Key Takeaways
- The FDA has advised consumers not to inhale nitrous oxide products, including flavored canisters sold online and in smoke shops, gas stations, and vape shops.
- Nitrous oxide inactivates a vitamin B12 dependent enzyme, and repeated use can damage the spinal cord and nerves even when diet is normal.
- Early warning signs include numbness or tingling in the hands and feet, leg weakness, unsteady walking, and changes in mood or memory.
- A standard B12 test can sometimes look normal in people with nitrous oxide nerve damage, so it helps to tell a doctor about the use directly.
- Treatment combines medical care, including stopping use and B12 replacement under a doctor, with therapy for the pattern of use and any co-occurring conditions.
Nitrous oxide has a harmless reputation. It is the gas in whipped cream chargers and the “laughing gas” at the dentist. But the large, brightly colored, flavored canisters now sold in smoke shops and online are not being bought for dessert, and the FDA has warned consumers not to inhale them. Nitrous oxide misuse can cause something many young adults have never heard of: nerve and spinal cord damage tied to vitamin B12. This guide explains how that happens, the warning signs, and what treatment looks like when occasional use has become a habit.
Many people who use nitrous oxide do not think of it as a drug at all. That is part of the problem. It is legal to buy for culinary use, marketed with candy flavors, and its high lasts only moments, so frequent use can add up quickly without anyone noticing how much is being inhaled.
Nitrous oxide misuse, defined: inhaling nitrous oxide gas for its brief euphoric or dissociative effect, usually from whipped cream chargers (“whippets”), balloons, or larger canisters and tanks. Medical nitrous oxide is given in controlled doses mixed with oxygen; recreational use has neither safeguard.
Why Flavored Nitrous Canisters Caught Regulators’ Attention
In March 2025 the FDA advised consumers not to inhale nitrous oxide products and updated that warning in June 2025. The agency described canisters, tanks, and chargers marketed as food propellants, some flavored, sold online and at smoke shops, vape shops, and gas stations, and it named brands including Galaxy Gas. The FDA said it had seen an increase in adverse event reports.
The harms are not limited to rare cases. Researchers at the University of Mississippi and the University of Illinois, citing CDC data, reported that deaths attributed to nitrous oxide poisoning rose by more than 110 percent between 2019 and 2023. Deaths remain far fewer than for opioids or alcohol, but the direction is concerning, and the injuries that do not kill can still change a life.
How Nitrous Oxide Causes B12 and Nerve Damage
Vitamin B12 is essential for maintaining the protective coating around nerves in the spinal cord and peripheral nerves. Nitrous oxide inactivates a B12-dependent enzyme called methionine synthase. With repeated exposure, the body effectively loses the use of its B12, even if diet is normal.
The result can be a condition clinicians call subacute combined degeneration, damage to the spinal cord’s sensory and motor pathways, along with peripheral nerve damage. The FDA lists B12 deficiency, limb weakness, paralysis, and spinal cord or brain damage among the harms of inhaling nitrous oxide, and notes that neurological effects can persist even after someone stops.
A practical point for families: a standard B12 blood test can sometimes look normal in people with nitrous oxide nerve damage. Published research has found elevated homocysteine and characteristic spinal cord changes on MRI in these patients. That is why it helps to tell a doctor directly about nitrous oxide use rather than waiting for a test to find it.
How harm develops
From occasional use to nerve damage
A general pattern described in medical reports. Not everyone follows it, and serious harm can occur at any point.
Occasional use
Brief euphoria, dizziness, and risk of fainting, falls, or frostbite from cold gas.
Frequent or heavy use
B12 function is disrupted. Early signs can include tingling or numbness in the hands and feet.
Ongoing use
Unsteady walking, weakness in the legs, and trouble sensing where the feet are, signs of spinal cord involvement.
After stopping
Many people improve with medical treatment, but some nerve damage can be lasting.
Educational summary based on FDA warnings and published case reports. Anyone with numbness, weakness, or balance problems after nitrous oxide use should see a physician promptly.
Whippets Side Effects and Warning Signs
Beyond nerve damage, the FDA lists loss of consciousness, blood clots, frostbite, psychiatric disturbances, and, in some cases, death. Inhaling directly from a canister or tank can cause cold injury to the lips, mouth, and airway, and using in a car or while standing raises the risk of serious accidents.
Signs that a loved one may be misusing nitrous oxide include:
- Empty chargers, large canisters, or balloons found in a car, room, or trash
- Frequent purchases from smoke shops or online sellers of flavored canisters
- Numbness or tingling in the hands or feet, or new clumsiness and stumbling
- Complaints of leg weakness or trouble walking, especially in the dark
- Changes in mood, memory, or concentration, or unusual confusion
Confidential Substance Use Help
Noticing these signs?
A medical visit comes first for nerve symptoms, and a confidential assessment can help with the use itself.
Is Nitrous Oxide Addictive?
Nitrous oxide does not usually produce the kind of physical withdrawal seen with opioids or alcohol, but people can develop a compulsive pattern of use. The effect is brief, so people repeat it many times in a session. Sessions become more frequent. Money, time, and attention shift toward it, and use continues even after physical symptoms appear. Those are the features of a substance use problem, whatever the substance.
Nitrous oxide also tends to show up alongside other substances, often at parties or in combination with alcohol or cannabis. If that sounds familiar, our guides on polysubstance use and nicotine and vaping recovery may help, since many of the same retail channels and habits overlap.
Nitrous Oxide Misuse Treatment
Treatment has two tracks that should run together.
- Medical care. Anyone with numbness, weakness, balance problems, or memory changes should see a physician and mention nitrous oxide use specifically. Medical treatment typically includes stopping nitrous oxide and replacing B12 under a doctor’s care. Earlier treatment generally offers the best chance of recovery.
- Behavioral treatment. No medication is specifically approved to treat nitrous oxide use, so care centers on therapy. Cognitive behavioral therapy helps identify triggers and build alternatives, and treatment for co-occurring anxiety, depression, or ADHD can reduce the pull to use.
For young adults especially, family involvement helps. Parents and partners often notice the empty canisters long before the person using is ready to talk, and learning how to raise the subject without a fight can make the next conversation more productive.
How Heights Can Help
Heights Behavioral Health is an outpatient practice in the Houston Heights serving adults. We do not provide medical or neurological care, so anyone with nerve symptoms should see a physician first, and we are glad to coordinate with medical providers. Our substance use treatment includes clinical assessment, individual therapy, group therapy, intensive outpatient programs with evening options, and family programming, along with care for co-occurring mental health conditions.
Crisis notice. If someone loses consciousness, has trouble breathing, or is seriously injured after inhaling nitrous oxide, call 911. For poisoning questions, call Poison Help at 1-800-222-1222. Heights Behavioral Health provides scheduled outpatient care and is not an emergency service. If you are in crisis, call or text 988.
Frequently Asked Questions
Can whippets cause permanent nerve damage?
They can. The FDA warns that neurological effects, including spinal cord damage, can persist after someone stops. Many people improve with prompt treatment, but some damage may be lasting.
Why does nitrous oxide affect vitamin B12?
Nitrous oxide inactivates an enzyme that depends on B12. With repeated use, the body cannot use its B12 properly, which can damage nerves and the spinal cord.
Is Galaxy Gas legal?
Nitrous oxide is sold legally as a food propellant, but the FDA has advised consumers not to inhale these products. State and local rules vary and have been changing.
What should I do if my adult child is using whippets?
If they have numbness, weakness, or trouble walking, get a medical evaluation first. Then talk calmly about the use and consider a professional assessment to understand what is driving it.
Sources
- U.S. Food and Drug Administration. FDA Advises Consumers Not to Inhale Nitrous Oxide Products. fda.gov
- University of Mississippi. Researchers Concerned About Rise in Nitrous Oxide Misuse, Deaths. olemiss.edu
- Frontiers in Neurology. Elucidating Unique Axonal Dysfunction Between Nitrous Oxide Abuse and Vitamin B12 Deficiency. frontiersin.org
Written and Reviewed by Licensed Clinicians
Joni Ogle is a Licensed Clinical Social Worker (LCSW) and Certified Sex Addiction Therapist (CSAT) with over 37 years of clinical experience in mental health and addiction recovery, dual diagnosis treatment, behavioral addictions, and family intervention. She is the founder of Heights Behavioral Health and Heights Mentoring in Houston, Texas, where she leads a team of licensed clinicians.
Texas LCSW #37376 · Verify license
Deborah Darnell-Drake, LCSW-S, ACSW, LMFT is the Chief Clinical Officer at Heights Behavioral Health and a clinical reviewer. With more than five decades of experience in mental health and substance use disorder treatment, Deborah specializes in addiction, co-occurring mental health conditions, family dynamics, and behavioral addictions including gambling and technology addiction.
Texas LCSW-S #14508 · LMFT #1125 · Verify license
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