By: Kat Mulligan
Photo Credits: Pinterest
You gambled with a winter night out, swapped spit with a stranger in a dive bar bathroom, or neglected your vitamins for too many days in a row. With these pleasures now resigned to the past, you lie in bed pondering their worth as your sinuses hammer urgently at your brain like an irate landlord. You caught the bug. In contagious torture, you try feebly to remember the sensation of water gliding smoothly down your throat and air passing graciously through your nose, these sensations which your illness has deprived you of all familiarity with. Oh, what you would give for the monotonous normalcy of health again—that feeling of feeling nothing. And how are you to heal if your congestion prevents you from sleeping?
Oxymetazoline offers you peace in a controlled dose mist. With one spray of this medicated nasal spray in each nostril, within minutes you will be breathing clearly again. Similar to the urge to tear your skin off in oppressive heat, congestion leaves you desperate for a reprieve from your discomfort—if given the option to finally close your mouth again, why wouldn’t you take it? The nasal spray calls out to you as you trudge, leaden-limbed, through the pharmacy.
Eventually, your sickness waves its white flag, and you emerge from your blankets and merrily walk the streets again. Swallowing is no longer a dreaded chore, and you no longer fall asleep in your soup. Your nose, however, bombarded with medication over the past few days, periodically inflates and deflates like a lung. You begin to carry your bottle of nasal decongestant with you wherever you go. “Do not use for more than three consecutive days,” the label says, an omen that has fallen on deaf ears.
You are overjoyed to rejoin society, but little do you know you have merely traded in your old illness for a new one. With every dose of nasal spray, the blood vessels in your nose mercifully constrict to allow airflow—that simple pleasure, that God-given right of easy breathing. Then, when the medicine wears off, your blood vessels mercilessly swell again. To make matters worse, the more you use it, the shorter the intervals between comfort and discomfort become. Rebound congestion, or rhinitis medicamentosa, now keeps you on a short leash.
Whether by winter air, foreign saliva, or scurvy (take your pick), I have found myself in this situation numerous times throughout my life. As a child, when I was sick and at my wit’s end, my father would offer me his bottle of Afrin and warn me not to use it for more than three days. I defiantly used it as much as I needed it, and consequently would incur the wrath of rebound congestion that miraculously cleared up within two weeks without any effort on my part. In October of 2022, however, I did not get off so easy.
It was the classic sickness story, one that I attempted to rewrite with copious amounts of nose spray. I refused to stew in my discomfort. When my cold subsided, I was hooked on Otrivin (as was customary), but I remained unbothered, convinced that sooner or later my body would arrange itself in the right order and snap out of its dependence. On the contrary, what followed was an addiction that lasted over a year.
This addiction was admittedly a ridiculous one, with little social weight. You cannot be kicked out of a restaurant for using nose spray. You can be under its influence at school. It rewards you with no writerly pathos for future biographers to feast on. As obscure as it is, it carries no stigma. The only anxiety I ever had about using it in public was when people assumed that it provided a physiological high, which it did not—in their defense, I was shooting chemicals into my nose and would occasionally shudder at the impact. Anyone who wondered about my decongestant usage on the metro could easily chalk it up to allergy medication anyway.
Nonetheless, I was under its boot. My nasal spray became so much an appendage of me that there came a time in every new friendship or first date where, after my nose indignantly blocked itself up again, I would assume a farcically embarrassed tone and explain my “frequent congestion” to my interlocutor before taking out my nasal spray (which usually occupied a prime place in my pocket). Sometimes I would leave it at a simple congestion problem. Other times I would give a brief overview of rebound congestion, to which they would respond with petty surprise, having never heard of this ailment, and I would laugh just the same. Other addictions, in contrast, are typically skirted around and sneakily accommodated until a solid bond is formed between the user and their friends. Mine, so silly and poorly understood, had the privilege of being immediately approached.
With the people who knew me well, I would look around bashfully and my friends would giggle whenever duty called and the nose spray emerged from my bag. “I’ve never been addicted to nicotine,” I’d exclaim, “but I get stuck with this goofy nose spray!” No intervention was ever staged. I was not hiding out in dark corners to get my fix, nor borrowing money from friends to buy the spray, nor undergoing any visible physical deterioration. The ridiculousness of nose spray dependence allowed me to be open about my use and alleviated the worries of my peers, as it was not nearly as dangerous or stigmatized as other addictions. It became something of a quirk, nothing more, and I was as guilty of giving it that status as the people around me. I would have never purported to suffer the same weight as those afflicted by rampant physical and psychological addictions, for whom I had far more sympathy than I afforded myself. The only situation in which I ever became severe about this dependence was when friends, pained by their own congestion, would ask to try my nasal spray. With alarm welling in my eyes, I would fiercely urge them not to start, not to be like me.
The reality of nose spray dependence is much more grim than anyone (for the longest time, myself included) was willing to give it credit for. It is burdensome to be dependent on anything at all, having to monitor your supply and risking a meltdown if it has been depleted. You either have to buy ahead of your usage rate or know the locations of every 24-hour pharmacy in the city. From a financial standpoint, nose spray is the kind of expense that warrants being budgeted for. Averaging around ten dollars a bottle, prolonged use comes at a cost. Nose spray usage is not free of physical consequences, either. For one, it raises your blood pressure. Similar to but happening at a much slower pace than cocaine, nasal decongestants can wear your septum down to collapse (saddle nose deformity), which you will have to undergo surgery to correct. I also read that the microbiota in the nasal cavity have a link to Alzheimer’s disease, and that damage to the nasal membranes (which I interpreted as either erosion due to nasal spray dosing or the dryness and itchiness that nasal spray causes) can increase your risk of developing it. On a more everyday scale, very rarely did I sleep uninterrupted through the night. My congestion often shook me loose from my dreams and demanded to be dealt with. Even more disquieting was the taste of the spray slithering from your nose to your throat if you shot it at the wrong angle.
Numerous influences were attempting to scare me straight. In every video I encountered about nose spray dependence, the comments were flooded with testimonies about other people’s struggles with it. “This is my second year and counting,” one said. “My mother has taken it every night for the past six years,” another said. I knew full well that I needed to break my habit, lest I chain myself in a lifelong dependence. After a year of clockwork doses, shame had begun to throttle me every time I pulled out my nose spray in company. “When are you going to beat that thing?” my best friend once asked. “I don’t know,” I replied, brow heavy and eyes downturned. People were beginning to notice my nearly Sisyphean plight, and were no longer laughing.
This friend gave me a Vicks Vaporub inhaler, which I never used but nonetheless thanked her for with the same forced gratitude as when people would suggest saline spray to relieve my congestion. They meant well, but due to their misunderstanding of rebound congestion (completely justified, by the way), they were unaware that these remedies were the equivalent of slapping a Band-Aid on a stab wound. I had heard positive things about steroidal nose spray but was unsure how to access it.
Never did I love breathing so vehemently as when I considered beating my addiction. Therein lay the principal struggle with quitting; it is the same reason you develop the addiction in the first place. When you have the option to pacify your suffering, it takes a superhuman amount of discipline not to. When you are breathing clearly through your nose, you tell yourself that the next time your congestion takes hold you will deny it its victory—but every time, without fail, you give in to temptation. In addition to mouth breathing being unnatural and uncomfortable, it boasts a whole array of adverse effects such as dry lips, bad breath, fatigue, a receded chin, irritability, and increased blood pressure. To willingly submit to it is a courageous choice, one that I put off continually in search of the “perfect day”. What I subconsciously knew but refused to openly admit was that there was never a perfect day to quit. A busy day never seemed right, for the distraction of congestion would plague me. But then again, a relaxing day at home was equally unfit for the task, as the lack of stimulation would cause me to concentrate on the sensation in my nose.
One morning, lying in bed with one nostril suffering its routine morning-time congestion, I came across a video about nose spray dependence. Watching it, the sense of my addiction crashed down on me, and I felt like a panicked animal clamoring against the walls of its cage. My dependence on nasal spray terrified me deep down, but beating it was equally frightening. I had tried for the past year to ignore it, pushing off my attempt to quit to some more opportune time, but that morning I decided I would go through with the struggle. My congestion was not as severe as it usually was upon waking up, so I took that as an in.
For the next week, I only took a dose in each nostril at night so that I could make it to sleep. The days were wrought with stuffiness, headaches, and shallow breathing that became unbearable by evening. Slowly they lost momentum, and for the next few days, I only sprayed the medicine in one nostril at night, then rushed off to sleep before the other nostril noticed. I continued to wake in the middle of the night with my nose fastened shut by pressure, but with Herculean might I ignored it. At the week and a half point, I awoke one morning to the realization that I hadn’t taken a dose the night before. Having crested that hill, I had officially disrupted my body’s schedule. I was still congested during the day, but it was manageable enough to where I could get on with daily life and suppress my cravings for nose spray. So it continued—I had broken free, and the only hardship that remained was the typical hardship of a deviated septum haver. A miracle had been performed on me!
Yes, I continue to sleep upright like a horse. Yes, I start the day with a skull full of snot. Yes, when I sit around for too long my nose swells again for whatever reason. But my nose spray has no power over me anymore, and its empty bottles litter my shelf as if it were a graveyard. I made a vow to never again touch that elixir of corrupted hope, as it were—my next cold will put me to the test.
Works Cited
Jin Xie, Shimin Tian, Jun Liu, Ruiyi Cao, Pengfei Yue, Xinfu Cai, Qiang Shang, Ming Yang, Li Han, Ding-kun Zhang. Dual role of the nasal microbiota in neurological diseases—An unignorable risk factor or a potential therapy carrier, Pharmacological Research, Volume 179, 2022, 106189, ISSN 1043-6618, https://doi.org/10.1016/j.phrs.2022.106189.