I Might Be Addicted To Nasal Spray – What Should I Do?

It appears I am addicted to nasal spray. Only one kind of spray works on me, the 4-Way kind. My problem seems to be getting worse and worse; the more I use the less it does. I would like to know if there’s anything I can do without seeing a doctor? I am trying saline spray but that doesn’t seem to help much. Will going cold turkey solve this? Is there something I can buy or do?

Over-the-counter nasal sprays can create this problem, and although I think addiction is too strong a word to use, they can seduce a user into the need to keep using the product more and more to maintain clear nasal passages and permit one to breathe through the nose. How is it that such a product, which is so instantly helpful when one first starts using it, can become less effective but unstoppable?

All the products contain a decongestant chemically similar to the old standby pseudoephedrine (Sudafed) but formulated for local use unstead of being swallowed. In the case of 4-Way for example, the active decongestant is phenylephrine. Other ingredients which are not decongestants are stabilizers and antiseptics.

The problems with these decongestants comes from two facts. One is that the nasal mucosa rapidly develops tolerance to the effect of the decongestant. This means that ever larger doses will be needed to maintain a benefit. The other is that the products are intrinsically irritating to the nasal mucosa, and with prolonged use that irritation will develop even as the cold or allergy which caused the congestion in the first place recedes. The result is the dilemma described by our writer today: using more and more spray with less and less benefit.

Because of this problem, all of the sprays carry a warning that one should not use them for longer than three days, about the time that the irritation starts to develop. I once used them a lot myself for chronic allergies, and I am convinced that they contributed to my totally losing my sense of smell, only temporarily, thank goodness, but that’s another story. I now rarely advise people to use them, and then only for special situations, such as having to fly when you have a cold, or for the occcasional person who absolutely cannot tolerate breathing through their mouth when they have a cold.

Our writer will have to quit the nasal spray cold turkey; there is no way to slowly cut down. However, there are a few things he can do to make the process less painful. One is to continue the saline nose drops that he is using, which tend to liquify the mucus in the nose and make it easier to expel. The other step that might make it easier for him to breathe, is to use oral pseudephedrine. Although one develops tolerance to the oral drug just as to the spray form, it may provide some relief, and will obviously avoid the continuing irritation of the nasal spray.

The best way to do it though requires a visit to a doctor, as a prescription will be necessary. This is the method that I have used with people I have seen in this situation. Substituting one of the many cortisone (steroid)-type nasal sprays will decrease the inflammation and permit him to stop the decongestant. A steroid spray can be used with the oral pseudephedrine. They unfortunately take five to seven days before they have an effect, so he may have to use them and continue to use the decongestant spray for a few days until they begin to help. In this situation, one should spray the decongestant first, wait till the nose clears a bit, and then spray the steroid spray. After spraying the steroid spray, hold your breath for a count of ten to allow the medication to settle on the membranes before breathing through the nose.

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