"Abuse" is such a vague term. For context, the amount is 100+ canisters/day

> Most patients also had psychiatric symptoms. Nearly every patient estimated using 100 or more canisters of nitrous oxide per day in the months before being seen. Four patients also reported engaging in B12 supplementation (both oral and parenteral), aiming to circumvent the harmful sequelae of prolonged nitrous oxide misuse.

100 chargers is not an enormous amount. That’s two normal sized boxes and when each one gets you high for 20 seconds it’s not hard to understand how you can rip through a box. Not trying to be dramatic here, I don’t consider people doing a couple whippets at a festival a public health issue, but from a harm reduction perspective the difference between occasional bouts and regular use of nitrous is somewhat distinct compared to other drugs.