Ep.30: How to Avoid and Treat Severe Afrin Addiction
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.
- Feeling nervous
- Nausea or vomiting
- Loss of appetite
- Dry mouth
- Chest pain
- Heart palpitations
- Dizziness or fainting
- Numbness or pain in hands or feet
- Difficulty breathing
- Bloody diarrhea and abdominal pain
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
- 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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