Nobody Regulates the Gas Station Whippet Aisle Until Someone Dies. Then It Takes a Lawsuit.

Margaret Caldwell was 29 when she died in Orange County, Florida, and the product that killed her is legally sold at gas stations under a name that sounds like a party favor: Galaxy Gas. Her family’s wrongful-death lawsuit, filed against the product’s manufacturer, isn’t asking for money as its primary goal — it’s asking a court to stop the company from selling nitrous oxide canisters to the public at all. That a lawsuit is the mechanism required to force that question tells you almost everything about how inhalants are regulated in this country: barely, unevenly, and mostly after the fact.

Nitrous oxide killed roughly six times as many Americans in 2023 as it did in 2010, and the product responsible is still sold next to the energy drinks at a lot of gas stations.

If you’ve never thought about inhalants as a serious substance-use category, you’re not alone — and that’s part of the problem. Inhalants get treated as a punchline (whippets, nail polish remover, keyboard cleaner) or a phase kids grow out of, not as a substance class with its own biology, its own deaths, and its own patients. That framing is exactly backwards, and the data on nitrous oxide specifically should end it.

What’s actually happening in the body

Nitrous oxide is a gas, and when you inhale it in concentrated form, it starves your body of oxygen and interferes with how your cells use vitamin B12 — a vitamin your nervous system needs to maintain the protective coating on nerve fibers. In plain terms: repeated heavy use can damage the nerves in your hands, feet, and spinal cord badly enough to cause numbness, and in severe cases, temporary or lasting paralysis. That’s not a rare complication in the reporting — one woman referred to in national coverage as “Meg,” from Orlando, described her use escalating to $300–400 a day at a smoke shop before she lost bladder control and the use of her legs. Two other women profiled in a national news segment were left unable to walk or care for themselves. This isn’t the drug’s edge case. It’s what heavy, sustained nitrous oxide use does to a body, documented repeatedly enough that it should be common knowledge and currently isn’t.

The mortality data backs up what those individual accounts describe. Researchers at the University of Illinois Urbana-Champaign and University of Mississippi, analyzing CDC data from 2010 to 2023, found nitrous oxide deaths rose from 23 in 2010 to 156 in 2023 — roughly a sixfold increase — with 1,240 deaths total over that period and nearly three-quarters of them concentrated in just the final seven years. Poison-control reports of intentional nitrous oxide exposure rose another 58% between just 2023 and 2024. “Without any type of regulatory intervention,” lead author Rachel Hoopsick told her university’s press office, “deaths and poisonings from nitrous oxide will increase at an accelerating rate and become a tremendous public health issue.” She published that warning in July 2025. It reads, one year later, like it was correct.

The regulatory patchwork, and the loophole that built it

Nitrous oxide has a legitimate medical and culinary market — it’s used in dentistry, in surgery, and in whipped-cream dispensers — which is exactly what has let the recreational market hide in plain sight for decades. Products get sold as culinary supplies, with warning labels about “not for human consumption” that function as a wink rather than a deterrent, while everyone involved in the transaction understands what the product is actually for.

States are starting to close that gap one at a time rather than all at once. Washington became the second state, after Louisiana in 2024, to ban retail nitrous oxide sales this year, with an exemption preserved for legitimate medical and culinary use. A federal bill, the Nitrous Oxide Safety Act, has been introduced in Congress and referred to committee, but referral is not passage, and there’s no functioning federal retail restriction today. That leaves a state-by-state patchwork where the same product is a controlled item in Baton Rouge and a convenience-store impulse buy three states over.

Washington became the second state, after Louisiana in 2024, to ban retail nitrous oxide sales this year, with an exemption preserved for legitimate medical and culinary use.

Poppers — alkyl nitrites, historically tied to LGBTQ+ nightlife culture since the 1970s — sit inside an even older version of the same loophole, sold for decades as nail polish remover, leather cleaner, or tape cleaner despite the FDA never approving them for human use and officially banning them for consumption since the 1980s. That loophole started closing this year too: federal agents raided a Texas poppers producer in February with no advance warning, halting the company’s operations — a reminder that “technically illegal since the 1980s” and “actually enforced” have been two very different things for forty years.

This isn’t the first time the country has gone through exactly this cycle. In the late 1950s and through the 1960s, a wave of glue-sniffing among teenagers set off what public health historians now call a genuine moral panic — newspaper coverage, congressional hearings, and by the mid-1960s, ten or more states passing laws restricting the sale of model glue to minors. The response was fast, punitive, and focused almost entirely on restricting access to a single product rather than building treatment infrastructure for the people already using. Today, 24 states have some form of inhalant-specific law on the books, and the pattern from sixty years ago is repeating with a different chemical: legislate the product, and leave the medicine behind.

The part nobody’s built yet: treatment

Here’s the gap that should worry anyone working in this field more than the regulatory patchwork does. There is no FDA-approved medication for inhalant use disorder — not one, for any inhalant, unlike opioids, alcohol, or nicotine, which all have at least one approved pharmacotherapy. Treatment relies entirely on psychosocial approaches — cognitive behavioral therapy, family therapy, motivational interviewing, and medically supervised detox when withdrawal is severe — because there’s genuinely nothing else to offer. A 2024 clinical review in the Primary Care Companion for CNS Disorders put it bluntly: the “diversity of clinical manifestations obscures diagnostic efforts,” meaning inhalant use disorder often doesn’t get identified as what it is until a patient is already in crisis.

The population most affected makes this worse. Adolescent inhalant experimentation runs as high as 26% by some estimates, with roughly 4% becoming regular users, and NIDA’s own data puts inhalant use disorder at around 0.1% of the population past-year — over 300,000 people, small as a share of all substance use but concentrated heavily among homeless and at-risk youth, the group least likely to have consistent access to any treatment at all, let alone one built specifically for what they’re using.

If you’re a clinician or case manager and inhalant use hasn’t been part of your standard intake screening, this is the week to add it — not because it’s rare, but because it’s exactly the kind of use that gets missed. A person showing up with nerve pain, numbness, or unexplained gait problems and no clear diagnosis is a candidate for an inhalant-use question your intake form probably doesn’t ask.

None of this means there’s nothing you can do if inhalant use is part of your life or a client’s. B12 deficiency from nitrous oxide use is treatable — supplementation can slow or in some cases reverse nerve damage if it’s caught early, which makes early conversation, not silence, the single most protective thing available right now. That’s still true even without a dedicated medication, and it’s still yours to reach for tonight if you need it.

The product that killed Margaret Caldwell is still on shelves in most states. Her family’s lawsuit might change that in Florida. It won’t change it everywhere, and it shouldn’t have taken her death to make the question worth asking in the first place.

It won’t change it everywhere, and it shouldn’t have taken her death to make the question worth asking in the first place.