Can nasal spray be addictive? | Knowledge & Environment | DW

himself at one stuffy nose for a week or two with decongestant nasal spray Getting some air, that’s what many of us do. According to ENT doctors, this is also perfectly fine. It brings relief when our nose is no longer closed and blocked when we have a cold, when we can finally breathe deeply again and inflammatory secretions can flow out of the sinuses. Nasal sprays are a popular and effective solution, at least if we don’t overdo it.

Fluid transition

Nasal spray ensures that the mucous membranes reduce swelling when you have a cold or a runny nose. “The nasal conchae have strong blood vessels. The nasal sprays work on that,” says Thomas Deitmer of the German Society for Ear, Nose and Throat Medicine. “The vessels constrict, the turbinates swell. This frees up the airway in the nose.” The usual sprays are active ingredients similar to adrenaline, according to the ENT doctor. “But they are not mentally addictive drugs.”

When you’re fed up

Most nasal sprays contain mainly xylometazoline or oxymetazoline. These belong to the so-called sympathomimetic agents . These substances cause the blood vessels to constrict, and the unpleasant swelling goes down. We can breathe again. But our mucous membranes quickly get used to a daily dose of the spray that makes you feel so good.

This can lead to the so-called rebound effect lead to a vicious circle: the more frequently we use nasal spray, the faster the effect wears off and the faster we need a new dose. At some point, however, even that no longer helps and a chronic cold can occur with dried out mucous membranes, which can only be kept moist with great difficulty.

Many sufferers administer a portion of nasal spray at least three times a day, many without even thinking about it. After all, nasal spray is not on the list of addictive substances and drugs.

Just a habit or already an addiction?

The feeling that the nose is completely blocked disappears when we use nasal spray. If this effect decreases, we take another dose, maybe even a higher dose. This can then become a never-ending story. If you use nasal spray more and more often, you won’t do yourself or your nose any good in the long run. The nose gets used to the pleasant effect and always wants more of it.

The dangerous drug cocaine is inhaled

The boundaries between pure habit and dependency are often fluid, there Heino Stoever from the Institute for Social Science Addiction Research in Frankfurt (ISFF) to consider. “Nasal sprays have a pleasant effect that clears our forehead, so to speak, and it’s something you can get used to.”

Stöver knows what he is talking about. He can draw on his own experiences. “When I was young, I used excessive nasal sprays myself for years: two to three sprays of spray every day for a period of about two years. I got dry nasal mucous membranes from it. They haven’t recovered from it to this day,” says Stöver.

He took nasal spray at a time when there was no awareness of the problem. It was handled relatively carelessly. Today we know that anything longer than a period of two weeks can have various negative effects. “On the scale of danger, however, I would place nasal sprays at the lower end and not say that they have a huge potential for addiction,” says the expert.

That drug alone does not create dependency. The constant use of nasal spray is not considered an addiction, but it is borderline, says Stöver.

“These drugs have none psychotropic effect, such as cocaine, cannabis or alcohol. On the contrary, they are less effective,” explains ENT doctor Deitmer. “This in turn means that people no longer spray spray into their noses three times a day, but maybe eight times. ”

It becomes very unpleasant when a so-called stinky nose develops

When it really stinks

The effect of nasal spray gradually wears off until it has no effect at all. What remains are dry mucous membranes and they can no longer fulfill their protective function. Our nasal mucosa is there to fight off germs, and this requires moisture.

Constant use of nasal spray has thinned the nasal mucosa so much that the nose can no longer properly moisten the air we breathe. But that’s exactly the purpose of our nose, that it warms, cleans and moistens the air we breathe. “If she can no longer do that, many will appear in the nose bark which then typically become bacterially infected,” says Deitmer ozaena come to a stinky nose. The bacteria that get into the nose cause a foul smell,” explains Deitmer. The nose stinks. Those affected usually don’t smell it themselves, but the people around them do. Nasal sprays are not the solution, but the cause.

Nasal spray can affect our sense of smell

From habituation to weaning

“If you’re not feeling well or you don’t feel well, then you realize how important nasal spray has become in everyday life and that you can’t easily do without it anymore. You simply don’t have the substances,” explains Stöver. With so many people, downright desperation can arise if there is no nasal spray at hand.

One strategy to get rid of the nasal spray is certainly to taper off the remedy, to take it very consciously and less and less. If necessary, you can even keep a record of when you took the last dose, whether there were any signs of illness or whether you just continued to take it out of habit, explains Stöver. There is no real therapy, possibly with an inpatient stay. Everyone has to do it themselves.

It could get worse

The best way to wean off is with sea salt spray, a natural substance. In this phase, many then repeatedly struggle with a blocked and dry nose. But before reaching for the bottle again, it is advisable to see a doctor.

Because dry nasal mucosa can hide serious illnesses and, in the worst case, they are not as harmless as a cold. “You have to try to figure out why the patient has a stuffy nose. It may be in his nose mucosal polyps are. We can then remove them surgically,” explains Deitmer. “But it’s also possible that the patient has an allergic disease that causes the nose to become clogged.” This can then be examined allergologically and then an appropriate therapeutic approach can be found .

Another possible cause of a constantly blocked nose can also be a deviated nasal septum. Surgeons can surgically correct them. In the worst case, there could be tumors in the nose, but that is extremely rare, says Deitmer.

It is clear, however, that a constantly blocked nose has an adverse effect on those affected. “You have a dry mouth, you may snore at night and you don’t sleep well.” Putting nasal spray into our olfactory organ several times a day cannot be the solution.

The doctor and naturalist Paracelsusalready knew about 500 years ago: “All things are poison and nothing without poison – only the dose makes that a thing is not poison.”

This article was originally published on 10/14/2022 and updated on 12/28/2022.