No2N2O.org - We are stonger together

Resources

This page contains tips on:
1. How to quit using nitrous.
2. How to help someone you care about quit.

How to Quit

This is a very practical set of suggestions for how to stop using nitrous divided into short term, medium term, and long term suggestions.

Everyone’s recovery will be different, and different approaches work better for different people. What’s below is a list of steps that have helped others.

Immediate Steps

Nitrous addiction resembles a black hole. Its gravitational pull on you is strongest when you’re closest to it. The less time that’s passed since you used it, the stronger the pull. The more easily available it is to you, the stronger the pull. That means that early sobriety, especially if you are in a situation where you can acquire it easily, is the very hardest phase. Getting to the point that you have a week, a few weeks, or a few months, is the hardest and most critical point. Every day and week that passes, it will get easier. So the short term steps are, in many ways, the most important.

Create Barriers Between You and Nitrous

You need to create space and impediments that make it harder for you to get nitrous:

Go somewhere you can't use. Empty time where you are unsupervised or feel like you can use nitrous are the most dangerous times, especially in early sobriety. Put yourself in a living situation where you can’t get nitrous without being caught.

Tell stores to stop selling to you. Tell every store that has sold you nitrous - and every other store that sells nitrous near you - to stop selling to you. Be polite and reasonable. Don’t blame them. But be blunt with them: “I’m addicted to this drug. It’s killing me. It’s ruining my life. It could lead to me being paralyzed or worse. As a favor, please don’t sell to me, even if I come in and tell you I’ve changed my mind.” If you need to, take a friend or family member with you when you make these visits - but you must be the one who asked. If visiting seems too difficult, call them by phone and describe yourself. One of our members went so far as to print fliers with their face on them that said, “At this person’s request, please do not sell nitrous to them. They’re addicted and are working hard to stop.” This step sounds incredibly difficult, but is extremely useful. Making it harder to access nitrous makes it easier to stay sober.

Give someone else control of your money. If step 2 isn’t sufficient, the next step is to give someone else control of your money. One option is to use something like a recovery-oriented debit card like the one from TrueLink Financial. This is a prepaid debit card that gives a friend or family member the ability to load money onto the card, to monitor your spending, and to allow or disallow different categories of stores and even different merchants.

Go to inpatient treatment. If none of the above work for you, consider going to inpatient rehab. Inpatient rehab is only a temporary solution, to be clear. It is unlikely to be a cure for you. Many of us have been to inpatient rehab and relapsed immediately after. But it will create temporary time and space where you are separated from nitrous. You must use that time to plan, to change the life you’ll return to (perhaps doing steps 1-3, or some of the steps under “medium term”), and to put other tools of sobriety in place. If you don’t do those things, inpatient treatment will be pointless.

Move to a state, county, or even country where nitrous isn’t available. Another step that is an even bigger life change is to move to a geography where you just can’t acquire nitrous oxide. At the time of writing, four US states ban nitrous sales: Louisiana, Florida, Indiana, and Kentucky. Four counties in California also ban nitrous sales: San Mateo county, Santa Clara county, Orange County, and Humboldt County. Many countries also make it difficult to acquire nitrous oxide, including Mexico. A “geographic” solution is discouraged in most 12 step programs, and we acknowledge that it's not a full solution. Like going to inpatient rehab, it’s likely to only work while you’re separated. You must use that time to change the life you’ll return to.

Medication and Psychedelic Treatment Options

It’s possible that supplements, prescription medications, and/or psychedelic therapy may make a difference in your recovery.

Supplements. In terms of supplements, there’s evidence suggesting that NAC, Sarcosine, and D-Serine reduce nitrous cravings. However, don’t expect these to be a cure. They will help bolster your resistance, but are unlikely to solve the issue all alone.

Prescription Medications. Among prescription medications, there’s (largely indirect) reason to believe that acamprosate, topiramate, and naltrexone may reduce nitrous cravings. Again, these are unlikely to be cures on their own, but may reduce cravings and make recovery easier. An anti-depressant may also help.

On the health page we have more about supplements and medications to reduce nitrous cravings.

Psychedelic therapy. Finally, while perhaps controversial, a few members of our community have found nearly instant relief from therapeutic psychedelic treatment for addiction, particularly psilocybin. There’s evidence that this treatment works quite powerfully for alcoholism and nicotine, and subjective reports that it helps for nitrous oxide and the related addiction of ketamine. The health page also has more on the use of psychedelic therapy to break nitrous addiction.

Medium and Long Term Life Changes

Whatever you do to break out of nitrous, you need to also make changes in your life to reduce the risk of relapse.

Find a community and fellowship of recovery. It’s extremely helpful to connect to other people who are struggling with addiction and trying to get clean. We’ve found that it’s especially useful to connect to people struggling specifically with nitrous addiction, as it’s so different from other addictions. You’re welcome to join our non-judgmental online meetings, which are held nearly every day of the week. The meeting schedule and links are here. We also have an online discord chat which operates 24/7, allowing you to connect to other people who are or have struggled with nitrous addiction. Finally, for some people, online groups aren’t sufficient. It’s helpful to connect to others fighting addiction in person. While there are no in-person nitrous-specific support groups, you may find that you connect to the people in a Narcotics Anonymous, Alcoholics Anonymous, Dharma Recovery, Refuge Recovery, or SMART Recovery group. There are likely to be NA or AA meetings near you. Whether you believe in god or accept all the tenants of the 12 steps or not, the sense of fellowship and connection to others can help. Dharma Recovery and Refuge Recovery are buddhist-oriented groups that emphasize meditation. SMART Recovery is a totally secular recovery group with in-person meetings. Again, you don’t need to accept all the tenants or beliefs of such a group to get value from them. Try them out and see if you connect with the people in the meetings. Fellowship is more important than specific beliefs.

Consider an IOP and/or Sober Living. Either an Intensive Outpatient Program or a Sober Living house (or both) can provide you with ongoing structure and accounatability in your recovery. This is especially if you went to inpatient rehab or moved to a place where you were unable to use nitrous. But it can also be very helpful if you used any other path to break free of the addiction for the short term. An IOP is a program where, typically, you meet in a group setting for a few hours a day, 3 or 4 days or evenings a week, to work on your recovery with other people in early recovery. A Sober Living is a living arrangement that is less restrictive than inpatient rehab, but where you live and sleep in a group home where no substances are allowed, with housemates also in early recovery. Many people live in a Sober Living while taking part in an IOP. These sorts of programs can help in establishing healthy habits in the real world and strengthening your coping skills and muscles of sobriety. The academic literature finds that IOP programs are just as effective in promoting sobriety for most people as more intensive inpatient treatment facilities. That said, some IOP and Sober Living facilities will only accept you if you've recently conducted an inpatient program.

Create connection, rather than isolation, in your life. "Connection is the opposite of addiction”. That’s the message of a popular TED talk by Johann Hari. Nearly all of us find it rings true. Nitrous addiction is highly isolating. Addicts use in isolation, and usage causes us to hide, to avoid social interactions, and to say horrible things to people we care about. You must solve that. Seek out connection. Reach out to people you’ve become estranged with. Apologies with humility. Take ownership and responsibility for the things you’ve said or done. Ask them to spend time with you doing sober things. Reconnect with old friends of family members. Show up at social events even if they’re scary or anxiety-producing. Connect with new friends met in sobriety meetings. Be honest, transparent, and vulnerable about where you’ve been and what you’re feeling. The more you can connect with others, the more resilient you’ll find yourself, and the less hold addiction will have on you.

Relearn and practice coping skills. A common pattern in nitrous addiction is that we use nitrous to cope with stress, anxiety, or emotional pain. To reduce the pull of nitrous, we need to learn alternate ways to cope with those emotions that we want to avoid or escape. What helps you cope? For many of us it’s reaching out to a friend, exercise (or even a long walk), time in nature, meditating, or doing a hobby. You have to practice these things again to strengthen those coping muscles and relearn those habits. There’s much written online on this, and it’s a frequent topic in recovery meetings and in treatment.

Discover what you want more than addiction. Finally, at the end of the day, you must want something more than nitrous. What do you enjoy? What do you love? What motivates you? Much of recovery focuses on the stick, or the avoidance of the pain of relapse. That’s useful. It’s also useful to find the carrot - the thing or things that create an alternate pull that’s stronger than the gravitational attraction of the black hole of addiction.

How to Help Someone Quit

Helping an addict is extremely challenging. It may push you emotionally. Be prepared for that.

First, understand that your friend or loved one is not him or herself. Nitrous addicts, particularly in the midst of a multi-day binge, become deluded, paranoid, and often hostile. They stop making sense. They stop forming memories at times. They're prone to persecutory delusions, thinking everyone is out to get them. And they sometimes say terrible things that they don't really mean and will intensely regret when they sober up. Please keep this chemically induced paranoia in mind as you deal with them. This also means that nitrous addicts often don't deal well with being told what to do or any perception that they're being forced into something.

Also, bear in mind that your real friend is still inside. Their behavior is being warped by their addiction. Keep hope: These behaviors will end and their old personality will return when they've achieved sobrietly.

Finally, understand that if you're going to help them, it's most likely that you're going to see them go through relapses. We can all hope that isn't true, but it's the norm. That doesn't mean that they're not trying or that they don't want to get better. Nitrous addicts often desperately want to quit, and try quite hard. It's just a very challenging thing to escape from. Prepare yourself emotionally, and don't assume that a relapse means that your loved one doesn't want to get well.

All that preamble said, some suggestions:

Get them the supplements they need. Your friend is damaging his/her nervous system and circulatory system. There are four things they should be taking every day during active usage, and for a week or two beyond. All of these can be purchased from Amazon and most from your local drug store. No prescription or doctor's visit needed.
- L-Methionine or SAMe. This is the single most important supplement for anyone using nitrous oxide. It's a molecule your body needs to make DNA, and that you can't produce on your own while using nitrous. In animals, it prevents the nerve damage that comes from constant nitrous exposure. It helps even when actively using nitrous.
- Betaine. This helps lower the risk of blood clots and stroke. It works even for those who are actively using nitrous oxide.
- Sublingual B12 in the form of methylcobalamin. This helps in preserving their nervous system and their ability to walk. It may also help with brain fog and psychosis. It's not totally clear how much it helps for people who are actively using, which is why we recommend L-methionine first and foremost.
- Methylfolate (a form of folic acid). This lowers the risk of blood clots and stroke and also helps with numerous other body functions.
We have a full supplement list with the science behind them and links to buy in the essential supplements section of the health page.
Convey that you're on their side. Because someone in the midst of a nitrous binge is often paranoid, deluded, sometimes psychotic, and believes the world is against them, it's imperitive to approach with concern and compassion rather than control. When we were in active addiction, many of us perceived anyone scolding us or coming on too strong as being against us in some way. This made us more paranoid of and resistant to their feedback and advice. It was the people who approached us with love and told us how scared they were for us, how concerned they were, or that they still loved us that really motivated us to listen and to try harder.

Help them separate from nitrous. In the midst of a nitrous binge, people can't think rationally. They probably hate what's happening, are scared and ashamed, and loathe themselves. But they also view the nitrous as their safety blanket, as the one thing that can soothe the anxiety of the situation they've put themselves in. Nitrous addicts believe (correctly) that crushing anxiety will rush in as soon as they quit using. Long term planning becomes impossible. Willpower shrinks to just enough to load another balloon or get another tank. A nitrous addict needs time and space away from nitrous for rational though to return. And it will return. After hours of sobriety, the person becomes more like themself. And after several days they may be fully themselves. The question is how to get them there. Things that can work:
- Staying with a friend or family member. Is there somewhere they can stay for days or weeks where they can't use or access nitrous?
- Giving up control of their money and maybe their phone. Are they willing to give their wallet and all forms of payment to someone else? How about their phone and laptop? This is a very big step. Forcing it will probably just generate resistance. But if they're really willing to quit, this is a huge temporary help.
- Telling smoke shops not to sell to them. One of the best things possible is for your friend to go to smoke shops in their area and tell those smoke shops not to sell to them. Can you talk your friend or family member into doing this? Can you offer to go with them to these smoke shops to bolster their willpower?
- Detox, hospital, or inpatient rehab. If none of the above work or are viable, they may need to go to the hospital or an inpatient rehab facility. You or their other loved ones can help them by researching the options and presenting them to your friend. Just bear in mind that while this works as a temporary break, many addicts relapse immediately after leaving the hospital or inpatient. This isn't a cure. It's a pause to let them collect their thoughts and plan for the future. The home situation they return to must be different than the one they left, or they will relapse and the inpatient trip will be wasted.
  
  Your loved one needs you most just before and just after they leave inpatient treatment. There is no other time so vulnerable and yet so amenable to help as just when they are leaving inpatient and returning to the real world. Many friends and loved ones throw themselves into attempting to help during a binge or other active usage, but your ability to change anything is quite limited in that period. You have the most ability to help during your friend's periods of sobriety, and a period immediately after the end of inpatient treatment or any other major change is a period when they're at very high risk of rehab. If you can be there for them and make sure that they have support, companionship, and accountability, you have a chance of making a difference.
Longer Term Help.

Connection, community, and love. The opposite of addiction is connection. Your friend probably feels incredibly isolated. The more that you can help them by letting them know that you love them, by spending time with them, and helping them connect with others, the better. Healthy sober activities together are particularly great. You have far more ability to positive impact your loved one through actions that you take during their spells of sobriety, and particularly time and affection spent in these periods, than by anything you do during their active usage.

Psychedelic treatment. This may be controversial, but excellent results are being achieved in sobriety with psychedelic treatments, specifically psilocybin. There are psilocybin retreats in Mexico and in Oregon. They cost money, but are much cheaper than inpatient rehab and can dramatically reset someone's relationship to themselves and to their addiction.

Meetings and/or an Intensive Outpatient. We have nnitrous-specific recovery meetings, online, almost daily. Your friend can connect with other people who've suffered or are fighting an addiction to nitrous oxide there. In addition, many addicts find help in AA or NA. Others who don't enjoy AA or NA have found that they connect well with buddhist-themed recovery meetings (Refuge Recovery or Recovery Dharma) or secular approaches like SMART Recovery. Can you encourage your friend to go to such things? Would you attend with them, in person or online? The other option is an Intensive Outpatient Program (IOP) which will comprise anywhere from 6-12 hours a week while living at home (or with friends or family). Studies find that IOPs are just as effective as inpatient rehab, while disrupting life less and costing a fraction as much.