Dr. Menachof, MD, has specialized in conditions around the head, throat, ear, nose, neck and face for over 20 years, and was the first to bring sublingual allergy drops to Colorado in 2005. He has been recognized as a Fellow by multiple academies, named one of America’s Top Facial Plastic Surgeons continually since 2003 and is featured in multiple national publications.
When you’re suffering from seasonal allergies or sniffles from the common cold, nasal sprays can be a quick solution to find relief and breathe a bit easier. But maybe you’ve heard the whispers to be wary of these tiny remedies, that one spray can cause you to become dependent for life — addicted even! Before you reach for the pump bottle, it’s important to understand the different nasal spray options and how your body responds to each one. The bottom line — nasal spray “addiction” isn’t a true addiction, but overuse can lead to dependency and more serious problems down the road.
There are several conditions that nasal sprays can help, including:
Dependency vs Addiction
After a few uses, your body builds up a tolerance to decongestant nasal sprays (DNSs). While this can lead to physical drug dependence, you can’t actually be addicted to nasal spray. Addiction is a complex condition where a person compulsively uses a substance, despite harmful consequences. Nasal sprays don’t cause the same physiological cravings as other addictive drugs.
Nasal Spray Types
A nasal spray is a medication that’s inhaled through the nose, primarily used to treat nasal congestion caused by colds or allergies. The most common nasal sprays include:
What Is a Saline Spray?
A saline nasal spray is a simple saltwater solution that you can buy over the counter. They’re drug-free and help provide relief from nasal dryness and congestion from the common cold or allergies. Saline sprays typically come in a pump or squirt bottle and are available at pharmacies and grocery stores.
Are they addictive?
No, saline nasal sprays are not addictive and have little risk of side effects — you can use them as often as needed.
Types to use
There are many saline nasal sprays, including Ayr, Sinex, Simply Saline, Ocean Mist, etc.
What Is a Steroid Spray?
Steroid nasal sprays help reduce swelling and inflammation in the nose, and are often prescribed for chronic nasal congestion caused by allergies or irritants. Steroid sprays contain a medicine called a corticosteroid. You can find them over the counter and by prescription.
Is it addictive?
No, steroid sprays are not addictive and are safe to use for seasonal allergies. If you find you need a steroid spray for longer than six months, you should speak to a doctor.
Types to use
Flonase, Nasacort, and Rhinocort are steroid nasal sprays available over the counter. Prescription steroid nasal sprays include Beconase, Dymista, Nasarel, and Nasonex.
What Is an Antihistamine Spray?
Antihistamine nasal sprays contain a substance that blocks the effects of histamine, which causes allergy symptoms like sneezing, itching, and congestion. Antihistamine nasal sprays treat nasal allergy symptoms at the source and can cause fewer side effects than pills. Antihistamine sprays are available by prescription.
Is it addictive?
No, antihistamine sprays are not addictive and can be used daily for up to 12 weeks. If you find you need to use an antihistamine spray longer, you should speak to a doctor.
Types to use
Common antihistamine nasal sprays include Astelin, Astepro, and Patanase.
What Is a Decongestant Spray?
Decongestant nasal sprays contain oxymetazoline and pseudoephedrine that work to shrink the swollen, irritated blood vessels in the nasal passages. DNSs are good for short-term problems like colds or flus, but shouldn’t be used for more than three days. You can purchase decongestant nasal sprays over the counter at pharmacies and grocery stores.
Is it addictive?
If you use a decongestant spray for too long or too frequently, your body will build up a tolerance for the medication. This is called “rebound congestion,” and is often confused as nasal spray addiction. While it’s not a true addiction, overuse of decongestant nasal spray can lead to dependency and cause long-term damage to the nose.
Types to Use
Common types of decongestant nasal spray include Afrin, Sinex, and Neo-Synephrine.
What Happens If You Use a DNS for Too Long?
Typically when you experience congestion, your nasal passages have become swollen, shrinking the amount of space in your nose that air can move through. Decongestant nasal sprays work by immediately shrinking the swollen blood vessels, which provides fast relief and helps you breathe easier. However, when the drug wears off, your blood vessels swell up again (sometimes even more than before!).
DNSs are only intended for temporary relief (no more than three days). After a few days of using a nasal decongestant spray, your nose becomes less responsive to the effects of the medication. You’ll find yourself needing more and more to get rid of your congestion. Or, when you stop the spray, your congestion may return right away. This rebound effect, or Rhinitis Medicamentosa (RM), is often mistaken as addiction to nasal spray. If you continue to use a decongestant nasal spray for too long or too frequently, this swelling can become worse and lead to tissue damage inside the nose.
How Much Is Too Much?
Decongestant nasal sprays are intended for short-term relief. Product labels warn you not to exceed the recommended dose and you should not use a DNS for longer than three days.
How to Break Dependency and Reduce Risk for Rebounding
If you’ve been using a decongestant nasal spray for an extended period of time, it can be difficult to stop. You can quit cold turkey and expect to experience severe congestion and discomfort until your nasal passages have time to heal. Recovery typically takes less than a week and withdrawal symptoms are easy to manage.
We suggest seeing a doctor, who can examine your nose to check for damage or excessive swelling. A doctor will likely recommend a steroid nasal spray solution in addition to discontinuing the use of the decongestant nasal spray. This process will help alleviate discomfort as you break your dependency.
How Is Rhinitis Medicamentosa Treated?
Rhinitis Medicamentosa, also known as rebound congestion, happens when you overuse a nasal decongestant. Treatment for RM includes discontinuing the use of the decongestant nasal spray to allow the nasal passage to heal, sometimes including the use of a steroid nasal spray. After recovery, a doctor can determine your underlying nasal problems and recommend a safer treatment plan.
How to Use a DNS Properly
To use a decongestant nasal spray properly, you need to point the nasal spray toward the back of the nose so that you can inhale the medicine. Avoid spraying directly at the nasal septum (the middle portion of your nose) because you can damage tissue and cause a bloody nose. Here are a few other tips for using nasal spray:
- Always read and follow product directions
- Before using, blow your nose to clear nasal passages
- Close the opposite nostril before administering
- Inhale gently as you apply dosage
- Avoid blowing your nose for several minutes after
- Don’t share nasal spray with others
Decongestant nasal spray dependency is a real thing and it can become a real problem. If you’re experiencing chronic congestion, rebound congestion, or overusing nasal spray, we encourage you to speak to a doctor. We’ll work together to uncover your underlying problems, offer you treatment options, and help you breathe safer and easier.