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Can You Become Dependent on Nasal Spray?

Do you have the sniffles, a runny nose or nasal congestion? With allergy season, cold season and the COVID-19 pandemic, you may be a little extra cautious about mucous or congestion—especially when it’s your own.

It may seem like a no-brainer to reach for an over-the-counter nasal spray to zap the snot and stuffiness, but know that not all nasal sprays are created equal. In fact, with some types, you might get a little “hooked.”

While it may provide temporary relief, could you become addicted to your nasal spray?

“Overuse of some nasal sprays is most often a result of dependency,” said Kelly Erdos, PharmD, a clinical pharmacist with Banner Baywood Medical Center. “People may become dependent to nasal spray because of something called the rebound effect.”

Dependency vs. Addiction: The Rebound Effect

The rebound effect occurs when you use nasal sprays, specifically decongestant sprays, regularly. After a few days of using this type of spray, your nose will become less responsive to the effects of the medication. You may have problems with your nasal congestion returning, or rebounding, once the medication is stopped. As a result, you may need to use more and more to combat the congestion.

Some people confuse the rebound effect with addiction, but Dr. Erdos said nasal spray addiction isn’t a true addiction. “Addiction is defined as a severe substance disorder that results in continuous and compulsive use of a substance despite that substance causing harm,” she said. “Over-the-counter nasal sprays, however, don’t cause the same physiological cravings.”

While the rebound effect of some nasal sprays isn’t a true addiction, they can lead to negative consequences such as rhinitis medicamentosa (rebound congestion), chronic sinusitis and other long-term problems.

To better understand the different kinds of nasal sprays and how to use them safely, here’s a breakdown of the four different types.

Four Types of Nasal Sprays

1. Saline Sprays

Over-the-counter saline sprays can help thin mucous and cleanse your nasal passages of pollen and other allergens.

Addictive? No, these don’t cause irritation or dependency, although some preservatives or additives can cause irritation if you are sensitive to them.

What types can I use? Most over-the-counter saline nasal sprays are made of the same saline concentration that’s in your body. They will specifically say “saline” or “drug-free” on the label. Look for sodium chloride (also known as salt) and sterilized water as the main ingredients. While saline sprays can be effective, humidifiers can also be an alternative, especially in drier months.

2. Steroid Sprays

Steroid sprays are used to reduce swelling and inflammation in your nasal passages. These can be a great alternative for those who experience side effects from medications taken by mouth.

Addictive? No, steroid sprays are safe to use and a good option for seasonal and environmental allergies. If you need the nasal spray longer than 6 months, however, talk to your doctor.

What types can I use? Look for steroid sprays that contain corticosteroids. They may also appear as fluticasone propionate or triamcinolone acetonide. There are several available both over the counter and by prescription, so talk to your doctor and pharmacist about which product is best to treat your symptoms.

3. Antihistamine Sprays

Antihistamines block a chemical in your body that is responsible for allergy symptoms and like steroid sprays, they can also cause less side effects than pills for some people.

Addictive? No, antihistamine sprays are not habit-forming.

What types can I use? Look for sprays that contain cromolyn sodium. They usually work best if used 1 or 2 weeks before the start of allergy season for it to have full effect. If you’re unsure, ask your doctor or pharmacist which product is best to treat your symptoms.

4. Decongestant Sprays

Decongestant sprays constrict the blood vessels in the nose and reduce inflammation, which can be efficient for treating a runny nose or congestion.

Addictive? Yes, rebound congestion occurs when you use decongestants like oxymetazoline. They may only be effective for a short period and should be used sparingly for no longer than 3 days in a row.

“The downside to nasal decongestants is that over time people may need higher doses to achieve the same effect and may also experience rebound congestion,” Dr. Erdos said. “Some people may develop a dependence to this type of medication and overuse it since symptoms return once they try to stop using it.”

What types can I use? They can be used for short-term symptoms for a cold or flu, but limit use to no more than 3 days in a row. Talk to your doctor before using a decongestant spray.

How Can I Break My Dependency to Nasal Spray?

Medications are used to treat health problems and make you feel better so it can be difficult to know the difference between having a medication work and being dependent on it. If you are using a nasal decongestant spray for more than 5 to 7 days and are unable to stop using it, what’s likely happening to you is a rebound phenomenon.

“When stopping a nasal spray, you may notice a return to your baseline of nasal congestion and return of other symptoms like sneezing and a runny or itchy nose,” Dr. Erdos said. “Talk to your doctor or pharmacist about how best to cut back on the medication to help with withdrawal.”

How Can I Reduce My Risk for Rebounding?

To lower the risk of dependency and exposure to side-effects, use the lowest dose of a medication for the shortest period possible. Specifically, limit nasal decongestant sprays to 3 days of consecutive use and do not use them more than twice a day.

When using other types of nasal sprays including saline, steroid and antihistamine sprays, be aware of how often you are using them and if that amount of use is necessary. “Often, people may only need to use a nasal spray a few months out of the year for allergies or when the weather is dry and cold,” Dr. Erdos said.

Takeaway

Overall, nasal sprays are an effective way to relieve nasal congestion from allergies and colds, but frequency of use can vary. Your best bet is to ask your doctor or pharmacist about the best over-the-counter or prescription nasal spray to treat the symptoms you are experiencing.

The nose knows when something isn’t right. Check out these other articles related to your nose, allergies, colds and other mucous-related issues:

Need a doctor? No problem. Our Banner Health specialists can answer all your nasal spray questions and concerns. To find a doctor near you, visit bannerhealth.com.

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