How Are Nasal Decongestants Addictive?

QUESTION: An article in a health magazine stated that the constant use of
nose sprays can be addicting. How is it possible that a nose spray can lead
to an addiction, when there are no narcotics in the liquid?
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ANSWER: If you consider the definition of the word "addiction" to mean the
habitual use of a substance upon which the body comes to depend, then we can
proceed with an explanation. I am sure that the article that you read was
referring to a condition called "Rhinitis Medicamentosa". Before I get into
this condition itself let me describe rhinitis. This condition features
runny, stuffy and itchy nose accompanied by a dry mouth and sneezing. It is
caused by inflammation of the tissue's lining the nasal passages along with
enlargement of the blood vessels, that run inside the tissue. Nasal sprays
cause the blood vessels to contract which, in turn, reduces the amount of
inflammation. When the sprays are used constantly over a long period of time,
say 1-2 weeks, the tissues become dependent on the medication to keep the
blood vessels shrunken, and the inflammation controlled. Unfortunately when
you stop using the sprays, control is lost, the vessels will enlarge once
again and the runny nose returns. This time though it is not due to the
illness, but to the nasal tissue's dependence or "addiction" to the nose spray.
This is the condition called rhinitis medicamentosa, more commonly called
"rebound rhinitis". As a matter of fact, if you take the same medicine
(decongestant) that was contained in the spray, in tablet form, the rebound
condition does not occur. People with bad allergies or other medical
conditions that can lead to symptoms of rhinitis should be evaluated by their
doctor and followed closely in order to keep a check on the medications they
use. Remember, while using over-the-counter medications for a short period of
time for minor maladies is safe, long term, continual applications bring on
unwanted and often unexpected side-effects. If that happens to you, or if
runny and stuffy nose symptoms persist far beyond the time you would expect
your cold or allergy to persist, it would be wise to check with your doctor,
to make certain something more serious is not developing.