About Nasal Spray Addiction
There are those, like James T. Li, M.D., asthma and allergy specialist with the Mayo Clinic, who contend that nasal spray addiction doesn't exist. Dr. Li defines addiction as a "compulsive physiological need for and use of a habit-forming substance known to be physically, psychologically or socially harmful." He contends that over-the-counter nasal sprays contain no habit-forming ingredients and don't cause compulsive cravings. Others, like James Thompson, M.D., board certified allergist, say that nasal spray addiction does exist because prolonged use of nasal spray leads to compulsive use and possible physical damage.
Both doctors agree that prolonged use of OTC nasal spray can lead to rhinitis medicamentosa, or rebound congestion.
Physical Effects of Nasal Spray
Blood vessels in the sinuses have special receptors that respond to the chemicals in nasal spray. When the chemicals hit the receptors, the blood vessels shrink and open the airway. The effect of these nasal sprays is almost immediate, and many patients use the sprays repeatedly because of their fast effects. Manufacturers, however, recommend that patients only use these products for a maximum of three consecutive days.
Rebound Congestion/Rhinitis Medicamentosa
Normally, the body keeps the sinus passages clear, and we only run into problems when we're sick or exposed to irritants. If we ingest or use something that does the work of an existing bodily process, the body stops that process. In the case of nasal spray, the body stops clearing the sinuses in favor of letting the chemicals do all of the work. Additionally, by using the product beyond the suggested time frame, we saturate the receptors on the blood cells. When receptors get saturated, the body down-regulates by reducing the number of receptors--which reduces the effectiveness of the drug. Prolonged OTC sinus spray use creates two distinct problems: The body no longer keeps the sinuses clear on its own, and the body needs more of the drug to keep the sinuses clear.
The body can heal itself, but it requires that the patient wean himself off the nasal spray or stop entirely. According to Dr. Li, patients who stop using nasal spray for a couple of weeks should return to normal. If the patient wants to use nasal spray again, he shouldn't do so beyond the manufacturer's suggested time frame.
