Case Summary
- Tina Mari Halvorsen (31) became addicted to nasal spray after trying it for pollen allergies. She has used Otrivin since 2018 and has tried various methods to quit.
- Halvorsen discovered Proponent, a new treatment from Pharma Nordic, and was able to stop using Otrivin after three days of use.
- A study led by Professor Sverre Steinsvåg showed that Proponent helped one third of participants quit Otrivin completely, and two thirds reduced their use by more than 50 percent.
The summary is created using artificial intelligence (AI) from OpenAI. The content is quality assured by TV 2’s journalists.
– I’ve never really liked nasal spray, Tina Mari Halvorsen (31) tells TV 2.
But seven years ago, she tried regular nasal spray to relieve the discomfort from pollen allergies.
– I lived with someone who was dependent on nasal spray, and it turned out that I borrowed a bit when I was congested.
It quickly led to addiction.
– It didn’t take many days before I also had to buy my first bottle of Otrivin. It took ten days, and then I was fully addicted, Halvorsen recounts.
She says it was nice to be free from being congested and having a runny nose, but when she tried to quit the nasal spray, her nose became more blocked than it had ever been.
– The worst has been at night. You can be motivated to quit, but when night comes and you lie there almost unable to breathe.
– I have used this since 2018, and I have tried everything, says Halvorsen.
Has tried most things
She has been prescribed corticosteroid nasal spray from a doctor. She has tried nasal rinses with saline and nasal sprays from the pharmacy that are supposed to be non-addictive.
– But it is completely impossible to quit. You don’t just become normally congested, but you feel like you’re almost suffocating because it goes all the way down to your throat.
Marte Kvittum Tangen is the leader of the Norwegian Association for General Practice.
– The most important thing is to avoid using the regular nasal sprays, such as Otrivin and Rhinox, for more than a week continuously.
– If they are used longer, there is always a risk of some kind of addiction where you’ll be congested if you try to quit. There are now many viruses and bacteria circulating that cause nasal congestion, but try to use as little nasal spray as possible, and most of it will resolve itself, says Kvittum Tangen.
In early October, Tina Mari heard that a study had been conducted on the new treatment Proponent, marketed by the Ålesund company Pharma Nordic.
She ordered a bottle.
– After three days, I was done with Otrivin. You have to be a bit tough the first few days. But as long as you can breathe a little through your nose the first day, it gets so much better, says Halvorsen.
She has thrown away the Otrivin.
Received placebo
In February, TV 2 reported on André Hagen (56), who had been addicted to nasal spray for 50 years, ever since he was six years old. His mother gave him nasal spray to help him with a nose that was blocked due to allergies.
Since then, he has not been able to quit the spray.
PLACEBO: Nasal spray addict André Hagen received saline instead of Proponent during the blind test. Photo: Olav Wold / TV 2
In February, he was to participate in the world’s first study of Proponent spray to see if the new treatment could cure the addiction.
– I apparently received a placebo. It was not hard to tell, Hagen tells when TV 2 calls him to ask how it went.
– Saline solution reduces congestion somewhat, of course, but using that “Proponent” caused more discomfort, a lot of headaches, and complete nasal blockage.
– How quickly did you realize this was a placebo?
– After day one. There was no effect. Nothing was drying up, and it was blocked up in my forehead and sinuses, and I had a terrible headache, he recounts.
André (56) has been addicted to nasal spray for 50 years
He recounts that he had to rely on the regular nasal spray, Otrivin.
Independent study
– There are several hundred thousand Norwegians who define themselves as addicted to nasal spray to breathe through their nose, tells chief physician and professor Sverre Steinsvåg at Sørlandet Hospital and Haukeland University Hospital in Bergen.
He has led the study of the new treatment. The study is funded by Pharma Nordic, but Steinsvåg emphasizes that he has no financial ties to Pharma Nordic or the new nasal spray.
Used nasal spray for 100,000 a year
Steinsvåg explains that on average, those who volunteered for the study had been addicted to nasal spray for 14 years.
– They spend considerable amounts on this. The worst we encountered used up to 40 sprays a day. It cost her almost 100,000 kroner a year.
According to Steinsvåg, those who are addicted have sprays everywhere.
– Many have a spray in bed, in the car, at work. People become completely desperate if they don’t have one available, says Steinsvåg.
He states that the result is a significantly reduced quality of life and a significant loss of capability concerning work and leisure because they sleep poorly.
Promising results
– Until now, we haven’t had very effective countermeasures, says Steinsvåg.
But now, the new nasal spray has been tested on humans for the first time in a double-blind test. This means that neither the doctor nor the patient knew what was in the bottles the patients received.
194 people participated in the study.
– Half received saline and half received Proponent. The study shows that those who used Proponent were much more likely than those who received saline spray to quit using Otrivin, says the professor.
According to a preliminary tally from the study, about one in three managed to quit Otrivin entirely.
Two-thirds managed to reduce their dependency on Otrivin by more than 50 percent, meaning they halved their consumption.
Additionally, Proponent showed no signs of being more addictive than
The study will now undergo quality assurance and peer review before being published in an international research journal.
– There has been some drop-out of patients in this study, and now we are looking at whether the drop-out has been greater in the saline group or the Proponent group. But my impression is that the drop-out has definitely been greater among those who received saline, says Steinsvåg.
– The spray contains a sodium bicarbonate that has an osmotic effect. It draws fluid out of the nasal mucosa and causes the mucous membranes to contract, allowing for more space.
Must be used correctly
The addictive nasal sprays are nasal sprays like Otrivin, Zymelin, or Rhinox that are effective in the short term. But the packaging states that they should not be used for more than ten consecutive days and that prolonged use can lead to persistent nasal congestion.
It is the British pharmaceutical company Haleon that markets Otrivin in Norway.
Haleon’s Norway director, Signe B. Kullmann, writes the following to TV 2:
“We are aware of the study conducted on behalf of Pharma Nordic. Consumer safety is Haleon’s highest priority and it is important that medication like Otrivin is used in accordance with patient information that you find in the packaging insert and on the packaging. If in doubt about correct use, always contact healthcare professionals for advice.”
– The nasal spray that Tina Mari has tried, I have no experience using for patients. It is not a registered product that we as general practitioners can prescribe. It is sold over-the-counter and contains a hypertonic solution that is supposed to reduce nasal mucosa swelling, says Kvittum Tangen.
– It is quite expensive, so if you can avoid becoming addicted to regular nasal spray, that is absolutely the best alternative, she explains.
PUFF: The nasal spray Proponent appears to have promising effects against nasal spray addiction according to a study. Photo: Frode Hoff / TV 2
– It is not dangerous to try out if it can help someone who has had prolonged use of ordinary nasal sprays with active ingredients and cannot quit.
– Sometimes there is something other than nasal spray addiction that causes nasal congestion, so it is also important to rule this out, continues the leader of the Norwegian Association for General Practice.
The pharmaceutical company Pharma Nordic is paying between six and eight million kroner to conduct the study.
– For us who deal with people with nasal spray addiction, which is quite common in everyday practice in an ear-nose-throat practice, this seems to be a good addition, says Professor Sverre Steinsvåg.
BETTING: Director Bent Andreassen at Pharma Nordic explains that they plan to acquire 40 percent of the rights to the nasal spray Proponent. Photo: Frode Hoff / TV 2
– What are the risks associated with long-term use of traditional nasal sprays like Otrivin?
The text discusses a recent study on a new nasal spray referred to as “Proponent,” which shows promise in treating addiction to commonly used nasal sprays such as Otrivin. Led by Professor Steinsvåg, the research was funded by Pharma Nordic, though he has no financial ties to the company or the product.
Key Points:
- Background on Nasal Spray Addiction:
– Many individuals can become addicted to nasal sprays, often using them for many years—averaging 14 years among study participants.
– Severe cases include individuals using up to 40 sprays a day, costing nearly 100,000 kroner annually.
- This addiction leads to a diminished quality of life, affecting work, leisure, and sleep.
- Study Findings:
– The study involved a double-blind test with 194 participants, where half received saline and the other half Proponent.
– Initial results indicate that one in three participants completely stopped using Otrivin, and two-thirds reduced their usage by more than 50%.
– Proponent did not show increased addictive potential compared to traditional nasal sprays.
- Mechanism of Proponent:
– Proponent contains sodium bicarbonate, which has an osmotic effect, helping to reduce nasal congestion by drawing fluid away from the nasal mucosa.
- Correct Usage and Safety:
– Existing addictive nasal sprays should not be used for more than ten consecutive days due to the potential for persistent congestion.
– Haleon, the company marketing Otrivin, emphasizes that patient safety is paramount and correct usage should be adhered to.
- Expert Opinions:
– Medical professionals advise caution and highlight that while trying Proponent is not necessarily dangerous, it’s essential to rule out other causes of nasal congestion.
– General practitioners suggest avoiding addiction to regular sprays as the best approach.
- Future Steps:
– The study will undergo quality assurance and peer review before publication, and more data will be analyzed regarding participant drop-out rates.
This research could lead to significant advancements in treating nasal spray addiction, potentially offering a new solution for those struggling with this issue.