How many balloons are too many? We asked an expert how bad NOS actually is for you

Ah, the humble NOS balloon, kind of illegal but not really, and the seventh most popular drug in the world.

Our own National Drug Survey earlier this year showed that 74 per cent of Manchester students and a whopping 82 per cent of UWE balloon connoisseurs are regularly huffing away.

But how does laughing gas actually work? How bad is it for your health? And how many balloons can you do before your brain starts melting and falling out of your ears?

These are all valid questions that need to be answered, so we asked Dr Adam Winstock of the Global Drug Survey to explain everything we need to know about NOS.

What is it about NOS that gets you high?

When inhaled, nitrous oxide acts in a similar way to ketamine. This explains some of its pain-relieving effects. Inhalation of nitrous oxide produces a very short lived but intense euphoria which at higher doses can evolve with psychedelic effects including feelings of dissociation and mild changes in perception of body image. It can enhance the effects of other drugs, especially when used with with alcohol, MDMA and psychedelics being most common.

What are the main risks when taking NOS?

There are reports that cheap whipped cream bulbs imported from China leave an oily residue when the gas evaporates – probably making them unfit to dispense cream let alone to inhale. So, if you are going to inhale, try accessing your gas from a quality supplier.

Accidental injury, fainting, nausea and hallucinations are quite common, especially if you take one hit after another, so make sure you're sitting down to avoid injuring yourself.

Death is very rare, about one a year in the UK over the last 40 years, typically from asphyxiation, with the risk increased if a bag is used over the head or nitrous is used within an enclosed space.

NOS also binds to haemoglobin more tightly than oxygen so people can in effect suffocate if they keep using one bulb after the other.

Those in Australia seem to have preference for direct inhalation from the whipped cream dispenser itself. It’s really important not to spray the gas directly into the mouth from those silver bullets because the gas comes out super cold and could cause a cryo-burn, or even worse, send your heart into an abnormal rhythm by stimulating your vagus nerve at the back of your throat.

Most people use the drug sparingly, using five to ten hits in a day. Some go way over that, with five per cent (depending on the country) reporting 25-49 bulbs in a session.

Is there a ‘safe’ level that you can do without it causing long term effects?

Used in a safe environment (away from roads and rivers for example), and at a dose of a few balloons or bullets every so often, is pretty safe.

Try not to use more than five balloons in a session and leave several minutes between each hit. Also, give yourself breaks between each NOS session to refill those vitamin stores. Animal protein (beef and fish in particular), eggs, and cheese are good sources of B12. Fortified soy products and supplements can be used by vegetarians. And Marmite!

What are the long term effects of doing NOS regularly? Are there any negative effects on long-term health?

Long-term heavy use does seem to prompt health worries in some users, with about three per cent of our sample being very worried about the impact on their physical and mental health.

Most notably, around one in 20 people reported persistent numbness and tingling lasting days or weeks after their last use of NOS. This is a worry because existing research suggests that heavy use of nitrous can lead to a nerve condition called a peripheral neuropathy with tingling, numbness and weakness in the arms and legs due to inactivation of vitamin B12 (which can also cause anaemia because there's not enough working red blood cells).

Also, almost one in ten users expressed worry about the effects on their mental or physical health and two and a half per cent thought their use was out of control.

More articles recommended by this author:

– How laughing gas became our favourite drug

– 'No dosh, no NOS': Interview with a laughing gas dealer

– What combining certain drugs actually does to your body