In 2020, during the COVID-19 pandemic, Virginia Barbatti moved with her family to Martha’s Vineyard full time.
It’s an idyllic beach island off the coast of Massachusetts, a summer retreat for presidents from Ulysses S. Grant to Barack Obama.
In the evenings, around dinnertime, deer roamed Barbatti’s yard. “That was really exciting for us when we first moved here,” Barbatti says. “It felt like we were connecting with nature and the outdoors.”
Fast-forward a few years, and Barbatti’s feelings have changed. “Knowing that there are thousands of ticks potentially on a deer as they’re walking through your yard, and they’re dropping and moving them across the landscape — it really starts to shift perspective.” She’s now director of a nonprofit, started in December 2025, called Tick Free Martha’s Vineyard.
Barbatti’s island haven is plagued with ticks — small arachnid parasites that live in the grass and woods, hitch rides on roaming animals and drink their blood.
When some types of ticks bite humans, they can provoke life-threatening allergies to red meat. Others can transmit bacteria that cause Lyme or other diseases.
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The months of May and June are, unfortunately, primetime for them. “According to our Tick Bite Tracker, ticks are out everywhere,” says Alison Hinckley, epidemiologist and Lyme disease expert with the Centers for Disease Control and Prevention. “We’ve seen a real uptick in areas where Lyme disease occurs.”
Almost all Lyme disease cases come from the Northeast, Mid-Atlantic and Upper Midwest, Hinckley says.
While it won’t be clear how this tick season compares with others until it’s over, it’s shaping up to be among the top three in the past decade, Hinckley says: “So it’s an important time to watch out for tick bites.”
Deer diary
The rise of tick bites and their diseases came with the resurgence of white-tailed deer, especially in the Northeast.
A hundred years ago, the white-tailed deer population was nearly wiped out in the region, says Lea Hamner, an epidemiologist focused on tickborne diseases. Many celebrated their return to the forests as a success for conservation efforts. Now, “we’ve overshot that comeback story significantly,” she says.
Hamner works with the Martha’s Vineyard Tick Program, an initiative of the local government. The island has an average of more than 50 deer per square mile — three to four times what state wildlife officials recommend.
Excess deer can damage forests by overforaging and increase the risk of collisions with cars. They also help grow tick populations. While ticks feed on various mammals and birds, they often find their mates crawling around on the broadside of a deer. “We like to call them the party bus or the singles bar for ticks,” Hamner says.
The ticks drop off the deer and lay eggs, wherever the deer roam. So more deer means more ticks.
For decades, it was deer ticks. Parasites that can transmit bacteria that cause Lyme disease.
Then, in 2011, the lone star tick moved up from the Southeast — probably on the backs of migrating birds. Their appearance sparked a new wave of panic, Hamner says.
Lone star tick bites are itchier and more unpleasant than deer tick bites, and they can gather in what Hamner calls a “tick bomb”: “When they’re babies, they stick together and they get on you all at once. They’re very, very small. But to have hundreds of tiny ticks on you is terrifying,” she says.
Then, there’s the alpha-gal syndrome. Lone star ticks have a sugar in their saliva that can cause life-threatening allergies to certain foods. “Red meat, mammalian meat, is the common denominator,” Hamner says. “Less people are also reactive to dairy products, which come from mammals as well.” Some also develop sensitivities to gelatin capsules used in medicines, and certain soaps and shampoos.
On Martha’s Vineyard, local chefs are trying to offer alpha-gal friendly food options, piecing their new menus together from the internet. “They don’t want to be armed with Google,” Hamner says. “I literally had a restaurant ask me, ‘Is there something better? Because I feel like this is not good enough for me just to be Googling to protect my patrons from having an allergic reaction.'”
Right now, there isn’t. The science and regulatory requirements are still catching up.
The ticks’ slow march
A few years after lone star ticks arrived on Martha’s Vineyard island, they came ashore to mainland Cape Cod — probably also on birds.
“The risk of developing an alpha-gal allergy is not consistent across all of the state,” says Catherine Brown, state epidemiologist at the Massachusetts Department of Public Health.
In April, the state became the 14th jurisdiction to require cases of alpha-gal syndrome to be reported, Brown says, in an attempt to track where the risks are high and where the condition is emerging.
In a cozy office space in South Yarmouth, Mass., where the walls are covered in posters of beetles and butterflies, Escher Cattle keeps his tick collection. He’s an entomologist and tick educator for the Cape Cod Cooperative Extension program in Barnstable County, which covers Cape Cod.
He pulls out glass vials with ticks preserved in alcohol. Some are from a nearby farm. The ticks are small — ranging from the size of a poppy seed to a sesame seed, depending on their life stage.
For someone who goes looking for ticks, Cattle has a good track record: “I’ve only gotten bit by ticks once in my time here so far,” he says.
His main tips are to pretreat outdoor clothing, starting with shoes, socks and pants, with an insecticide called permethrin, to wear EPA-approved insect repellent on exposed skin and to do a full-body tick check after you’ve walked through potential tick habitat. “Get really familiar with your different raised moles and everything so that you can really tell if a tick has attached to you,” he says.
Getting ticks off quickly lowers your chances of getting disease.
Beyond personal measures
Public health leaders say the onus can’t just be on individuals.
“Some people are very good about paying attention and doing the tick checks and using repellent,” says Brown with the state of Massachusetts. “But at the same time, we’ve continued to see the number of tickborne diseases, the types of diseases, and the numbers [of tick bites] generally increasing.”
In the near future, she hopes that a Lyme disease vaccine, developed by Pfizer, will be effective at preventing Lyme disease and approved by federal regulators. “It’s not a solution to the tick problem, but it could be an important tool to help reduce the most common tickborne diseases,” she says.
In the long term, she hopes researchers can figure out how to reduce tick populations.
But research on tick control lags behind mosquito control by decades. “We’ve been studying mosquitoes as a disease vector since the 1900s, so we know a lot of different things about what works on them,” Cattle, with Barnstable County, points out. “But for ticks, we’ve only really been studying them in this kind of capacity since the 1980s,” when the bacterium that causes Lyme disease was identified.
In the past few decades, researchers have tried multiple strategies, says Stephen Rich, executive director for the New England Center of Excellence in Vector-borne Diseases (NEWVEC) at UMass Amherst.
“We’ve tried spraying ticks on the yard, we’ve tried treating ourselves and even tried making nest boxes for mice where the mice can go and get treated. Nothing has worked the way we want it,” he says. They haven’t made big dents in the tick population or the number of tick bites people get.
Rich is adapting an idea from an oral medicine that protects pets, by making their blood toxic to fleas and ticks, for deer. “There’s some tricks to that,” he says. “There’s differences in the digestive system of white-tailed deer versus dogs and cats. And there’s also the fact that these are game animals, so they have to be treated as a food source.”
In New York City, Staten Island is trying a different solution for deer: controlling the population by sterilizing them. “Every male — or at least most of them — have had vasectomies,” says Maria Diuk-Wasser, a professor in the department of ecology, evolution and environmental biology at Columbia University who tracks tickborne diseases.
The bucks are tranquilized and sterilized in the procedure. She says they’re even watching for new deer coming in from New Jersey, to give them vasectomies too.
The project, which started in 2016, appears to be stabilizing the population. Very few new babies are born, “but the deer can live many years, so it’s not yet a drastic decline overall,” Diuk-Wasser says.
In late May, U.S. Health Secretary Robert F. Kennedy Jr. announced new federal investments in preventing, diagnosing and treating tickborne diseases.

Rail-thin and hiding under a fake beard, a former Army intelligence analyst walked into a Medford pharmacy 15 years ago Friday, fatally shot all four people inside, but stole neither the cash in the register nor the valuables on the dead. Instead, he stuffed his backpack with thousands of addictive painkillers and walked out.
That pharmacy, Haven Drugs, has since moved to another Medford strip mall. The killer and his getaway driver, also his wife, spend their days and nights in maximum security prisons.
A Queens painkiller clinic operator, who had illegally prescribed the killer more than 2,500 oxycodone and other pain pills, was convicted and died in state prison.
New legislation, including tighter restrictions on access to prescription opioids, stepped-up law enforcement and a heightened awareness of opioids on Long Island and across the country also followed the robbery. As for Long Island overdose deaths, they have fallen in recent years.
A senseless tragedy
For James Manzella, the violent scene he walked into on June 19, 2011, seemed so senseless. He spotted the killer, David Laffer, leaving Haven Drugs that Sunday morning, felt something was suspicious and exited his vehicle. Inside the mom-and-pop pharmacy, he found his fiancee, Jaime Taccetta, dead, along with another customer, a pharmacist and a clerk.
“I have no mercy for that guy,” Manzella, 51, of Farmingville, told Newsday, referring to Laffer.
“The guy could have robbed the store, left everybody intact and got a slap on the wrist. … Maybe he would have got caught, maybe he wouldn’t have, but at least four people would have walked away with their lives.”
New York City Special Narcotics Prosecutor Bridget Brennan, who prosecuted Dr. Stan Li, a pain management specialist, for illegally prescribing narcotics to Laffer, told Newsday the Medford killings signaled a new brazenness rarely seen among pharmacy hold-ups.
“This was by far the boldest one that I recall seeing,” Brennan said, adding it was “clearly planned.”
“He was in and out relatively quickly and just fired the shots and killed people,” Brennan said. “It caught a lot of people’s attention and so I’m sure that it helped move some of the efforts to try to get this under control forward.”
In 2011, before the pharmacy killings, Brennan’s office established a Prescription Drug Investigation Unit. Investigators learned that Li, who treated Laffer for pain, was among several physicians doling out a “significant” number of oxycodone and hydromorphone scripts compared to years prior, she said.
It was a time when patients cut off from their opioids, “went to drastic means in order to get prescriptions to not be sick,” Dr. Jarid Pachter, who practices addiction medicine through the Stony Brook Medicine-affiliated Southold Family Medicine, told Newsday.
Other addiction specialists familiar with the case said it marked a “boiling point” of the opioid crisis.
“People began to understand this was an issue for the larger society,” said Jeffrey Reynolds, president and chief executive of the Family & Children’s Association, a Garden-City based nonprofit that provides help for substance use among other services.
“When people are walking around sick and desperate, that has implications for the entire community,” Reynolds said. “This now was seen as a public health crisis that can affect anybody on an average Sunday morning.”
At point-blank range
Laffer, a 1995 Patchogue-Medford High School graduate and former Army private who worked in intelligence, had lost his clerk job two weeks before the pharmacy killings.
At point-blank range, according to a Newsday story at the time, he executed pharmacist Raymond Ferguson, 45, of Centereach; store clerk Jennifer Mejia, 17, of Medford; customer Bryon Sheffield, 71, also of Medford; and Taccetta, 33, of Farmingville.
Ferguson was covering a shift so another pharmacist could celebrate Father’s Day with his family.
Mejia was buried with the high school diploma she would have received on her graduation day. Sheffield was picking up a prescription for his wife of nearly half a century. Taccetta, a mother of two, was also picking up a prescription. She was buried in her wedding dress.
Then-Suffolk County Police Commissioner Richard Dormer described the scene as “one of the most heinous, brutal crimes we’ve ever experienced.”
A three-day search — fueled by phone tips, a fingerprint Laffer left on a piece of paper at the pharmacy and even help from Brennan’s office — culminated in a successful raid at his Medford home on Pitchpine Place.
Laffer, 48, pleaded guilty to first-degree murder and is serving a life sentence at the Elmira Correctional Facility with no chance for parole. His wife, Melinda Brady, 44, pleaded guilty to robbery and is serving 25 years at the Bedford Hills Correctional Facility. She could be released as early as 2032 following an appearance before the parole board, according to corrections department records.
Spotlight on the crisis
Laffer, and the havoc unleashed by his .45 caliber pistol, “absolutely” raised awareness that opioid addiction was a public health crisis, said Ann-Marie Foster, president and CEO of Phoenix House, which helps Long Islanders and New York City residents with addictions overcome them.
“When you’re addicted like that, your body is craving it, and you’ll do all sorts of things to get it,” Foster said. “It was a wake-up call.”
Newsday reported that Laffer and Brady had been prescribed almost 12,000 pain pills from various doctors in the four years preceding the Haven Drugs hold-up, including more than 2,500 from Li, whom Brennan later prosecuted. During that same time, robberies at pharmacies in which addictive painkillers were stolen were on the rise on the Island and across the country.
The day after the Medford homicides, Brennan said her office investigated whether any of Li’s patients ever filled prescriptions at Haven Drugs. Two did: Laffer and Brady. That information was passed along to the Suffolk District Attorney’s Office, which helped build the case against the couple, Newsday previously reported.
Li was eventually arrested, charged and convicted on two counts of manslaughter, six counts of criminal endangerment and 180 counts of illegal sales of prescriptions for controlled substances, including selling to Laffer. Li was sentenced to up to 20 years in prison in 2014. He died in 2020 at Fishkill Correctional Facility in Beacon, according to the state corrections department.
Significant legislation
Advocates for substance abuse treatment told Newsday the most significant state legislation aimed at restricting opioids since the killings was the Internet System for Tracking Over-Prescribing Act, known as I-STOP. The law requires medical providers to check a state-created system for their patients’ histories of receiving prescriptions for controlled substances.
As a result, Pachter said, “I never get patients coming in specifically for these prescriptions anymore.”
When physicians consult the prescription monitoring program and catch a patient “doctor shopping,” or getting addictive pills from various providers, Pachter said, they should “do a more thorough investigation” before deciding the best care to offer.
“If that person has opioid use disorder, then you discuss treatment for that as opposed to something that could enable the addiction or make them worse,” he said.
To further restrict the prescription opioid supply, in 2016, doctors were barred from writing scripts by hand.
“Prescription pads were being stolen,” Brennan said. “Sometimes the pads or the paper was sold rather than prescriptions or pills.”
Memories never fade
Manzella, the first to enter that scene and who testified against Laffer, said that while he never married after the death of Taccetta, he chose “to not let one man basically ruin my life.”
“Me and my friends and my family, we all have good memories of her,” he said of Taccetta. “We had good times. She was a wonderful woman, an unbelievable mom. … I got to go forward in some way, shape or form. I had no choice. But you can never get back what those people took from everybody.”
To this day, Manzella said he still feels for the other families who were forever changed on that Father’s Day.
For Lesly Gonzalez and her family, she said “even though time has passed, a part of us has frozen in time.” Gonzalez was 16 when Mejia, her older sister, was killed in a manner “that’s so sudden and so violent,” Mejia’s job at Haven Drugs helped her earn money to send to her grandmother in El Salvador and others in need there.
“People always ask me, ‘do you have any siblings?’ I always mention her,” Gonzalez, 31, of East Patchogue, said. “I’m like ‘yes I do,’ but then I have to tell them, and it’s something that becomes a part of you. You learn to live with the pain of losing someone and you don’t forget them. You don’t just move on from something like that.”
In recent years, experts said the state invested into local nonprofits; police departments continued to not only seize drugs, but introduce communities to the opioid overdose-reversal nasal spray naloxone, more commonly known as Narcan; and opioid settlement funds made treatment more widespread. But there was “a lag time” between the crackdown on the pill problem and the bolstering of treatment, substance use advocate Reynolds said.
“If the state had created that treatment availability at the very same time it restricted the supply, we might have seen a faster resolution, we might have seen fewer overdose fatalities,” Reynolds added. “There was a shortage on the street, the price of prescription pills went up, people turned to heroin, to fentanyl, to other drugs. … Now we’ve resolved some of that because treatment availability is far better than it’s ever been in Long Island’s history, but it’s probably still not enough.”

Health and Human Services (HHS) Secretary Robert F. Kennedy Jr.’s latest cause, outside of losing fights to snakes, is centered around Lyme disease and ticks.
In late May, RFK Jr. and HHS announced a “sweeping” plan to tackle Lyme and other tickborne illnesses. Though the plan does have some solid aspects, such as increased research funding, others are based on conspiratorial and unsupported beliefs about the disease—namely the idea that Lyme is routinely causing chronic infections that can’t be treated with conventional antibiotics and are being ignored by most doctors.
“Tickborne infections, including Lyme, are a real and growing public health problem, so some might view this move by HHS as a step in the right direction even if they disagree with Kennedy on other issues. But it’s the exact opposite—it is yet another love letter to medical pseudoscience and conspiracism from RFK Jr.,” Adam Gaffney, a critical care and pulmonary physician as well as a former president of the Physicians for a National Health Program, told Gizmodo.
Why ‘chronic Lyme’ is on shaky ground
Lyme disease is caused by certain Borrelia bacteria, which are transmitted by various species of tick. In the U.S., Lyme is usually caused by B. burgdorferi and is typically transmitted through the bites of female blacklegged, or deer, ticks (Ixodes scapularis).
In most cases, a simple 2- to 4-week course of oral antibiotics can clear a Lyme infection, especially the earlier it’s caught. Infections that go unnoticed for too long can cause more severe illness but are still curable with prolonged antibiotic therapy. That said, a small percentage of people with Lyme, perhaps around 10%, will develop lingering fatigue and other symptoms that can last months after treatment.
This condition is formally known as post-treatment Lyme disease syndrome. Its cause isn’t entirely clear, but it might be linked to immune dysfunction sparked by the infection or an immune response to inert remnants of the bacteria. Some people, however, strongly believe these cases are actually the result of a persistent infection that never went away, a.k.a. chronic Lyme disease.
The symptoms that people with PTLDS experience are certainly real, but there isn’t strong evidence that its root cause is usually a chronic infection. Several trials have failed to find that a lengthy course of antibiotics (up to three months) can improve symptoms of PTLDS or people’s quality of life relative to a placebo, for instance. Some research has also found that a majority of people with long-term symptoms attributed to Lyme have no sign of an active infection and that many people’s symptoms could be better explained by other known conditions.
Of course, chronic Lyme advocates have soundly rejected this evidence and constructed elaborate rationales to justify their belief. These advocates include “Lyme-literate” doctors and alternative medicine practitioners who might ignore a patient’s negative results on standard tests or use unproven tests to detect supposedly hidden infections; they also prescribe long-term antibiotics or other unconventional treatments for the condition.
RFK Jr. is no stranger to supporting all sorts of dubious beliefs, such as the notion that Lyme disease was created as a military bioweapon (it wasn’t), and his new plan certainly appears intended to boost the chronic Lyme community.
RFK Jr., the Lyme warrior
Last December, for instance, Kennedy claimed that former top government officials denied the existence of Lyme—a jab that wouldn’t make much sense unless it was about chronic Lyme. At a New Hampshire event in late May touting the new initiative, he similarly claimed that doctors routinely tell patients that there’s “no such thing as Lyme disease.” And when asked by members of the media about the skepticism many in the medical community have about chronic Lyme, he responded that this perception will soon change.
“The idea that the government has been ‘denying’ the existence of Lyme is baseless conspiracism that has been around for decades,” Gaffney said. “Kennedy is not talking about Lyme disease—he is talking about so-called ‘chronic Lyme’—and accepting a long-standing perspective of the infection rejected by mainstream medicine but embraced by some activist communities.”
These comments aside, some of the ticket items in RFK’s plan are perfectly unobjectionable. HHS and the Centers for Disease Control and Prevention are launching a multimillion-dollar pilot program to find ways to reduce ticks in the wild before they can reach people, for example. HHS is also planning to devote more resources to alpha-gal syndrome, a tickborne condition that causes people to effectively develop an allergy to red meat.
One particular aspect of the new Lyme agenda is plenty concerning, though: a “public-private collaboration to help patients connect with experienced providers.”
HHS is specifically partnering with the International Lyme and Associated Diseases Society (ILADS). The ILADS is an organization that has long endorsed the validity of chronic Lyme, and via its search tool, people can find Lyme-literate medical providers who have signed up for ILADS membership. People can now access that same tool directly through the HHS’ Lyme page.
Chronic Lyme isn’t just a harmless belief. It can lead people to fruitless, even dangerous interventions. Numerous Lyme-literate providers, including ILADS members and officers, have been sanctioned by state medical boards for providing inappropriate treatments to their chronic Lyme patients; some have been prosecuted as a result. A 2017 report from CDC researchers and others detailed at least five cases of people who developed severe bacterial infections and other complications linked to their chronic Lyme care, including one woman who ultimately died of septic shock.
“Studies have shown that many ‘diagnosed’ with chronic Lyme have no evidence of ever having had a Lyme infection, and such patients are often victimized by unscrupulous practitioners pushing unproven therapies,” Gaffney noted.
The care people deserve
RFK Jr. is right about one thing: Lyme disease is a serious and growing public health threat, one that affects roughly half a million Americans every year. And we urgently need new tools to help combat it and other tickborne illnesses.
“The administration’s increased interest in Lyme diagnosis and treatment, and the greater public awareness it is building with this initiative, are welcome developments. Patients and ID physicians have long faced challenges in diagnosing and treating Lyme disease and other tickborne illnesses,” Jeanne Marrazzo, CEO at the Infectious Diseases Society of America (IDSA), told Gizmodo.
At the same time, the IDSA has repeatedly criticized the Trump administration and Kennedy’s job performance, even calling for his resignation last fall following his dismantling of the CDC’s senior leadership. And Marrazzo states that any interventions for Lyme that might emerge from this initiative should be backed by strong data.
“The treatment for any infectious disease must be evidence-based. Public-private partnerships can be an extremely effective tool for public health, but the administration has a responsibility to emphasize those that value and promulgate evidence-based guidance,” she said.
Tellingly, Kennedy has given practically zero attention to one such crucial tool that could be used against Lyme: vaccines. There are several Lyme vaccine candidates in development that have reached clinical trials, not that you would know that from browsing through the HHS’ reformulated Lyme website. The only mention at all on the front page references how experts in “vaccine injury” will help build new guidelines for managing Lyme “infection-associated chronic conditions and illnesses.” RFK Jr., of course, has a long history of spreading misinformation about the safety of vaccines and countless other health-related topics. That said, Kennedy has stated his support for reauthorizing the Kay-Hagan Tick Act, legislation that would help boost vaccine development.
Similarly, even if chronic Lyme isn’t a well-supported diagnosis, the people who claim to have it are still suffering. It is important to study the underpinnings of PTLDS and other post-infectious conditions. We may yet learn new things about how these infections can trigger lingering health issues even after they’re gone, at least in a subset of people, and, from there, potential new treatments.

Dr. Varun Vohra, senior and academic director of the Michigan Poison and Drug Information Center, said the use of nitrous oxide in Michigan is on the rise.
Large canisters of nitrous oxide, also known as whippets, are easily available at gas stations, convenience stores and smoke shops, making them very accessible.
Vohran said the larger cannisters make it easier for people to use more nitrous oxide more frequently, leading to concerning health problems.
The senior and academic director of the Michigan Poison and Drug Information Center told the Detroit Free Press he’s seeing a disturbing trend among otherwise young, healthy people in the state: They’re calling the poison center, 911 or are turning up in hospital emergency departments with numbness and tingling in their hands and feet, and feeling faint or weak.
Some have lost coordination, and others have racing heart rates or blood-clotting problems. Still others report hallucinations, delusions, anxiety and depression.
The mysterious constellation of symptoms isn’t tied to a virus or bacterial infection. Rather, what these people have in common is that they inhaled nitrous oxide, said Dr. Varun Vohra, who also is an associate professor in the department of emergency medicine at Wayne State University School of Medicine.
Large cannisters of nitrous oxide — also known as whippets or laughing gas — are widely available and sold at Michigan gas stations, convenience stores, smoke and vape shops, ranging in size from 2 liters to 6 liters. The big cannisters allow people to inhale the gas in large quantities, taking hits repeatedly from the same cannister.
“These are being marketed to youth via various social media outlets and Reddit forums,” he said, noting that the canisters now come in colorfully decorated packaging and in various flavors aimed at increasing the appeal to recreational drug users looking for a high. “Historically, it’s been thought of as sort of a harmless substance that people just do recreationally at parties or festivals and concerts and whatnot.”
Nitrous oxide gas has approval from the U.S. Food and Drug Administration for use as a pain reliever at dental offices and medical clinics. It’s also used to create the foamy texture in whipped cream, and can boost the horsepower in certain automobiles when it’s added to the fuel intake system.
However, when it’s inhaled — especially in large volumes — it can have dangerous effects on the body, said Vohra, who also is a pharmacologist and clinical toxicologist.
That’s because nitrous oxide can effectively shut off the body’s ability to use the vitamin B12, which can result in a cascade of health problems.
Most commonly, he said, people report numbness and tingling in the extremities, loss of coordination and feeling faint or weak. Some have lost consciousness. Among the cardiovascular problems are stroke-like symptoms, pulmonary embolisms or deep-vein thrombosis.
“All are related to the inactivation of that vitamin B12,” he said, adding that there also is “growing evidence in literature that suggests recreational use of nitrous oxide in younger people can affect the developing brain and reduce cerebral perfusion. That can lead to brain atrophy, and damage to the hippocampus, which is responsible for memory.”
And then there are the neuropsychiatric and psychiatric effects.
“It’s been linked to hallucinations, delusions, mood disorders, depression, anxiety, etc.,” he said. “So, that’s, obviously, a really big cause for concern.”
Rare reports have identified heavy users who’ve so badly damaged their nervous systems, they became paralyzed.
“There are cases out there where patients literally have to relearn how to walk because their nervous system is so badly damaged because of the frequent and chronic use,” Vohra said.
Data from the Michigan Poison and Drug Information Center shows the number of people who had adverse medical effects from using nitrous oxide was nearly five times higher in 2023 than in 2019.
Hospital emergency department visits involving people who used nitrous oxide jumped 757% in that timeframe — from 10 cases in 2019 to 60 in 2023 — and response calls from emergency medical services rose 420%.
In that four-year span, EMS first responders identified 14 deaths with nitrous oxide involvement.
The numbers, he said, are an underestimation: “We’re not capturing every case.”
What complicates data collection, Vohra said, is that there isn’t a simple test to detect the use of nitrous oxide. If a person doesn’t disclose it, their doctors might not recognize the true cause of the symptoms.
“Clinicians who may not be familiar or are just not even thinking about it because it’s not on their radar … are just not picking it up,” Vohra said.
Still, he said, preliminary data from the last 2½ years — from 2024 until May 2026 — shows ongoing increases beyond 2023 levels.
Of the 112 known cases of intentional nitrous oxide use that resulted in injury reported to the state poison center in the last 2.5 years, Vohra said, 48 people were hospitalized. Of them, 10 needed treatment in a hospital intensive care unit.
“We’ve run into patients who have gotten into motor vehicle accidents because of the numbness and tingling,” Vohra said. “So, they can’t actually feel their feet on the brake pedals and the accelerator, which places them and, obviously, other motorists at risk from driving while impaired.”
New state laws were enacted in 2024 to ban the sale of devices specifically designed to help people recreationally inhale nitrous oxide — making it a misdemeanor — and imposed stiffer penalties on those who sell whippets to minors.
But based on the data, it appears as if the ban on the so-called “crackers,” which are used to puncture or pierce the nitrous oxide canisters so the gas can be more easily inhaled, don’t appear to have made much of a difference in the number of incidents involving injuries among whippet users.
The U.S. Food and Drug Administration issued an advisory in 2025, warning consumers not to inhale nitrous oxide products, whether they come from large or small canisters, tanks, or chargers, and whether they are flavored or unflavored.
Some of the brands they’re sold and marketed under include:
Baking Bad
Cloud 9ine
Cosmic Gas
Euro Gas
ExoticWhip
FastGas
Galaxy Gas
Goo Sticks
HOTWHIP
InfusionMax
MassGass
Miami Magic
Monster Gas
NITROX
Whip-it!
Vohra said the state poison center is working to find ways to improve screening and detection of nitrous oxide use when people seek care in medical settings while informing toxicologists and clinicians of the most common symptoms and helping them understand what to look for to spot signs of its use in laboratory testing.
He said he hopes state lawmakers will consider an outright ban on the sale of nitrous oxide cannisters at gas stations, convenience stores and smoke/vape shops. The easy access, he said, makes it too easy for people to buy large quantities of the drug — and use it.
“I think change starts with access and the ease of availability … and tackling what’s right in front of us first,” he said. “It’s affecting our actual local communities right in our backyards. That, to me, is high yield and can make a pretty significant impact.”

What’s worse than spreading a disease? Not even realizing when you’re doing it.
Unfortunately, it happens more often than most people think because of simple, everyday behaviors that may seem harmless.
Dr. Bruce Hirsch, MD, an attending physician of infectious diseases at Northwell Health, teveals the super common habits that make him squirm because of their likelihood to spread pathogens.
And while they’re a bad move for anyone, he warns that they’re especially risky for people who are more vulnerable to illness, like those with weakened immune systems and delicate GI tracts.
1. Not washing hands properly before handling food
Washing one’s hands might not come as a surprise, but it’s not just about getting rid of dirt.
The bigger concern is the bacteria you may be carrying without even knowing it. Hirsch explained that while many of those germs don’t make you sick, they can be harmful to someone else.
“Often, a lot of us are colonized with bacteria that we’re getting along with fine but can cause illness in other people,” he told The Post. “If a person is colonized with potentially dangerous bacteria, then that becomes a real issue. Sometimes, it’s not just the bacteria, it’s what the bacteria are doing.”
The fix is simple: Wash your hands thoroughly with soap and running water, creating friction by rubbing them together for at least 10 seconds before rinsing.
And don’t stop there. Hirsch said it’s important to dry your hands with a towel or hand dryer rather than just shaking off the water.
2. Improper sneezing technique
Everybody sneezes. The problem is where those sneezes land.
Many people instinctively sneeze into their hands, which can quickly spread germs to everything they touch afterwards. But your elbow is actually the safest target, Hirsch said.
“You’re supposed to put all the sneeze right in there so that it impacts a spot that never will touch anybody else or anything around you,” he explained.
He advises achooing right inside the bend of the elbow, pulling up your arm and turning away from anyone nearby.
“That way, you’re not putting all this stuff on your hands, which manipulates the area around you,” said Hirsch.
3. Overusing alcohol sanitizer
You can be too clean for your own good.
While hand sanitizer has its place, Hirsch says there are some people who “bathe themselves or their desks in alcohol sanitizer,” an extreme that does more harm than good.
“In medical literature, there’s this concept called the hygiene hypothesis,” Hirsch explained. “[It] states that over keeping the environment super clean has been associated with an increased frequency of allergic conditions such as peanut allergies in kids.”
His views align with a body of research suggesting that exposure to the natural world can benefit both the immune system and the gut microbiome.
“We did not evolve in the presence of alcohol hand- cleansing gel,” he said. “We became what we are in response to an environment that often contained bacteria and germs, and we persevered as a species and evolved as a species anyway.”
4. Shaking hands in a hospital
In most settings, refusing a handshake might come across as rude. But in a hospital, it could be the smarter, safer move.
Hirsch said he values connecting with patients and their loved ones, but a handshake can be especially risky. Hospitals, in particular, are filled with people battling different illnesses and taking different antibiotics, creating a unique environment for germs to run rampant.
“These patients pose a higher risk than seeing people in different types of social settings. In hospitals, it makes sense to avoid unnecessary casual contact,” explained Hirsch. “Let’s tap elbows instead.”
He expressed less concern about by the spread of “the regular poop bugs” in fecal mater than pathogens, such as MRSA, or methicillin-resistant staphylococcus aureus, a prevalent “peculiar bug” he considers one of the biggest offender.
5. People wearing a mask in their chin — not their mouth and nose
A mask can’t do its job if it’s not covering the parts of your face it’s designed to protect.
That may sound obvious, but Hirsch says he still sees plenty of people wearing masks under their noses or dangling from their chins, especially in healthcare settings where respiratory illnesses like the flu and COVID are a concern.
“It’s a very peculiar kind of performative gesture, wearing a mask on your chin or below the nose so that you’re able to breathe out in the atmosphere,” he argued.
“In this case, the mask is not doing any good. And yet, you’re wearing it on your face anyway.”