Is Your Nasal Spray Making You An Addict?

Are you suffering from a blocked, runny nose? And need to clear its passage to breathe normally? You reach out for a nasal spray bottle to get instant relief. You spray it a couple of times and the liquid works well to subside things for better. After a while, you again feel the urge to clean your congested nose and use the spray consecutively. This is repeated several times throughout the day..

Even when you commute to your workplace, you make sure to carry another spray in your purse in case you need it on the go. This becomes a compulsive habit and before you realise its severity, you are already an addict.

The nasal obstruction could be caused by “colds, allergies or sinus infections. However, latest medical reports and ongoing case studies reveal nasal spray addiction as a growing health concern,” ENT specialist Dr Mayur H. Ingale raises an alarm.

The Obsession

Nasal spray addiction is a typical indicator of modern-day behavioural pattern linked to anxiety, stress, erratic lifestyles and the tendency to pop in pills or apply sprays habitually. It precisely highlights the overuse and dependency on over-the-counter (OTC) decongestant nasal sprays, particularly those containing oxymetazoline, xylometazoline or phenylephrine (provide momentary relief by compressing blood vessels in the nasal passages).

“When administered beyond the recommended three-five days, the nose develops a rebound effect i.e., rebound congestion, leading to a cycle of urgent and recurrent usage of the spray to breathe comfortably,” explains Dr. Rajan Bhargav, ENT surgeon, Regency Health Kanpur. Medically, this condition is called Rhinitis Medicamentosa (RM).

Demerits

Instead of improving nasal blockages, the prolonged use of nasal sprays at the drop of a hat can worsen the situation for their users.

“This could provoke excessive dependence to keep the nasal passages open for longer periods. Once the effect wears off, the patient is further induced to use the spray, thus creating a vicious cycle,” warns Dr Ingale, professor and HOD, Dept. of otorhinolaryngology at Dr. D.Y. Patil Medical College, Hospital and Research Centre in Pimpri, Pune.

The Trigger

Unlike other forms of addiction related to drugs, alcohol, nicotine/cigarettes or substance abuse, nasal spray dependency is usually detached from experiencing euphoria or seeking pleasure. It is more of people’s physiological reliance on the spray to release their nasal clogs and maintain normal breathing. However, this could also prompt psychological craving as patients feel anxious or distressed and might get hyper without the spray that seems so indispensable at a given point in time.

Symptoms

A string of symptoms can determine nasal spray addiction. They include persistent nasal jamming or constant stuffiness despite frequent spray use; requirement of the spray every few hours to clean the accumulated dirt and breathe properly; short-lived relief after use and reduced effectiveness over time; dryness, irritation or burning sensation in the nasal passages and bleeding of the nose in some cases, etc.

“Increased reliance on nasal sprays and their long-term use can result in certain health risks. It can damage nasal tissues, cause chronic congestion and hamper quality of life to a great degree,” lists Dr Ingale.

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Blow to the Nose

Sadly enough, the addiction may affect the nose — our sensory organ of smell, its breathing passages, parts/features, etc. “The nose can be locally affected with chronic swelling of its nasal lining, damaged mucosa, loss of olfaction (anosmia: partial or full loss of smell in severe cases), nasal dehydration and contracting regular infections. Also, the natural airflow via breathing ducts decreases and sinus problems deteriorate,” informs Dr. Bhargav.

But are other physical organs adversely impacted? “Although direct systemic organ damage is rare but overuse of sprays for extended duration may augment blood pressure level, jeopardise heart health and cause headaches due to systemic absorption,” shares Dr. Bhargav.

Slow and Steady Wins the Race

People who overuse nasal sprays are often encouraged to slowly taper the frequency of their application in phases instead of abandoning the habit suddenly, which will be like stopping cold turkey.

“Taking it easy is a prudent approach. Simple activities like using steam inhalation, staying hydrated and practising breathing exercises can help ease congestion naturally and not abruptly. Developing patience during the healing process and replacing the habit with healthier alternatives play a big role in improving a patient’s condition,” suggests Dr Nayan K Shetty, consultant ENT surgeon at Wockhardt Hospital, Mumbai Central.

Withdrawal Symptoms

A point to ponder is whether patients suffer withdrawal symptoms when they stop using nasal sprays during the recovery period. If yes, then what are those tell-tale signs and how are they helped to overcome the crisis?

“Withdrawal symptoms usually emanate from addiction to the decongestant sprays. Rebound congestion and nasal blockage with watering of nose are primarily noticed. During the treatment of chronic rhinosinusitis, the medicated sprays do not cause any withdrawal symptoms. However, patients might sense similar symptoms if the underlying disease is not fully recovered,” claims Dr. Rakesh Gokul Singh, associate consultant (ENT, and head and neck surgery) at Max Multi Speciality Centre in Panchsheel Park, Delhi.

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Addressing Addiction

A host of treatment options is available to help a person quit addiction. One may skim through the list comprising gradual weaning off the spray, switching to saline sprays or nasal rinses for relief, adopting steroid nasal sprays (prescribed, not OTC) to moderate inflammation, undergoing allergy management (if underlying allergies exist), resorting to short-term oral medications for de-cluttering nasal debris under medical supervision, et al.

Surgery and Steroids

SSteroids (nasal or oral) are commonly prescribed to patients for recovery of nasal mucosa, while surgery is considered only in extreme cases where chronic damage to nasal tissues, deviated septum (the wall of bone and cartilage that divides the nasal cavity into two separate nostrils) or sinus issues coexist. Operation helps restore airflow but is not the first-line treatment option for addiction.