Ep.30: How to Avoid and Treat Severe Afrin Addiction
Show Notes
Afrin nose spray works wonders to improve nasal congestion but it is not meant for long term or recurrent use. I have already shared some doctor-approved tips for using Afrin, but let’s be honest, many people still use it incorrectly. Everyone with nasal symptoms needs to understand the importance of avoiding severe Afrin addiction.
Many people have heard that nose sprays are bad because they can be addictive, and this can be true. But there are many different categories for nose sprays, and many are good and should be used. The category that can lead to worsening problems is called a decongestant, and this includes Afrin.
I used to be able to say over the counter nose sprays are the ones that can be addictive, but now nose sprays that are good for daily use are also over the counter! This issue highlights the importance of knowing the name of the medications that you are taking.
What are decongestants?
Decongestants are a type of medicine that can give some short-term relief for a blocked or stuffy nose. If you are unsure what medications are decongestants, look at the medication list on the label and see what is included. Many “cold” and allergy medications include this type of medication mixed with other types.
Nasal decongestant sprays contain such ingredients as oxymetazoline (e.g., Afrin), phenylephrine (e.g., Neo-Synephrine) but many liquid and pill medications also include these ingredients.
Some people choose decongestants on purpose while others do not realize they are using them. Zytec D, Claritin D, and Allegra D are often surprising decongestant medication to many people since they are often labeled as allergy medications.
But just know that “D” is a decongestant, so it is meant for only short term use. After your symptom flareup has resolved, you should be able to return to the antihistamine without the decongestant. If not, you may consider a trip to your physician to discuss the best allergy treatment for your particular symptoms.
What are the side effects of decongestants?
Decongestants often do not have any side effects, and if they do, they are usually really mild. Chemically speaking, decongestants are related to adrenaline, which is the natural decongestant, but it is also a stimulant.
- Confusion
- Feeling nervous
- Headaches
- Nausea or vomiting
- Loss of appetite
- Tremor
- Restlessness
- Dry mouth
- Chest pain
- Heart palpitations
- Dizziness or fainting
- Numbness or pain in hands or feet
- Difficulty breathing
- Hallucinations
- Bloody diarrhea and abdominal pain
- Seizures
Most people can use decongestants safely, but they may cause health problems for some people. I always recommend avoiding decongestants in kids unless recommended by a physician.
Also, you need to let your physicians know ALL of the medication that you are taking or have at home to take as needed. There may be interactions or consequences that happen when medications are mixed together.
A good rule of thumb might be to avoid taking decongestants if you have any of the following:
- Kidney disease
- Diabetes
- Glaucoma
- High blood pressure
- Heart disease
- Overactive thyroid
- Prostate problems
- Women who are breastfeeding
Remember to keep your physician in the loop when you begin to take any new medications. Healthcare has become much more complex with many of us getting care at a variety of urgent care centers because they are convenient. Please remember that even though urgent cares are helpful, you must keep your personal physicians updated because they act as the gatekeeper to your healthcare. Someone needs to know your entire healthcare story and oversee its management.
What is severe Afrin addiction?
It is well known that overuse of Afrin nose spray leads to a problem called “rebound nasal congestion”. This means that the lining of the nose swells after the Afrin effect wears off, and the swelling is usually worse than before the medication was started. The technical name for this issue is called rhinitis medicamentosa,
This severe rebound congestion can only be improved by continuing to use the nasal spray. This becomes a vicious cycle and explains why you will hear people say they have become “addicted” to the nose spray.
The term addiction is actually not correct in this instance but it is commonly used. True addiction is a compulsive physiological need for and use of a habit-forming substance known to be physically, psychologically or socially harmful. Over-the-counter nasal sprays don’t cause the physiological cravings that mark an addiction. They do however make people feel good by helping them to breathe easier.
People develop a tolerance to decongestant nose sprays such as Afrin. This means they need to take increasingly larger amounts to achieve the desired effect. Tolerance can lead to physical drug dependence, which is different than drug addiction. You can become dependent on nasal spray, but not addicted to it.
According to the National Institute on Drug Addiction, there’s a difference between physical drug dependence and addiction. You may be physically dependent on medications when skipping a dose causes withdrawal symptoms, such as nasal congestion.
How can I avoid severe Afrin addiction?
Steps to avoid severe Afrin addiction or dependence:
- never use it for more than 3 days.
- consult your primary care physician to learn about the underlying nasal problem
- consider using nasal steroid which are long term anti-inflammatory medications to reduce swelling
- See an ENT surgeon to determine if there is a structural problem like enlarged adenoid, deviated septum, enlarged turbinates or chronic sinus infection (consider having surgery to remove the structural blockage will allow the recurrent swelling to be treated more effectively.)
Is there a way to wean off Afrin nose spray?
Most people successfully recover from their nasal decongestant tolerance by completely stopping the nose spray. However, there are people who repeatedly fail because they cannot tolerate the rebound symptoms.
Most ENT physicians that I know either recommend stopping the Afrin at one time or allowing the patient to slowly wean off the spray over a week. To help control the withdrawals symptoms, we often recommend nasal steroid sprays and a short course of oral steroids.
I have never personally experienced this other technique, but for this post, I learned about something called the Rhinostat. The Rhinostat kit includes a metered dose delivery system that dilutes the nasal spray dose by 10 percent to 15 percent every day until the nasal turbinates are able to resume their normal functioning. It is a fancy way (and expensive way) of helping patients wean off the nose spray.
Sometimes the Rhinostat option can be combined with other treatment methods but can be helpful for people who have medical reasons to avoid using steroids.
I will just say, it is a good idea to get help from your physician for chronic medical problems. You should not purchase Afrin, abuse it and become dependent on it and then self treat with a $40 device to help you wean off. Your physicians are here to help determine why you needed the spray in the first place and how to prevent a recurrent problem.
How often will severe Afrin addiction recur?
As I have said a million times, you need to understand why you have nasal congestion and work with your physician to determine a long term treatment plan.
There are people who have been misusing/abusing Afrin nose spray or other nasal decongestants for months or even years. Nevertheless, everyone can be successfully treated. Recovery typically takes less than one week and withdrawal symptoms can be relatively easily managed.
Research suggests that the best way to stop overusing nasal decongestant spray is to switch to a nasal steroid spray. About six months after stopping a medication like Afrin nose spray, most people no longer have a tolerance to it. Studies show that relapse is very rare.
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16 comments
Thank you Dr. Momma. Your post clarified it for me.
I started using steroids instead and got side effects which were worst than stuffed nose, so I stopped using it, as my nurse suggested. Now I am wondering if I could go cold turkey and how bad it is going to be. My nurse suggested a slowly wean off. I am not sure what the best way is.
I cannot give specific advice for your situation but I must ask, what does your primary care physician recommend? Physicians have completely different training from nurses or nurse practitioners. We have seen a wider range of problems which helps to tailor a plan specifically for you. There is no “one side fits all” answer. If your primary care physician cannot manage your problem, they will refer you to an ENT specialist because we have even more experience in this specific issue. Hopefully, this information is helpful.
I would like to say thank you for this article. Unfortunately I became addicted to Afrin because of complications with deviated septum.. It was helping me breathe normally but I abused it for almost a year. I just recently purchased the Rhinostat kit and I hope to wean off slowly. I tried to stop cold turkey while using Omnaris but my anxiety became too much to handle when it was time for sleep. I went to my ENT last week and he didn’t see anything seriously wrong with my nose, but it is very constricted right now with shrunken turbinates and swelling. I very much hope to be nasal spray free by January 2020, it would be a dream come true.
So sorry to hear this but glad you are on the mend. The Rhinostat is a good way to wean. Some severe cases need a few days of oral steroids while then beginning a nasal steroid spray. Good luck with your full recovery.
thanks for ALL the feedback MY GOD my anxiety is really high! I never had any issues with allergies or congestion.. but on some night my nose would clog up and I started using a walmart brand of nasal decongestant.. needless to say I got hooked and started to use this product Every Night! I found Rhinostat and going to use their product… hOPEFULLY MY ANXIETY AND FEARS WILL SUBSIDE!!
So happy I could help get you started on your journey to kick the Afrin habit. It is actually very common. If you find you are still having difficulty, please consider seeing an ENT to evaluate the cause of the nasal congestion.
I use Affrin occasionally at night when I can’t sleep due to congestion and don’t want to become dependent. I read multiple places (like your article) to not take it more than 3 days, but then what? Never take it again for life? Skip a day, or several days, or a week, or something else??? What pattern of use will prevent the rebound symptoms?
I am a big fan of understanding WHY medication is needed and then treating the underlying problem. Afrin only temporarily masks an issue. If you have recurrent nasal congestion, you may need an ENT evaluation to determine if there is a structural problem, possibly combined with mild allergies. It is always better to find a long term treatment such as flonase or saline washess instead of emergent Afrin use. Good luck.
My wife has been using Afrin non stopping for 3 years now and she can’t stop it. She may use it like 20 times a day yes 20. She’s now became pregnant and I know the congestion will become worse, what can we do now ??
Thanks
Oh goodness, this is not a good thing. I recommend you see an ENT as soon as possible. I have outlined some of the treatment options but it needs to be tailored to her symptoms.
Really informative article. I wonder if you had a moment to answer a question? Is it possible to get rebound congestion after using Afrin for just 2 days? I’ve never used any nasal sprays before until this week. I’m battling what I believe is a cold and I have severe congestion. I tried Afrin and it worked amazingly the first 3 times I used it. (every 10-12 hours as directed) The fourth time I did it, it wore off much faster (like within a few hours versus the 10 hours it had lasted the previous times) and I feel like my congestion is actually even worse now. Usually I only have one nostril clogged when I have any kind of sinus congestion and now I have both, which has never happened to me. I can not breathe at all through my nose.
Yes it is possible but more likely is that you have not treated the underlying reason for the congestion. If there is a sinus infection or allergies, you would want to use the Afrin with saline nasal washes and possible nasal steroids which will treat the active problem. If ongoing symptoms, may need to be seen by your physician. It sounds like the Afrin is not working because another problem needs to be diagnosed and treated.
Thank you so much for your comment! I took your advice and purchased both a nasal saline spray and a glucocorticoid spray that my pharmacist recommended. I’ve never been prone to allergies, so I just assumed I had a cold. But after ditching the Afrin and using the steroid and saline sprays, I can already feel a huge difference in just one day. Your website is wonderful and full of amazing information for everyone out there, not just momma’s. You gained a fan in me.
So happy to hear this! Many people are unaware that they have allergies so I am working to help change what we consider allergies as well as when and how to treat them.
Thank you for your article. When I was a child I had a lot of sinus problems. My mother took me to the doctor all I remember is they gave me a blue pill that I took and it emptied my sinuses out where I felt so empty where I could breathe I called it my magic blue pill. But I never got any more after that Mom ended up putting me on Dristan in which I was on for years until I realized that was what was causing my insomnia. Somehow I ended up getting off of it it wasn’t easy but I did it. So I am embarrassed to say I’m in the same boat only with Afrin. I should have known better but it ended up being a gradual thing and I thought I had control wrong. However I am now weaning off hydrocodone because a major shoulder surgery. I am down to two pills and hopefully in 8 days I am totally off. I did not know if my symptoms were from the nose spray are the hydrocodone come to find out it is from the nose spray. It is harder getting off of it at this time then the hydrocodone because I am claustrophobic and just the littlest bit of not being able to breathe since me in orbit. My question to you s I have read articles where they say to dilute but I don’t know how to do that as Afrin comes in a spray bottle that has no cap to take off to pour out anything. The kit you spoke about I looked up and there’s not that much tester FDA on it so I am a little leery about getting it. Can you give me how to dilute the Afrin with what in order to wean myself off. Some places I have seen where they talk about 25% and Flonase.some talk about sntihistimine. Can you give me an idea how to dilute and what I should use to wean myself off I would appreciate any help you can give me. As I said I am going through weaning off hydrocodone as well. I want off this Afrin as soon as possible however I’m not sure I can do both at the same time
I am so sorry to hear about your nasal problems but you are not alone. Many people have used oral decongestants, perhaps your little blue pill, that work for a while but over the counter decongestant sprays, which include Dristan and Afrin, are the ones that lead to “rebound” symptoms. Have you been to see ENT? This can be a difficult problem to address on your own. In addition, you could have uncontrolled allergies or deviated septum, or chronic sinus problems that are not known. A more intensive nasal evaluation and treatment plan can be made specifically for you since everyone does not need the same approach. Best of luck to you.