How are nasal sprays addictive?

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Over-the-counter nasal decongestant sprays can be used to temporarily relieve symptoms associated with allergies and the common cold.

The chemicals in products like Afrin and Neo-Synephrine help to reduce swelling in the nasal passages, which help to make breathing easier.

Some claim that nasal sprays can be addictive, but it's important to distinguish between a substance that causes psychological dependence and one that causes chemical dependence.

Rebound congestion

People who use nasal sprays can often become dependent on them to breathe well through their noses, but the overuse of these products can lead to what doctors call rebound congestion.

"It works so well that you tend to keep using it," Dr. David Vernick, an ear, nose and throat specialist at Beth Israel Deaconess Medical Center in Boston, told the New York Times. "You're used to breathing well with the spray, and when you stop it, you get congested. So you use it a little more frequently, yet the congestion doesn't clear up for long."

The continuous use of nasal sprays for several days in a row can actually cause rebound congestion – even if the allergies or cold symptoms that originally caused the breathing problem have passed.

Addiction

Whether or not nasal sprays are chemically addictive is still debated in the medical community, but most experts agree that dependence is mostly psychological and behavioral in nature.

Overuse and dependence occurs as the patient needs the sprays to continue feeling sinus relief. Blood vessels in the nose appear to become tolerant to the drug very quickly. But months of use can cause damage to the nasal membranes.

The problem can be compounded when a patient sees a doctor and fails to include the nasal spray on his or her list of medications.

"You have to ask them," said Dr. Stanley Goldstein, an allergist in Rockville Centre, N.Y., "and ask how many bottles they have. They'll have them everywhere, in the house, in their car, in their briefcase, in their desk. They cannot function without the drug."

Alternatives

For severe sinus problems, oral decongestants like Sudafed are a better option, doctors say, because they don't carry the risk of rebound congestion. Saline nasal sprays are also a safer bet and are not associated with the same risks of products like Afrin.

Source: New York Times

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