackass" star known as Steve-O,
encountered the drug in 1994, while following the Grateful Dead on
tour. "It was called hippie crack," he said. He liked it. Later, he
became addicted, he said.

At times he would use hundreds of canisters per day, he said. "In my
active nitrous addiction, I would make every effort to inhale only
nitrous, like, to the exclusion of even air," he said. "To lose
consciousness wasn't failure - that was the goal."

This is not an uncommon sentiment. Some users put plastic bags over
their heads while inhaling, a practice linked to multiple deaths. (The
Wall Street Journal reported that Mr. Hsieh, for one, used nitrous to
deprive himself of oxygen, in order to "figure out what his body could
live without.")

Eventually Mr. Glover started experiencing psychosis. "I had tactile
hallucinations, visual hallucinations, audio hallucinations" - some of
them so strong that "it sounded exactly like I had an earpiece in my
ear," he said. He described voices compelling him to keep consuming
the drug.

"I was being instructed to kill myself, and I considered that demon
spirits," he said. He recalled "writhing on the floor, pounding on the
floor, trying to not breathe" in between hits of nitrous. "A lot of
times I just failed, I'd end up breathing," he said, and his demons
would berate him.

In 2008, Mr. Glover's addiction to drugs, including nitrous and
cocaine, led his "Jackass" castmate Johnny Knoxville to stage an
intervention.

He said the scariest part of his experience was the feeling of
powerlessness he felt under the drug's influence. "You are actively
killing yourself and can't stop," he said.

Another person who struggled with nitrous oxide addiction, Emily, said
her doctor told her that her incessant whippet use was the cause of a
transient ischemic stroke. (The Times agreed to withhold Emily's last
name because she is applying to graduate school.) She first used
nitrous as a drug 10 years ago when she was 16, she said, but it
became a habit in April, soon after the pandemic started. In July, she
said, she spent more than $5,000 on nitrous, and once used 700
canisters in a single day.

On Halloween, she was hours into a nitrous binge when she looked in
the mirror and saw that her face appeared lopsided.

"I couldn't talk. l was crawling around," she said. "I was paralyzed."
Still, like Mr. Glover, she felt possessed by a "whippet demon" that
was forcing her to keep loading and inhaling canisters.

Whippets, she said, are more dangerous than people realize. She's seen
"friends lose consciousness. You turn blue," she said. "It's a very
morbid drug." The diagnosis of her stroke terrified her enough to make
her seek treatment, she said.

In 2015, Dr. Emery Brown, a professor of medical engineering at M.I.T.
and an anesthesiologist at Massachusetts General Hospital, published a
study that found that nitrous also drastically slowed down brain wave
oscillations, potentially enough to have an impact on basic
respiratory functions if used without proper medical supervision. In
an interview, he described someone inhaling nitrous at home as "doing
an uncontrolled anaesthetic experiment on themselves," noting the
dramatic effect it has on the brainstem.

"The first time I saw these oscillations, I said, 'I understand now
why people can die,'" he said.

Mr. Glover also said that nitrous is misunderstood by many as a
lighthearted party drug. "'Hippie crack' is almost like a term of
endearment," he said, "which is ironic, because it's such a dark,
desperate thing."

In part because the drug seems fun, nitrous-related content now
flourishes on social media. A 22-year-old from Seattle (whom The Times
agreed to grant anonymity because of his employment in the tech world)
is among the most prominent posters in the TikTok nitrous scene, known
as WhipTok; his account has millions of views.

"It's definitely more, like, relevant now," he said, noting the
appearance of inhalants on the Instagram stories of musicians and
people showing off their dispensers online.

He is aware of the drug's dangers, even as a fan and a proponent.
"This one girl duetted me, and was like, 'Yeah, it's all funny until
you go to the hospital for having a seizure,'" he said.

Rave Culture, Burning Man and Silicon Valley

Mr. Hsieh was a regular attendee of Burning Man, the Nevada festival
popular in recent years among the tech elite. It is one of the most
prominent events seeking to capture the hippie zeitgeist in recent
decades, and nitrous is popular there.

Burning Man forums are full of tips for users, encouraging them to
recycle their canisters and avoid throwing them into fires lest they
explode. A nitrous oxide supply company called CreamRight even offers
Burning Man discounts. In a 2017 essay about Silicon Valley culture
published in N+1, the writer Anna Wiener describes a party that "feels
like a normal event in the Burning Man off-season -  whippets,
face paint, high-design vaporizers."

Ishaan Chugh, 30, was introduced to nitrous oxide at a Silicon Valley
party. The year was 2013, and the tech world get-togethers he attended
often featured the substance. A friend first showed him how to do
whippets using a whipping cream dispenser.

"It's a quick high, 15 seconds, you get a buzz and you feel very
lifted and positive," said Mr. Chugh, who was trying to get a tech
start-up going at the time. "Versus feeling miserable, which is what
you feel when you run a company which is not doing too well."

A casual whippets habit turned into three years of heavy use of a
powerful anaesthetic.

Mr. Chugh thinks the tech world's utopian ethos makes people
susceptible to this drug because it seems to expand the mind. "Lots of
Silicon Valley folks are very cerebral in nature," he said. "Nitrous,
in the early days, produces some kind of insight, or the illusion of
insight into consciousness."

Ultimately, though, it leads to delusional belief that the drug "is
actually good for you, and that you found something wondrous that the
rest of the world doesn't know about."

Only after losing his company - and damaging many relationships - did
Mr. Chugh seek treatment. He moved back home with his parents in
India. "A lot of things that I valued in life were all gone forever,"
he said. "That's when you will realize that no matter how alluring
that thing may be, you just got sucked into something really
monstrous."