There are at least 50 million people in the United States that suffer from chronic sinus problems. For some it means a continually runny nose, while for others it means constant nasal congestion.
The constant sinus problems, also know as sinusitis, can cause difficulty breathing, headaches, bad breath, and sleepless nights. Compounding this problem is the fact that chronic sinusitis is difficult to treat. Symptoms frequently continue to occur despite antibiotics and steroid treatment.
Sufferers frequently become frustrated with their symptoms and turn to over-the-counter (OTC) nasal sprays. These sprays are meant only for short-term use of about 3-4 days. Unfortunately, chronic sinusitis patients will continue to use the OTC nasal sprays indefinitely due to the severity of rebound congestion.
OTC nasal sprays use active ingredients like oxymetazoline, phenylephrine, and xylometazoline. Nasal congestion occurs when blood vessels in the nasal passages dilate. The nasal sprays’ active ingredients help to constrict those blood vessels, decreasing congestion.
The problem occurs when the nasal vessels no longer constrict with the recommended dosage of the active ingredient, and the sinusitis sufferer needs more frequent doses to keep symptoms at bay.
What’s worse is when sinusitis sufferers abruptly stop using these OTC sprays, the congestion comes back sometimes even worse than it was when they first started using the product. It often takes several days to a couple weeks for the nasal passages to adjust to not using the nasal spray.
This is where the idea of a nasal spray addiction is questioned. It is not a true addiction because there is no physiological need formed in the brain for nasal spray ingredients. Truly addictive drugs like cocaine and heroin cause an actual chemical change in the brain that causes the user’s body to absolutely need the drug. Nasal sprays do not have this affect.
The idea of addiction with nasal sprays is merely a comfort issue. Stopping the nasal spray abruptly causes discomfort due to increased congestion, so users do not want to stop using it. However, stopping the nasal spray is not harmful to your health, and you will not go through any physical withdrawal symptoms as you would with an actual addictive drug.
Also lending to the idea of addiction is the build-up of a tolerance to the sprays’ effects causing the user to need the spray more and more frequently. However, unlike a true addiction, the tolerance can be completely reversed. If you stop using the nasal spray for several weeks, you could go back to the recommended dosage and it will work just as it should.
Long-term use of nasal sprays can cause rhinitis medicamentosa (RM). This is the medical term for rebound nasal congestion that is worse after stopping the nasal spray than it was when the nasal spray was first started. Treatment for RM includes stopping all use of nasal sprays. The patient is then treated with steroids, systemic decongestants, and antihistamines. In some patients sedation, steroid injection, or surgery is required. Some patients also claim nose bleeds as a side effect of long-term use.
If you are having difficulty with sinusitis or stopping the use of OTC nasal sprays, please see your primary physician, allergist, or ear, nose, and throat (ENT) specialist immediately. There are other options available to help relieve your symptoms.
If you notice that you are needing to use your nasal spray more frequently than the package recommends, stop using the nasal spray immediately. If the rebound congestion is too much for you to handle, contact your physician immediately. Do not go back to using the nasal spray.
