Can you get addicted to nasal spray? It depends.
If you are one of the millions of Americans who suffer from chronic sinus symptoms, you know how bothersome it can be to find quick relief solutions for recurring symptoms like nasal congestion, runny nose, and the general discomfort that follows. With allergies being the sixth leading cause of chronic illness in the United States, it’s clear that upper respiratory issues don’t discriminate.
Throw in the countless remedies lining the drug store aisles — from confusion over medical labeling to horror stories about nasty side effects — it’s easy at times to think suffering is your safest option. This simply isn’t true, however, safe usage should always be your priority.
What are the different types of nasal sprays?
The more knowledge you acquire, the closer you’ll get to achieving relief. The reality is that the term “nasal spray” applies to a range of products. For some sufferers, an over-the-counter saline spray can work wonders to alleviate congestion and reduce swelling of the nasal passages. Other chronic sufferers may need more powerful drugs prescribed by a healthcare practitioner.
Nasal spray solutions are a powerful way to target nasal and sinus symptoms without delivering medicine to the rest of the body, where it may not be necessary. There are a number of nasal sprays available over-the-counter for mild or acute sinus symptoms, and by prescription for severe or chronic symptoms. These common nasal sprays include: corticosteroids, antihistamines, decongestants, and sodium chloride — better known as saline solution.
Nasal Corticosteroid Spray
A nasal corticosteroid spray reduces inflammation and mucus in the nasal passages, making it a common choice to treat allergic rhinitis (hay fever) symptoms and nasal polyps.
Nasal steroid sprays come in a number of different forms, including:
- Budesonide
- Fluticasone
- Mometasone
- Triamcinolone
Any of these medicines may be recommended to provide temporary relief for hay fever or other nasal conditions including congestion, irritation, and even to prevent nasal polyps from growing back after surgical removal.
It’s not uncommon for nasal steroid sprays to take up to three weeks before you feel their full effects. Consistent use of these medications according to your doctor’s instructions is essential to achieving relief. If you suffer from seasonal allergies, it’s best to start incorporating a nasal steroid spray into your routine at the beginning of the season.
Nasal Antihistamine Spray
Similar to nasal steroid sprays, antihistamines are non-habit forming and are recommended to treat itchy or runny nose, among other symptoms associated with allergic rhinitis. Nasally administered antihistamines like azelastine can start working within two hours and provide symptom relief that lasts 12-24 hours.
Side effects while using a nasal steroid or antihistamine spray may include:
- Burning or stinging in the nasal passage
- Nasal dryness
- Sneezing
- Throat irritation
Headache, nosebleed, perforated nasal passages if mishandled (uncommon, and should be reported to your healthcare provider).
Nasal Saline Solution
Saline sprays are a great natural alternative to loosen up mucus in the nose and sinuses, without the risk of medication-related side effects. There are numerous benefits of adopting a regular nasal hygiene routine centered on the regular use of nasal saline solution.
The benefits of using nasal saline solution as part of a daily nasal hygiene routine include:
- Thinning out mucus to alleviate nasal congestion
- Clearing out allergens that may trigger sinus inflammation and lead to infection
- Improving the effectiveness of medicated nasal sprays (when nasal saline is used first)
While saline nasal sprays are generally well-tolerated, nasal dryness is a common complaint among sufferers. In this case, opt for a saline nasal solution with additional moisturizing ingredients.
Nasal Decongestant Spray
Nasal congestion is among the top complaints by patients suffering from chronic sinus problems. Impaired breathing can lead to headache, lost sleep, and cause a decline in quality of life. While the promise of quick relief can be enticing to chronic sufferers, precautions must be taken to avoid severe side effects.
Some sufferers may find a natural nasal decongestant spray a helpful relief option without the risk of developing drug dependence. Nasal spray solutions formulated with natural extracts like xylitol and nasal-safe essential oils continue to be researched as effective treatment options for chronic rhinosinusitis and perennial allergic rhinitis.
Medicated nasal decongestant sprays provide significant — albeit temporary — relief for sinus congestion and pressure by shrinking the blood vessels in the nasal mucosa. This reaction — called “vasoconstriction” — prevents fluid from draining into the nasal tissues, alleviating blockage and inflammation. The benefits of a fast-acting nasal decongestant can be enticing amid sinus symptoms that just won’t seem to quit. But with big relief comes big responsibility. Here’s where the side effects of nasal decongestant sprays differ from corticosteroids, antihistamines, and sodium chloride solutions.
What are the dangers of nasal spray?
While medicated nasal decongestant sprays can be a powerful temporary solution for cold or flu sufferers, they should not be used for more than three or four days in a row, as overuse can lead to uncomfortable, and even severe, side effects.
The side effects of medicated nasal decongestant sprays include:
- Rebound congestion
- Bitter smell or taste
- Nasal irritation that includes burning and stinging
- Change in heart rate, frequent nosebleeds, tremors, excessive sweating (concerning and should be reported to your healthcare provider)
What is the addictive ingredient in decongestant nasal spray?
Medicated nasal decongestant sprays generally contain any of the following active ingredients:
- Oxymetazoline
- Phenylephrine
- Pseudoephedrine
- Xylometazoline
- Naphazoline
While the National Institute on Drug Addiction etches a clear line between physical drug dependence and addiction, overuse of these sprays can lead to withdrawal symptoms, including rebound congestion.
How long does rebound congestion last?
Rebound congestion — or rhinitis medicamentosa — refers to the inflammation of the nasal passages due to the overuse of nasal decongestant sprays. Becoming physically dependent on nasal spray can be classified as a subset of drug-induced rhinitis. In cases of prolonged overuse, it can take about a year to completely recover from rebound congestion.
Symptoms of rebound congestion may include:
- Shorter periods of relief after using decongestant spray
- Regular use without relief
- Feeling compelled to use more spray/ more often than recommended
- Being unable to achieve “normal breathing” without spray
- Mouth breathing
- Dry mouth
- Snoring
The rebound effect, though daunting, can be treated with the right tools and assistance. Remember that your body may have built up a tolerance, and getting back on a normal course will take some work. If you are experiencing the above symptoms, consult a doctor.
How do I stop my nasal spray addiction?
Treating rebound congestion begins with the cessation of topical decongestant spray. While this seems like a simple solution, patients should be aware that nasal congestion may temporarily intensify. Your doctor may prescribe nasal and/or oral corticosteroids and antihistamines to promote symptom relief in the meantime.
What nasal spray can I use everyday?
Depending on the severity of your condition, a simple nasal saline solution may be enough to keep allergens and other airborne irritants at bay. Incorporating nasal rinsing into your everyday routine can be a beneficial drug-free habit to build. If you’re not finding enough relief from a simple spray, understanding the limitations of spray pumps and rinse bottles in delivering cleansing saline, decongestants, or other nasal-safe solutions can help put you on the path to relief.
Need a solution designed to target inflammation or infection? Seek proper guidance before you make a decision on a medicated spray. Like any remedy, nasal sprays work best when appropriately leveraged to target specific symptoms. Make sure you consult your doctor or a compounding pharmacist that specializes in sinus before incorporating any medication into your treatment plan.
