Rebound Congestion & Rhinitis Medicamentosa
Rhinitis Medicamentosa (nasal spray addiction as a result of rebound congestion) is caused by the prolonged use of Afrin and other over-the-counter decongestant nasal sprays. The active ingredient in these sprays is a topical vasoconstrictor that temporarily reduces the size of the nasal turbinates, opens the nasal airway and provides decongestant relief from the rebound congestion.
When the decongestants are used for more than 3 consecutive days, it provokes a condition known as rebound congestion
Rebound congestion is the result of abnormal swelling and enlargement (hypertrophy) of the nasal mucosa, which blocks the nasal airway completely and causes extreme discomfort. This rebound congestion is temporarily relieved once again by the administration of another dose of Afrin or other nasal spray.
As soon as the temporary effect of the last dose of spray wears off, the swollen nasal mucosa again block the airway and another dose of spray is required to provide relief. The commencement of this cycle represents the initiation of the addiction.
Afrin nasal spray addiction can (and often does) last a lifetime. Rhinostat has documented many cases of individuals who reported that they have been addicted to Afrin and other nasal sprays for more than forty years.
Because the nasal spray itself is the root cause of the problem, the only effective way to eliminate it is to discontinue the use of the sprays.
As any person that has suffered with rhinitis medicamentosa will tell you, this is much easier said than done. Breaking this addiction is not simply a matter of will power. The ability to breathe comfortably is essential to normal human functionality.
Only a small percentage of these people (less than 4%, according to our research) are able to endure the misery associated with "cold turkey" withdrawal. Unable to sleep, eat, work or socialize comfortably, the large majority of these people simply return to the use of the spray to end their misery.
Implications For Persons Addicted to Afrin & Nasal Sprays
It is not uncommon for these people to keep their problem a secret from their families, co-workers, friends and even their physicians. They excuse themselves from social settings, wake up in the middle of the night and learn how to integrate the use of the sprays into their daily routines, in solitude.
They keep a bottle of Afrin in their pocket or purse, their nightstand, glove box, backpack, attaché case and anywhere else necessary to ensure that it is readily available when needed.
Addicted persons often stock up, plan ahead and buy in volume (when on sale.) They know every retail store in their neighborhood that carries the product. Some may even rotate the places they go to purchase it, so as not to reveal their addiction to sales clerks. They often purchase other items along with the sprays to draw attention away from the item.
They may not be experts in chemistry, but they know the name of the active ingredient in their particular spray. Oxymetazoline, Phenylepherine or Xylometazoline. Regardless of the specific brand, they always select a spray with the correct compound. Unless they have a very sympathetic and supportive spouse or partner, they buy their own sprays.
The prospect of things such as surgical anesthesia, a camping trip to an isolated location or an ocean cruise (where they have no easy and immediate access to the nasal sprays) is a nightmare.
Many of these people tell us that nasal spray addiction is the most miserable and frustrating problem they have ever dealt with. This entire physiologic and psychological phenomenon is something that Rhinostat is intimately familiar with and it remains the subject of our focused research.
How Physicians Treat Rebound Congestion & Rhinitis Medicamentosa
In search of an answer, many of these patients turn to their physicians for help in ending nasal spray addiction.
Rhinitis Medicamentosa is a very frustrating problem for physicians to effectively treat. There are no FDA approved drugs nor therapies specifically for the treatment of RM patients. Most commonly, these patients are given a course of intranasal and/or systemic steroids and are told to discontinue their use of the decongestants. In some cases, surgery to reduce the turbinates or to correct a deviated septum is performed.
Regardless of what treatment is prescribed, the cornerstone of the therapy is always the same. Patients must discontinue their use of the sprays. It is this aspect of the treatment that presents the problem for these patients.
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