What Is Afrin?
Afrin is a popular nasal spray used to temporarily relieve nasal congestion due to colds, allergies and sinusitis. Afrin contains water and a chemical called oxymetazoline, a topical decongestant exerting vasoconstricting properties. Vasoconstricting agents cause narrowing of blood vessels and capillaries. Spraying Afrin into your nose immediately produces constriction of blood vessels in the nasal passages, which reduces swelling of nasal tissues and congestion.
How Does Afrin Compare to Other Nasal Decongestants?
While Afrin uses oxymetazoline to relieve congestion, other brand-name decongestant nasal sprays like 4-Way and Neo-Synephrine use phenylephrine hydrochloride, another vasoconstricting agent that decreases swelling and congestion.
Since both oxymetazoline and phenylephrine hydrochloride are vasoconstrictors, the difference between Afrin and other nasal decongestants is minimal to none. Some people simply prefer using Afrin over other nasal sprays, and vice versa, for various reasons such as price, effectiveness and availability.
What Are the Side Effects of Afrin?
Afrin users rarely report allergic side effects. However, temporary side effects are common, especially if too much Afrin is sprayed into nostrils. Possible side effects of Afrin use include:
- Stinging and burning of nasal passage tissues
- Runny nose
- Sneezing due to irritation (sneezing stops after irritation diminishes)
Many people who use Afrin for over a week or more experience these side effects when Afrin starts wearing off and sinus tissues begin swelling again. Within seconds of using Afrin, these side effects usually disappear.
This is called the rebound effect of nasal sprays.
What Is the Rebound Effect Caused by Afrin?
Rhinitis medicamentosa is the clinical term for rebound congestion, a major problem caused by excessive and lengthy use of Afrin. This rebound effect has led to the erroneous belief that you can become addicted to Afrin.
Afrin-caused rebound congestion is not a form of addiction. Instead, suffering recurring nasal congestion due to overuse of Afrin is a physiological reaction involving tolerance of nasal passage tissues to oxymetazoline. The nasal spray rebound effect has no psychological component. People don’t crave Afrin the way they would a chemically dependent drug like opiates. The only thing that compels them to keep using Afrin is that they cannot breathe normally through their nose without repeatedly spraying oxymetazoline onto nasal passage tissues.
Is Flonase Addictive Like Afrin?
Flonase is a nasal spray prescribed by doctors for relieving symptoms of allergies and sinusitis. Belonging to the corticosteroid class of drugs, Flonase works differently than Afrin. In addition to reducing inflammation, Flonase also blocks the irritating effects of pollen, dust, mold and pet dander. Also, while Afrin starts working immediately to relieve congestion, Flonase users may not feel congestion relief for a few days.
Although Flonase doesn’t cause a rebound effect like Afrin does, long-term use of corticosteroid nasal sprays can promote recurring nosebleeds and headaches.
What Happens If You Can’t Stop Using Afrin Because of Rebound Congestion?
Your ability to stop using Afrin depends on how you can handle several days of a stuffy nose and being unable to breathe normally. Since the rebound effect isn’t an Afrin addiction, you can withdraw from daily use at home safely.
One way to defeat rebound congestion is to simply go cold turkey. Most long-term Afrin users cannot do this because having a stuffy nose 24/7 is just uncomfortable and interferes with eating, sleeping and work tasks. Saline solutions may help ease the side effects of rebound congestion and get you through the worst days.
Saline nasal sprays contain sodium chloride and water that moisturize nasal passages and remove debris such as pollen and dust. Clearing stuffy nasal passages with a saline solution also gets rid of excess mucus to facilitate breathing normally again. Although saline solutions are non-habit-forming and won’t cause a rebound effect, the relief you feel after spraying saline and water onto your nasal passages is a short 30 to 45 minutes. Fortunately, you can use saline nasal sprays as much as you want without harming nasal tissues.
If going cold turkey or using saline solutions doesn’t work, you can try eliminating the rebound effect by working on clearing one nasal passage. In other words, use Afrin on one nasal passage only while letting the other nasal passage remain congested until the rebound effect wears off. After a few days, you should be able to breathe well enough through one side of your nose to either go cold turkey or use saline sprays on the other side of your nose.
What Is the Clinical Definition of a Substance or Behavioral Addiction?
According to the American Society of Addiction Medicine, “Substance addiction is a chronic, treatable medical disease that involves complex interactions among genetics, chemicals in the brain, a person’s environment and a person’s life experiences. People with a drug addiction engage in compulsive behaviors that continue despite the person suffering harmful consequences as a result of their drug-seeking behaviors.”
The ASAM further states that “treatment approaches and prevention efforts put forth by local and federal agencies are typically as successful as approaches and efforts used to treat chronic medical diseases.”
The rebound effect caused by Afrin overuse is not an addiction to nasal sprays. Rebound congestion that occurs when you stop using Afrin doesn’t require professional intervention by experienced addiction counselors. Nor does it require medical detoxification to rid the body of harmful drugs. Also, rebound congestion is not a medical disease involving the brain. Finally, people compelled to use Afrin on a daily basis don’t engage in behaviors that severely compromise their jobs, relationships and general health.
An Exception: Process Addictions
While the chemicals contained within Afrin and similar drugs do not create a chemical, physiological dependency in the same way that drug families like opiates and amphetamines do, they can be part of a process addiction behavior. This refers to a behavior that someone is ‘addicted to’, not because of the specific chemicals involved, but the behavior’s psychological stimuli and reward of performing. Gambling addiction, for example, does not involve the introduction of external chemicals but is a system finely tuned rewards that can create destructive behaviors. Any urge and relief upon completion can be part of this cycle, but some are more prone to abuse than others. This type of behavior sometimes called a process addiction is an indication that treatment is needed but is only recognized as an official disorder in certain circumstances, such as video games and gambling.
Most can beat a dependence on Afrin by yourself. People with substance addictions cannot. They need empathetic, experienced addiction counselors and psychologists to help them understand why they’re addicted to drugs or alcohol and what they need to do to achieve a successful recovery.
When You Need Professional Treatment for a Real Substance Addiction
Many people entering our rehab center who are addicted to snorting cocaine, crushed opioid pills or methamphetamine have become heavily dependent on Afrin or other nasal sprays containing oxymetazoline or phenylephrine hydrochloride. Snorting drugs is known to gradually destroy nasal passage tissues. Frequent nosebleeds and the development of ulcerations within the nasal passages commonly affect cocaine and meth abusers and intensify the inflammation and swelling of nasal tissues.
FHE Health is a leading substance abuse and mental health treatment facility in Southern Florida that provides personalized care, medical detoxification services and inpatient/outpatient treatment programs to help adolescents and adults regain their physical and psychological health. We also specialize in treating co-occurring disorders involving substance addictions and mental illnesses. Please call us today if you or someone you know has co-occurring substance abuse and mental health disorders.