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A survey suggests a fifth of those who use decongestant sprays have done so for longer than seven days, risking developing a dependency, as ITV News Reporter Sam Holder explains
Several million people in Britain could be at risk of becoming “addicted” to using decongestant nasal sprays, research by ITV News and Ipsos suggests.
Overusing decongestant nasal spray can lead some people to developing to a condition known as rebound congestion, a cycle of worsening nasal stuffiness.
Sufferers can then develop a dependence on the spray, as they repeatedly attempt to relieve congestion with more of the product.
The condition is only caused by nasal sprays containing xylometzoline and oxymetazoline – not steroid nasal sprays, or those containing salt water.
The NHS and the product manufacturers themselves warn that these types of nasal spray should not be used for longer than seven days – and that continuous use for longer than this can lead to rebound congestion.
Our survey suggests more than a fifth of adults who have used the products have done so for longer than seven days.
This means an estimated 5.5 million people in the UK could have risked developing a dependency.
Charlotte Johnstone, 30, has been using decongestant nasal spray multiple times a day since she was seven years old.
She thought she was alone before seeing ITV News’ first report into the issue in April, which revealed the impact of this so-called addiction – with some people needing to have surgery as a result of their overuse.
Charlotte told us her dependence has caused her anxiety, and left her “dreaming about not being able to breathe”.
“I can’t sleep without having it, I wake up and the first thing I do is have my nasal spray,” she said.
“I don’t like eating if I’ve got a blocked up nose, it just makes me feel claustrophobic. I wouldn’t put myself in a situation where I don’t have it.”
After decades of using the spray, a dependence which costs her around £30 a month, Charlotte told us she fears the effects the medication may have had on her.
“I go through stages of losing my sense of smell. I know it’s doing something but I don’t know what,” she said.
“But for the sake of having a clear nose, I’ll just take it.”
Charlotte told us some GPs she had approached before had not known about the impact of overusing nasal spray – with some googling the condition during her appointment.
Those suffering with rebound congestion, or rhinitis medicamentosa, are often recommended steroid nasal sprays.
Charlotte told Sam Holder she has driven hours in the middle of the night to 24-hour supermarkets after running out of nasal spray. Credit: ITV News
This type of spray is not “addictive”, and can help people wean off decongestant sprays. However, for many, the process can be daunting.
“Going cold turkey, you’ve got to be really brave for that. I’d have to book a lot of time off work. And it’s very scary to think about,” Charlotte told us.
ITV News received thousands of comments and emails after our first report into the issue, with many reaching out to share similar stories.
“In 2022 I overused it, both nostrils were blocked for 6 months, this is no joke. It was the worst six months of my life,” one wrote.
Another said: “I’m on year 15 of nasal spray and have a full-blown panic attack if i go anywhere and forget it.”
If you’ve had similar experiences, share your story by emailing [email protected]
“I went to the GP because of my dependency on nasal spray and she laughed in my face,” another person added.
After our report, the Royal Pharmaceutical Society launched a survey into the issue – and is now calling for a change in product labelling.
Almost three quarters of pharmacists surveyed believe labelling could be clearer about the seven-day use limit.
Some 63% said they have had to intervene after coming across patients showing signs of overuse, sometimes having to refuse sales.
Professor Amira Guirguis, Chief Scientist of the Royal Pharmaceutical Society, told ITV News: “The response needs to be proportionate to the risk, and at the moment, the immediate, important step to take is to clarify the message and the health advice with a warning on the front of the packaging that this product should not be used beyond the seven-day limit.”
Professor Amira Guirguis told ITV News many pharmacists want to see clearer labelling. Credit: ITV News
The organisation recommends those struggling with the symptoms of overuse should get advice from their pharmacist about other treatment options, which include saline rinses, nasal strips, menthol products and steam inhalation.
A spokesperson from PAGB, the consumer healthcare association representing the manufacturers of these products, said: “The patient information leaflet which accompanies all nasal decongestant sprays, includes these instructions and outlines the risks of taking the medication for longer than its indicated use.
“As explained on the information supplied with the nasal decongestant sprays, OTC medicines manufacturers provide comprehensive accessible information to support people to make responsible informed decisions about the right product to self-care for their self-treatable condition.
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“People can also speak to their pharmacist if they have any questions or concerns about how to use a medicine or whether it is suitable for them to use.”
A statement from the MHRA said: “Patient safety is MHRA’s top priority. We continuously monitor all licensed medicines for safety and effectiveness closely.
“We advise patients to read the information provided with their medicine and adhere to the recommended dose and duration stated. If patients or their carers have any concerns they should talk to a healthcare professional.”
It advised patients with concerns to report them via its Yellow Card scheme.
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