Background and Aims: Nasal congestion is a prevalent symptom often alleviated with
over-the-counter nasal sprays containing decongestants. Rhinitis medicamentosa (RM),
caused by the overuse of decongestants leading to recurrent mucosal swelling, poses
a significant challenge for specialists in managing patients. Despite advancements
in understanding, research primarily consists of case series with limited data on
its impact on quality of life. This qualitative study aimed to explore the effect
of nasal spray overuse on quality of life and identify addiction components among
individuals with RM. Methods: Twenty participants with RM were interviewed by an otorhinolaryngologist
and addiction counsellor. The study employed a qualitative approach utilising directed
content analysis and revealed eleven categories, classified into addiction components
and distinctive features of nasal spray addiction. Results: The analysis revealed
the presence of all Griffiths' addiction components in the identified themes. Additionally,
sleep disorders, the feeling of suffocation, side effects, illness identity and psychological
effects on nasal congestion significantly impair individuals' quality of life. Conclusion:
This qualitative study identified key components of addiction in nasal spray overuse
and suggested that RM might be conceptualised in the DSM-5 category of "Other (or
Unknown) Substance-Related Disorders", considering the lack of psychoactive effects.
Nevertheless, in view of the current findings, it also seems to be plausible to examine
the phenomenon in the behavioural addiction framework. The study underscores the need
for further research and intervention strategies to address the significant impact
of RM on individuals' quality of life.
