Avoiding Nasal Spray Addiction
A stuffy nose can make a person miserable. In addition to difficulty breathing, nasal congestion can cause challenges with sleeping, and decreased senses of smell and taste. Nasal sprays such as Afrin can improve the symptoms of nasal congestion for eight to 12 hours. However, if the medication's directions are not properly followed, misuse of nasal spray can make things much worse!
If nasal spray medication is used as directed, for only two to three days, there are usually no problems. Unfortunately, it is very common for people to get caught up in a vicious cycle of continued nasal spray usage. When the spray eventually wears off, nasal obstruction and congestion can actually increase causing patients to continue nasal spray use far beyond the two-to-three-day time frame shown on the medication instructions.
Continued misuse of nasal sprays can result in rhinitis medicamentosa, otherwise known as nasal spray addiction. How does this "addiction" happen? Nasal sprays cause the blood vessels in the nose to constrict, which shrinks the nasal tissue and allows better airflow through the nose. Over time, the effectiveness of the spray decreases, leading patients to use nasal sprays more frequently than directed in order to keep the nasal passage open. That's when the problems begin. Because the spray constricts blood vessels and decreases blood flow in the nose, oxygen and other nutrients cannot be properly delivered to the nasal passages. This results in nasal inflammation.
As an ENT physician, I have seen countless patients who will not leave home without a bottle of nasal spray in their pocket, purse or car. They admit to also having nasal spray bottles spread throughout their home. People who have been using sprays for months or years will have extremely red and swollen nasal tissue that can result in easy bleeding and crusting. With extended spray usage, nasal tissue can be destroyed and the nasal septum can erode, resulting in a perforation and eventual collapse of the nose.
Completely eliminating the use of nasal spray will usually lead to recovery of the nasal tissue, but the healing process can take several weeks. Other medications, such as oral steroids, can help decrease nasal inflammation and make the symptoms less severe, but ultimately the patient must stop using the nasal sprays completely to make a full recovery.
Over-the-counter products are available to help those who are discontinuing the use of nasal sprays. These products may also provide some congestion relief. Hypertonic saline irrigation kits involve mixing sterile water with packets of salt. Adding an extra salt packet to the irrigation fluid helps decrease swelling in nasal tissue. Oral decongestants, such as pseudoephedrine or phenylephrine, may cause constriction of blood vessels in the nose and improve airflow, but not to the degree of a nasal spray. These decongestants should be used with extreme caution if you have heart disease or hypertension. Nasal steroids such as Flonase and Nasacort can also be effective, as can keeping your head elevated while sleeping at night.
Once you have completely stopped using nasal sprays, an ENT physician should closely examine your nasal cavity to see if there are any underlying medical factors contributing to chronic nasal obstruction. These factors may include chronic sinusitis, deviated septum, nasal polyps, adenoid hypertrophy or other abnormalities. If a problem is detected, a treatment plan can be developed to provide lasting sinus relief.
For short-term use, nasal sprays can be effective. However, as with any medication, these sprays should be used only as directed. Don’t let your need for quick relief of sinus congestion lead you spiraling down a path of nasal spray addiction and long-term problems.
If nasal spray medication is used as directed, for only two to three days, there are usually no problems. Unfortunately, it is very common for people to get caught up in a vicious cycle of continued nasal spray usage. When the spray eventually wears off, nasal obstruction and congestion can actually increase causing patients to continue nasal spray use far beyond the two-to-three-day time frame shown on the medication instructions.
Continued misuse of nasal sprays can result in rhinitis medicamentosa, otherwise known as nasal spray addiction. How does this "addiction" happen? Nasal sprays cause the blood vessels in the nose to constrict, which shrinks the nasal tissue and allows better airflow through the nose. Over time, the effectiveness of the spray decreases, leading patients to use nasal sprays more frequently than directed in order to keep the nasal passage open. That's when the problems begin. Because the spray constricts blood vessels and decreases blood flow in the nose, oxygen and other nutrients cannot be properly delivered to the nasal passages. This results in nasal inflammation.
As an ENT physician, I have seen countless patients who will not leave home without a bottle of nasal spray in their pocket, purse or car. They admit to also having nasal spray bottles spread throughout their home. People who have been using sprays for months or years will have extremely red and swollen nasal tissue that can result in easy bleeding and crusting. With extended spray usage, nasal tissue can be destroyed and the nasal septum can erode, resulting in a perforation and eventual collapse of the nose.
Completely eliminating the use of nasal spray will usually lead to recovery of the nasal tissue, but the healing process can take several weeks. Other medications, such as oral steroids, can help decrease nasal inflammation and make the symptoms less severe, but ultimately the patient must stop using the nasal sprays completely to make a full recovery.
Over-the-counter products are available to help those who are discontinuing the use of nasal sprays. These products may also provide some congestion relief. Hypertonic saline irrigation kits involve mixing sterile water with packets of salt. Adding an extra salt packet to the irrigation fluid helps decrease swelling in nasal tissue. Oral decongestants, such as pseudoephedrine or phenylephrine, may cause constriction of blood vessels in the nose and improve airflow, but not to the degree of a nasal spray. These decongestants should be used with extreme caution if you have heart disease or hypertension. Nasal steroids such as Flonase and Nasacort can also be effective, as can keeping your head elevated while sleeping at night.
Once you have completely stopped using nasal sprays, an ENT physician should closely examine your nasal cavity to see if there are any underlying medical factors contributing to chronic nasal obstruction. These factors may include chronic sinusitis, deviated septum, nasal polyps, adenoid hypertrophy or other abnormalities. If a problem is detected, a treatment plan can be developed to provide lasting sinus relief.
For short-term use, nasal sprays can be effective. However, as with any medication, these sprays should be used only as directed. Don’t let your need for quick relief of sinus congestion lead you spiraling down a path of nasal spray addiction and long-term problems.
