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Severe nasal spray oxymetazoline use disorder - a case report
Alicia Collette Podwojniak1, Kathy Chen1, Benjamin Pullinger2
1Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA.
Journal of Addictive Diseases
|February 11, 2025
Summary
This case report details a 20-year history of severe oxymetazoline nasal spray use disorder, a condition linked to rhinitis medicamentosa. It highlights the potential for addiction to this common over-the-counter decongestant.
Area of Science:
- Pharmacology
- Addiction Medicine
- Otolaryngology
Background:
- Oxymetazoline hydrochloride 0.05% is a common OTC nasal decongestant for rhinitis.
- Rhinitis medicamentosa (RM), or rebound congestion, is a known side effect.
- The link between RM and substance use disorder is under-documented.
Purpose of the Study:
- To report the first known case of severe oxymetazoline use disorder.
- To explore the relationship between chronic nasal spray misuse and addiction.
- To discuss contributing factors to oxymetazoline misuse.
Main Methods:
- Case report of a 44-year-old patient in addiction treatment.
- Evaluation based on DSM-5 criteria for substance use disorder.
- Review of oxymetazoline pharmacology and intranasal administration behaviors.
Main Results:
- The patient exhibited a 20-year history of severe oxymetazoline use disorder.
- Rhinitis medicamentosa progressed to a compulsive use pattern.
- Cravings and urges persisted despite interventions.
Conclusions:
- Oxymetazoline use disorder can develop from chronic misuse of OTC nasal sprays.
- Pharmacological properties and behavioral aspects may contribute to misuse.
- This case underscores the need for awareness regarding nasal spray addiction.
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