Paramedics Use Laughing Gas In Lieu Of Opioids To Treat Pain

By Keri Blakinger 08/13/18

“We feel if we can prevent someone from getting an opioid we are ahead of the game,” said one Indianapolis emergency responder.

EMTs preparing a stretcher

Paramedics in one Indiana town have decided to switch from fentanyl to laughing gas in an effort to keep injured patients from taking the drug, a synthetic opioid which has a high potential for addiction. 

The move comes as fentanyl is tightening its grip on the state’s capital, accounting for nearly 50% of opioid-related deaths in 2017—up from just 14% in 2013. 

The shift won’t entirely eliminate the Fishers Fire Department’s use of the addictive painkiller, but it could cut it down by about two-thirds, Capt. John Mehling told the Indy Star

“If it hurts a little, why give a lot?” Mehling said. “If you are going squirrel hunting, don’t bring an elephant gun.”

For some cases—including head injuries and collapsed lungs—paramedics will still give out fentanyl. But when it comes to things like broken bones, they’ll turn to laughing gas instead. 

“We feel if we can prevent someone from getting an opioid we are ahead of the game,” Mehling told the Indianapolis paper.

After decades of use in dentistry, it wasn’t until relatively recently that laughing gas started making its way into emergency room settings. It offers some advantages over other painkiller options, including the fact that it’s not addictive and doesn’t require an IV. Also, it typically takes effect within about a minute and has a good safety record.

But to use nitrous oxide, the patient has to be in good enough condition to put on the mask or tube and inhale to self-administer the gas. Then, three to five minutes later, they’ll need to do it again. Also, there have been some fatalities, and it can still present the potential for abuse, which makes it a potential target for thieves. 

The shift at the Fishers Fire Department is just the latest in a growing trend. Paramedics in more than two dozen states have already started buying laughing gas for ambulances—though not always in an effort to avoid using opioids, according to the Associated Press.

For some departments, laughing gas is convenient because it offers a means to combat pain even when medical workers who can legally provide narcotic painkillers are not along for the ride. 

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Keri Blakinger is a former drug user and current reporter living in Texas. She covers breaking news for the Houston Chronicle and previously worked for the New York Daily News and the Ithaca Times. She has written about drugs and criminal justice for the Washington Post, Salon, Quartz and more. She loves dogs and is not impressed by rodeo food. Find Keri on LinkedIn and Twitter.