Is Nasal Spray Addictive?

If you've ever had seasonal allergies, hay fever or sinus problems, you're probably familiar with intranasal spray. It comes in a variety of forms from over-the-counter brands like Afrin for short-term use to prescription varieties like Flo-nase that a doctor may have you use for a longer period.
Nasal spray can be powerful and employ steroids. And sometimes, after a while, people want to continue its use or up its dose. Does that mean nasal spray is addictive?

How Nasal Spray Works

Nasal sprays treat congestion and itching in the nose and sinuses by restricting blood vessels and thereby triggering decongestion and reducing swelling. Typically, doctors advise the use or prescribe these sprays for allergies, hay fever and colds, and occasionally as a presurgical treatment to reduce any swelling in the nose.

Steroids

Most nasal sprays rely on a steroid for their active ingredients. Although steroids can create long-term health concerns, and over-the-counter products have higher steroid levels, neither the steroids nor the sprays themselves are physically addictive.
Steroids in small doses have little to no long-term effects. However, steroids in larger doses and under prolonged use can affect hormone balances. In significant doses, they can increase strength, but affect testosterone balance. Nasal spray is unlikely to come close to having this type of effect. But many people worry about the unknown effects of prolonged use.

Tolerance

Repeated use of a nasal spray may lead to a tolerance issue. The usual dose no longer creates the initial effect. Therefore the patient may begin to increase dosage to re-create the decongestive result desired. This is sometimes perceived as a sign of addiction.
In fact, it's just that the body has gotten used to the spray and is no longer as receptive. Higher doses may cause the body to react again.
But physicians advise that the better course is to stop using the spray for a few days. After that, the body should again respond to the initial dose again.

Better Sprays

Traditional over-the-counter nasal sprays tend to be strong, use traditional steroidal solutions, and result in tolerance issues sooner. Many prescription sprays--especially new-generation medications--are better designed to avoid tolerance, or at least stave it off longer.
If tolerance is a problem, see a physician about prescriptive nasal spray options.

Other Choices

Another solution to nasal spray tolerance is to look into other methods for decongestion and allergy relief. Nasal spray is not always the best choice for everyone. Oral decongestants, oral antihistamines and saline nasal drops or sprays may be viable alternatives. Over-the-counter nasal sprays are not meant to be long-term or ongoing solutions. If a problem is chronic or long-lasting, these other options are very likely better choices.
Again, before using any intranasal treatment, it's always best to confer with a doctor.

References

• MayoClinic.com on nasal sprays
• Web MD on nasal sprays
• New York Times: Concerns