Nasal Spray Addiction
The drug Afrin and other stimulant nasal sprays help a lot of people with congestion, but they also have a dark side. This blog will discuss the topic of "nasal spray addiction" and offer some solutions for those trapped in this vicious cycle.
Congestion is a common issue, not to mention annoying. When one of our two airways are blocked, problems develop. In addition, mucous secretion out the nostrils or down the back of the throat can wreak havoc. With such problems, people go looking for solutions, the quicker the better. Enter stimulant nasal sprays.
The production of mucous in the nasal passages is fueled by a lacy plexus of blood vessels that lay along the tissue membranes. Water is delivered to the glands in the tissue that make the mucous. The medicine in nasal spray works quickly by causing the blood vessels to squeeze off. No blood means no water to the glands, which means no mucous. The results are usually quick and dramatic - a real Godsend.
Eventually, however, the dark hand is delivered after about five days. This occurs when a rebound relaxation of the blood vessels occurs. In turn, this leads to a fierce production of mucous by the glands. People logically go to the closest solution at hand - more nose spray. This solution works, but only to yield the rebound mucous production when the medicine wears off, and the cycle begins. Doctors call this rhinitis medicamentosa, but it's commonly known as nasal spray addiction.
Is This an Addiction?
If one considers a physical dependence on a substance that includes a psychological craving as the criterion for addiction, I guess that one could become addicted to nasal spray. This is debated, however. Regardless, people who find themselves in this vicious cycle are in a real pickle. I have had patients caught in this trap for years. Most are quite apprehensive about the notion of going off the nose spray, so it can take some real convincing that there are better nasal passages on the other side of the cycle.
It takes at least five days to break the cycle. If a person can tolerate the aggressive congestion caused by the rebound phenomenon, the "cold turkey" approach will yield success. Alternative nasal sprays that don't cause rebound congestion can also help.
One such nasal spray is a mist of an anti-inflammatory steroid that is laid over the nasal passages (several different brands). This medication usually takes a few days to become active. As such, I've had patients use both sprays for a few days and then drop the stimulant nasal spray.
Another popular nasal spray is azelastine (Astelin). It's an antihistamine that, like the steroid sprays, takes a few days to kick in. One problem with azelastine is that they require histamine stimulation to work as an anti-histamine. Because of this, I usually prefer the steroid sprays if replacement spray is the best option.
Finally, the neti pot offers a more mechanical solution to the rebound congestion. This device rinses the congestion from the nasal passages and can help to deregulate the rebound congestion. The neti pot can be used as much as needed without fear of rebound congestion.
Are Stimulant Nasal Spray Safe?
Yes, stimulant nasal sprays can be used safely, but within some guidelines. In fact, these nose sprays are considered the safer option for nasal congestion in pregnancy which can be a real problem. The caveat is that the medication should not be used for more than five days without a several day break.
Rinitis medicamentosa, commonly known as nose spray addiction, is a common and bewildering problem. What seems like the solution is actually the problem to this cyclic nasal congestion. However, with some determination, and maybe the help of an alternative decongestant, the cycle can be broken.