5.5 Million at Risk of Nasal Spray Dependency as Experts Demand Clearer Warnings

Imagine waking up in a state of panic, your first conscious thought not of breakfast or the day ahead, but of the urgent need to reach for a £3 bottle of nasal spray sitting on your bedside table.

For Charlotte Johnstone, 30, this has been her daily reality since childhood—a 23-year cycle of dependence that has quietly stolen her freedom and left her questioning what long-term damage the medication might have already inflicted on her body.

Yet her struggle is far from unique. New research suggests millions of Britons are trapped in an identical web of chemical dependency, often entirely unaware that the very remedy they're using to breathe more easily is the architect of their entrapment.​

A joint investigation by ITV News and Ipsos has uncovered a public health crisis lurking in millions of bathroom cabinets across the country.

The survey findings are stark: more than one in five adults who have used decongestant nasal sprays have done so for longer than the seven-day limit recommended by the NHS and manufacturers, placing an estimated 5.5 million people at risk of developing a serious dependency.

This is not merely about comfort or convenience. For many sufferers, the consequences stretch far beyond nasal congestion—they include anxiety, panic attacks, chronic sleep deprivation, and in some cases, the need for surgical intervention.​

How Nasal Decongestant Spray Addiction Develops: The Rebound Congestion Trap

The mechanism driving nasal decongestant spray addiction is both elegant and devastating in its simplicity. Sprays containing xylometazoline or oxymetazoline—found in commonplace brands like Vicks Sinex, Otrivine, and Sudafed—work by constricting blood vessels in the nasal passages, providing temporary relief from congestion.

However, prolonged use triggers a condition known as rhinitis medicamentosa, or 'rebound congestion,' in which the nasal tissues adapt to the medication and become increasingly inflamed. When users attempt to stop, their congestion returns with a vengeance—far worse than the original problem.

This creates an inescapable psychological and physiological loop: the only way to achieve temporary relief is to use more spray, deepening the dependency with each application.​​

The NHS and drug manufacturers explicitly warn against using these sprays for more than seven days in a row. Yet despite clear guidance, the practice persists on a staggering scale. Perhaps most troubling is the blindspot among both the public and healthcare professionals.

According to a survey by the Royal Pharmaceutical Society published on 8 January 2026, almost three-quarters of community pharmacists (74%) believe the packaging on these products is insufficiently clear about the seven-day restriction.

Furthermore, 59% of pharmacists surveyed felt that patients are entirely unaware of the rebound congestion risk, suggesting that millions are using these sprays in complete ignorance of the consequence they're inviting.​

Yet the crisis is not invisible to frontline workers. An extraordinary 63% of the 309 community pharmacists surveyed reported that they have intervened in suspected cases of overuse—often by recommending alternative treatments or, in some instances, outright refusing to sell the product.

These professionals are witnessing the human toll up close and witnessing it regularly.​

The Human Cost of Nasal Decongestant Spray Addiction: Stories From the Frontlines

Charlotte Johnstone's account reveals the psychological imprisonment that accompanies chemical dependency. She has been reaching for her spray multiple times daily since age seven, a habit that now costs her approximately £30 per month—a relatively modest financial burden compared to the immeasurable cost to her quality of life.

'I can't sleep without having it, I wake up and the first thing I do is have my nasal spray,' she told ITV News. Eating whilst congested leaves her feeling 'claustrophobic', whilst the prospect of being anywhere without her spray triggers avoidance behaviour that has restructured her entire social existence.​

Most striking is her resigned acceptance of mysterious internal damage. 'I go through stages of losing my sense of smell. I know it's doing something but I don't know what,' she confessed.

Yet the fear of what dependency might cost her during withdrawal proves more powerful than the fear of what continued use might cost her health. '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,' she explained.​

After ITV News's initial investigation into the issue in April 2025, thousands of viewers came forward with remarkably similar stories.

One correspondent revealed spending six months with both nostrils completely blocked following overuse: '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.' Another has been dependent for fifteen years and experiences 'a full-blown panic attack if i go anywhere and forget it.'

Perhaps most damning was the account from someone who sought help from their GP only to encounter dismissal: 'I went to the GP because of my dependency on nasal spray and she laughed in my face.'​

A System Failing Patients: The Call for Urgent Change

Professor Amira Guirguis, chief scientist at the Royal Pharmaceutical Society, has become one of the few authoritative voices demanding systemic change.

'Nasal decongestant sprays can be helpful for short-term relief, but using them for longer than seven days can make your congestion significantly worse,' she stated. 'Our research shows that many people are unaware of this risk, which means they may continue using these sprays without realising they could be prolonging their symptoms. We'd like to see clearer warnings on the packaging which you can't miss and greater awareness of the seven-day limit.'​

Olivier Picard, chair of the National Pharmacy Association, added crucial context: 'When a patient buys medication off the shelf in places such as a supermarket or a petrol station, they may be unaware of the potential side effects of what they are taking or how to safely take the medicine.'

This observation highlights a troubling gap—whilst pharmacists can intervene when they encounter suspected overuse, countless others purchase these sprays in non-pharmacy settings, beyond any professional guidance whatsoever.​

Yet hope exists. Safe and effective alternatives are available, including steroid nasal sprays, saline rinses, menthol inhalations, and steam therapy. For those already dependent, recovery is typically achievable within days of ceasing use, with relapse rates remaining exceptionally rare.

The medical pathway forward is clear. What remains uncertain is whether sufficient urgency will materialise to prevent millions more from becoming trapped as Charlotte Johnstone has been trapped—prisoners of a tiny bottle on their bedside table.​