Is nasal spray addiction a cause for concern?
The answer depends on the type of nasal spray they use. Some are safe to use daily for several months, but others can cause a "nasal spray addiction" if people use them for more than a few days.
Overuse is common. In 2014, researchers found that out of 895 participants with nasal congestion, half of them overused their medication.
Nasal spray addiction is not a true "addiction," but it can lead to tissue damage inside the nose. This can result in swelling and long-term stuffiness that leads to further use and overuse of the spray.
In some cases, a person may need to undergo additional treatment, and possibly surgery, to correct any damage.
Knowing about the different types of nasal sprays and how to use them safely can help to prevent this problem.
Saline nasal sprays
Nasal sprays can provide relief from congestion.
Drug-free saline nasal sprays tend to be safe for people of all ages.
Saline sprays can help to loosen and thin any mucus in the nose. They allow easier breathing when congestion arises due to colds or allergies. They contain no medication and have no side effects.
These sprays contain a small amount of salt and sterilized water. Some also contain preservatives that prevent the growth of mold or bacteria. Preservative-free formulas are available in aerosol cans that keep the liquid sterile.
Many saline sprays will specify "saline" and "drug-free" on the bottle. To be sure, people should look for sodium chloride (salt) and water as the main ingredients, with no "active" ingredients.
Are saline nasal sprays addictive?
No. Saline sprays have no side effects, and people can use them as they need.
A range of saline nasal sprays are available for purchase online.
Steroid nasal sprays
Steroid nasal sprays contain a corticosteroid.
Many people think of anabolic steroids when they hear about steroids. These are popular with bodybuilders who want to improve muscle mass.
A corticosteroid is not an anabolic steroid.
Corticosteroids are useful for calming inflammation that happens because of an overactive immune system response.
Steroid nasal sprays apply a corticosteroid directly into the nose to treat nasal allergy symptoms, such as sneezing and a runny nose.
They can provide relief from hay fever or nasal allergies, and can often replace other allergy medications taken by mouth.
These sprays typically start working after several days of use. A person must use them every day during the allergy season to continue to find relief.
Long-term use of any type of steroid can have side effects.
These may include:
Some types of corticosteroids may slow growth in children, especially if used for a long time.
A study published in The Journal of Allergy and Clinical Immunology found a small reduction in growth in children who used a particular type of nasal spray that contained a type of corticosteroid called fluticasone furoate.
Children should only use steroid nasal sprays under the guidance of a doctor for this reason.
Steroid nasal sprays are commonly available in stores, but some may need a doctor's prescription.
The active ingredients may appear on the package as fluticasone propionate or triamcinolone acetonide.
Are steroid nasal sprays addictive?
No. Nasal sprays with corticosteroids are safe to use daily for most people. People who need to use steroid nose sprays for 6 months or more should talk with their physician.
Antihistamine nasal sprays
Nasal congestion is a common problem for people with a seasonal allergy.
People use antihistamines to treat seasonal allergies. Antihistamines block a chemical called histamine that is responsible for allergy symptoms such as sneezing, itching, and runny noses.
Antihistamine nasal sprays allow a person to apply the medicine directly into the nose. This can help treat nasal allergy symptoms at the source and may cause fewer side effects than pills for some people.
Cromolyn sodium is an antihistamine spray that is available over the counter. It is safe for use from the age of 2 years. It may take a week or more of daily use before a person feels complete relief from allergy symptoms.
Are antihistamine nasal sprays addictive?
No. Cromolyn sodium sprays are nonaddictive. People can use them daily for up to 12 weeks. Those who need to use them for longer should ask their doctor.
Decongestant nasal sprays
Decongestant sprays are available over the counter. They shrink the blood vessels in the nose temporarily. This is known as vasoconstriction. This provides short-term relief from stuffiness, but it does not cure a cold or allergies.
These sprays have different brand names, but the two main active ingredients are oxymetazoline and pseudoephedrine.
Are decongestant nasal sprays addictive?
Yes. These sprays can cause a so-called "nasal spray addiction" in some people.
This often occurs when a person uses the decongestant nasal spray too frequently or for too long.
Strictly, this is rebound congestion and not an addiction.
With rebound congestion, a person may find that they need to use the spray more frequently over time, often several times a day or more. Each time they use the spray, the blood vessels in the nose narrow, causing the tissue inside the nose to shrink.
After the medicine wears off, the nasal tissue swells again. Sometimes it swells even more than before.
If the person continues to use it, this swelling can get more severe and lead to permanent swelling of the tissue.
Long-term use of these sprays can also damage the tissue, causing infection and pain.
Symptoms of rebound congestion or dependency on nasal spray may include:
- feeling congested again shortly after using a decongestant spray
- using a decongestant spray regularly but feeling that it doesn't work anymore
- feeling a strong urge to use the spray more often than the instructions recommend
- using the spray just to be able to breathe normally on a daily basis
To help people avoid this problem, the American Academy of Asthma, Allergy, and Immunology (AAAAI) recommend using it no more than twice a day for only 3 days.
Those who have been using the spray more frequently should see a doctor. They will examine the nasal tissue to check for damage or excess swelling.
Typically, a person will need to stop using the spray. They may need a different medication to relieve the swelling, such as a steroid nasal spray.
Other issues with decongestant nasal sprays
In addition, sometimes people abuse pseudoephedrine by using it to make an illegal recreational drug, methamphetamine, according to information from the American Academy of Family Physicians.
For this reason, some states may require a doctor's prescription for these products. In others, pharmacies may keep products containing this chemical behind the counter, even though they do not need a prescription.
There may also be a limit on how much you can buy each month, and individuals may have to show ID or give personal details when they buy this type of decongestant.
Alternatives to nasal sprays
Neti pots are an alternative to nasal sprays, but remember to use sterile water and clean them well after use.
A nasal spray is often the first choice for mild congestion due to allergies and colds. A saline nasal spray is drug-free and is generally safe.
Another option is to use a neti pot. These are an effective way to flush mucus and allergens out of the nose.
However, the United States Food and Drug Administration (FDA) have expressed concern about their use. They warn people to use neti pots with sterilized water and to clean them properly to avoid some rare but dangerous infections.
Another option is over-the-counter decongestant and allergy pills. It is important to use these medications as instructed on the label.
People should also ask a pediatrician before giving any medication to young children.
People should use decongestant nasal sprays with caution to avoid rebound congestion and damage to the delicate nasal tissue.
Nasal sprays are a type of medicine. People should never use them more frequently than the label advises.
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