My conversations with young people in Rochdale reveal a troubling picture of nitrous oxide use, shaped by religion, family expectations and a silence around addiction that we urgently need to confront.
Not long ago, I spoke to a young South Asian man in Rochdale who had started using nitrous oxide in his teens. He had been hospitalised several times and was now permanently disabled. Yet what stayed with me was not simply the extent of his injuries, but his explanation for taking the drug.
“It makes me feel happy when am depressed, i live in Rochdale. There's nothing to do. My home life is shit, so i take it to feel better.”
I have returned to those words repeatedly. Here was a young man whose life had been permanently changed by a substance he had turned to for temporary relief from unhappiness. Despite repeated hospital admissions, he had not accessed recovery support.
Through our conversations with young people at The Salik Project UK, I have become increasingly interested in how nitrous oxide, commonly known as laughing gas or NOS, has found a place within parts of British South Asian youth culture.
During our focus groups in Rochdale, some participants described seeing South Asian girls sitting in cars inhaling balloons. They recounted these encounters with genuine surprise, perhaps revealing as much about cultural expectations surrounding young women as about drug use itself.
One evening, after delivering a focus group, we returned to our house in Rochdale and noticed a South Asian teenage girl dressed in her nightgown, discreetly inhaling from a balloon. She appeared to be watching out for members of her family. When she noticed us, she discarded the balloon and hurried inside.
I knew nothing about her circumstances, but the secrecy struck me. Here was a teenager seemingly negotiating two worlds: the culture of her peers and the expectations of her family.
Other conversations revealed something equally interesting. Some young people suggested nitrous oxide was considered less haram — religiously prohibited — than cannabis. Others believed it was less harmful. Several pointed to its lack of a lingering smell. Unlike cannabis, they explained, someone could take a balloon upstairs to their bedroom without their parents necessarily knowing.
These were not established facts or religious rulings, but perceptions shared during our conversations. And they offered a glimpse into how some young South Asians negotiate drug use alongside faith, family reputation and the fear of being discovered.
The medical evidence, meanwhile, is deeply concerning.
A 2023 study published in the Journal of Neurology, Neurosurgery & Psychiatry examined 119 patients treated for nitrous oxide-related neurological injuries at hospitals in London, Birmingham and Greater Manchester. Their median age was just 22.
Asian or Asian British patients accounted for 73% of cases in east London, 54% in Birmingham and 29% in Manchester. The researchers could not establish why Asian patients were disproportionately represented, and these figures do not prove greater nitrous oxide use among South Asian young people.
Interestingly, the researchers also considered whether the gas might appeal to people who avoid other substances for cultural or religious reasons, although their findings did not establish this explanation.
Nevertheless, the figures should concern anybody working with our communities.
Nitrous oxide is commonly inhaled through balloons filled from pressurised cylinders, producing a brief feeling of euphoria or detachment. But repeated or heavy use can interfere with the body's ability to use vitamin B12, damaging the nerves and spinal cord. What begins as tingling fingers or numb feet can progress to difficulty walking and permanent disability.
There is also a dangerous misconception that taking B12 supplements can protect people who continue using the drug. It cannot reliably do so. Nitrous oxide interferes with the body's ability to use the vitamin, and the hospital study documented 13 patients who had taken B12 supplements before presenting with neurological injuries.
The government's Advisory Council on the Misuse of Drugs has similarly warned that supplementation without stopping nitrous oxide use appears ineffective at preventing neurological harm.
The dangers extend beyond the individual. In March 2026, 50-year-old Sylvester Abayomi was killed in Manchester when a car travelling at more than 130mph crashed into his vehicle. The driver and passenger had filmed themselves inhaling nitrous oxide during the journey. Both were subsequently imprisoned.
Meanwhile, illegal suppliers continue to operate. In March 2026, Birmingham trading standards officers seized 68 large cylinders during an operation in Sparkbrook, despite recreational possession and unlawful supply having been criminalised in November 2023.
But enforcement and medical warnings alone cannot explain why young people are using nitrous oxide, or why some struggle to seek help.
I have also begun to wonder whether we sometimes expect recovery services to understand communities that have long struggled to speak openly about addiction.
In some South Asian households, the fear of izzat and sharam — honour and shame — can discourage honest conversations about substance use. Important experiences remain hidden, leaving gaps in the understanding available to those designing and delivering support.
How can services fully understand these cultural complexities when communities themselves are reluctant to discuss them?
The responsibility must be shared. Communities need to challenge the silence surrounding addiction, while commissioners and recovery services need to work alongside trusted grassroots organisations to better understand the people they serve.
Our conversations in Rochdale are a small contribution to that understanding.
I think again about the teenage girl hurriedly discarding her balloon, and the young man who told me he used nitrous oxide because it made him feel better.
One was seemingly frightened of being discovered. The other had suffered devastating injuries but remained disconnected from recovery support.
Two very different experiences, yet both raise questions about what young people feel able to tell us, what we are prepared to hear, and what happens when those conversations never take place.
The Salik Project UK works with South Asian communities in Rochdale to reduce stigma around substance use and help people access appropriate support. Identifying details have been withheld to protect privacy.
