People have been using vasoconstrictor drops for years and are not even aware of the serious consequences. Together with otolaryngologist Herman Golubovsky from Dr. Sager's clinic, we figure out why a person gets addicted to vasoconstrictor drugs and how to get rid of this addiction.
He graduated from the pediatric faculty of the North Ossetian State Medical Academy with honors.
He completed his internship and residency with honors at the Department of Otorhinolaryngology of the Federal University of Education and Science of the Moscow Regional Scientific Research Clinical Institute (MONIKI).
In 2007 he successfully defended his Ph.D. thesis on the topic: «The use of exogenous nitric oxide in the complex treatment of patients with inflammatory diseases and injuries of the upper respiratory tract.»
German Golubovsky 
expert
Since 2001 he has been working as a doctor in the otorhinolaryngology department of MONIKI. Since 2003 he has been a physician at Dr. Sager's Clinic.
It's like a vicious circle — why a habit occurs
It is sad, but true — people have been sitting on vasoconstrictor drugs for years. We woke up, splashed something in the nose and ran on to live and work. Until a certain point, they don't even consider it a problem. But time passes, and a person begins to realize: something is going wrong.
When a patient comes to me with complaints of a persistent runny nose, the first thing I find out is whether he uses vasoconstrictor drugs and, if so, for how long. And I can already roughly imagine what will be discussed next: a person sincerely believes that he is sick with something, and drops or sprays supposedly help him cope with this disease. Only now, unfortunately, when the effect of these drugs wears off, nasal congestion returns.
Here the mechanism is as follows — vasoconstrictor drugs cause the muscular membrane of small vessels, which are rich in the nasal mucosa, to contract. The vessels are compressed, the mucosa is tightened, nasal breathing is facilitated. But the muscles cannot do without rest: after a while they relax, the vessels dilate, and the mucosa increases in volume. And the air again stops passing through the nose.
To restore breathing, we have to take out the spray again and again. The break between “puffs” is getting shorter, the dosages are also increasing, in the end the nose stops working normally, and the drugs stop helping.
Here you were bad, then it became good, and then bad again. And this «bad» is due to the fact that a few hours ago you sprayed a vasoconstrictor into your nose.
It looks like a vicious circle — a person understands that drops are not an option, but again and again deceives himself. Dependence on vasoconstrictors is much harder than any, even the most severe, cold.
Golubovsky German Alexandrovich 
expert
Since 2001 he has been working as a doctor in the otorhinolaryngological department of MONIKI. Since 2003 he has been a physician at Dr. Sager's Clinic.
As a result of such «treatment», the patient develops a persistent pathological condition, which is usually called vasomotor rhinitis. Puffiness in the region of the inferior turbinates does not go away, the dose of vasoconstrictors increases, and the intervals between instillations are reduced. The aerodynamics of the nose is disturbed, and this, in turn, can lead to impaired ventilation of the auditory tubes, which often provokes hearing loss and tubo-otitis.
Look at the label — many drops differ only in packaging
Communication with patients with vasomotor rhinitis in this regard is very similar to communication with drug addicts. The person is sure that there is no dependence, but he regularly changes drugs — first he uses one, then another, then the third. Indeed, the instructions usually say that you can drip or irrigate the nose for no more than seven days. Formally, the person did everything right — he changed the drug.
But I will tell you a little secret: when you buy a vasoconstrictor or any other medicine, pay attention to the active ingredient. Because — surprise — many drugs differ only in packaging.
Most vasoconstrictor or nasal decongestants contain xylometazoline, phenylephrine, naphazoline or oxymetazoline as the main active ingredient. You go into a pharmacy and you see a whole rack of drops and sprays in front of you, but in fact in all these boxes there will be only four active ingredients. Therefore, when you change, for example, «Rinostop» to «Tizin», then in fact you remain on the same drug.
How vasoconstrictors affect the body: from coughing to heart problems
Passion for vasoconstrictor drops is not only addictive, but generally not very good for health. The main problem is in their systemic action: when the vasoconstrictive effect extends not only to the “necessary” vessels, but also to many others.
These may be the vessels of the posterior pharyngeal wall — and then patients complain of dryness and sore throat. It can be the vessels of the brain — and then the drops affect the cerebral blood flow, and the person is worried about headaches, decreased memory and attention. Vasospasm can cause high blood pressure and heart palpitations. And the use of vasoconstrictors during pregnancy can lead to vasospasm of the placenta and increased uterine tone.
I'm not talking about the poisoning of children with drugs containing naphazoline as an active ingredient. In our country, these drugs are allowed for children older than two years, and in other countries these drugs are either discontinued or prohibited for children.
Why do we need these drops at all
The side effects that I talk about are mainly manifested with long-term use and non-compliance with the dosage. And so, vasoconstrictor drugs are never evil. Sometimes they are necessary, it's just that people don't always read the instructions carefully.
Here is a man who fell ill with seasonal SARS and had a stuffy nose. Can he use vasoconstrictor drops? It is possible, only not in order to breathe through the nose even during a severe cold, but so that there is no stagnation of mucus in the sinuses. Why is stagnation bad? Because mucus accumulates, microbial inflammation joins, purulent snot begins and the runny nose drags on. This is at best.
There is an expression: «If a runny nose is treated, then it lasts seven days, and if not treated, then a week.» Unfortunately, it is not true. I ask my patients to use vasoconstrictors during acute rhinitis. This will not only improve the general condition of the body, but will also prevent otitis media and sinusitis. It is important that there is an outflow of mucus so that the snot stands out and is transparent. If a runny nose is really well treated, then it lasts just a week.
How to get off the vasoconstrictors
1. Stop in time
You will feel the moment, maybe after 3 days, or maybe after 7, when the treatment with vasoconstrictors begins to turn into addiction. So you sprinkled the medicine — and life became beautiful, the nose breathes, the head does not hurt. And after a few hours — the nose is blocked, I want to lie down, everything is bad. And it seems that you need to “puff” again and everything will work out.
Gather your will into a fist, endure a couple of days, you will definitely feel better. If the addiction has already formed, then the recovery time for normal nasal breathing will increase — usually it takes about two weeks.
3. Move more
Woke up and my nose is not breathing. Do not immediately look for medicine on the bedside table. Get up, do exercises, take a contrast shower, drink hot tea or coffee — the blood will drain from the nose and it will become easier to breathe. An evening jog in the park, an active walk with children or a dog will not only distract from thoughts about the disease, but also alleviate the condition.
4. Alternate between vasoconstrictors and seawater sprays
If addiction cannot be avoided, try to slowly reduce the dosage and increase the interval of taking vasoconstrictors. You can switch to baby sprays, as they have a much lower concentration of the active substance. Alternate between vasoconstrictors and seawater sprays — they are safe and effective.
4. Monitor the microclimate in the apartment
Keep an eye on the humidity in the room and, if necessary, use humidifiers. The ideal healthy humidity is 45-50%. Raise the head of the bed, this position will improve the quality of sleep.
5. Bury the medicine in only one nostril
If it is difficult for you to wean, and your hands are reaching for the coveted bottle, you can do the following: bury the medicine in only one nostril, then the second mucosa will be like » rest.”
It is quite difficult to overcome dependence on vasoconstrictor drugs, often people feel helpless and desperate, they lack willpower. In this case, you should contact an otolaryngologist. The ENT will select the therapy and, if necessary, suggest other, more effective, methods of treatment.
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