Is Nasal Spray Addiction Real? What School Psychologists Need to Know
In a world where students are increasingly labeled with behavioral and psychological concerns, the question of what counts as an “addiction” is more important than ever. A recent commentary in the Journal of Behavioral Addictions challenges the idea that overusing nasal spray should be classified as a true addiction, raising important implications for how school psychologists think about dependence, behavior, and diagnosis.
The original study being critiqued attempted to apply a well-known addiction framework, identifying signs like tolerance, withdrawal, and relapse among individuals who frequently use nasal decongestant sprays. At first glance, this might sound convincing. However, the commentary argues that many of these so-called “addiction components” may actually reflect something much simpler: a response to physical discomfort, not a psychological compulsion.
This distinction matters. In school psychology, professionals are often asked to differentiate between behaviors driven by emotional or cognitive factors and those rooted in medical or physiological needs. For example, if a student repeatedly uses a nasal spray because they feel congested, that behavior may look repetitive or even compulsive. But according to this analysis, it does not necessarily meet the threshold for addiction, especially if it lacks long-term impairment or distress.
One of the most important takeaways is the difference between dependence and addiction. A person can rely on a substance to function, such as medication for asthma or ADHD, without being addicted to it. The commentary emphasizes that dependence alone is not enough. True addiction typically involves sustained harm, loss of control over time, and meaningful disruption to daily life. In the case of nasal spray overuse, there was little evidence that these more severe consequences were present or long-lasting.
For school psychologists, this has direct implications for assessment and intervention. Over-pathologizing everyday or medically driven behaviors can lead to unnecessary labeling, stigma, and even inappropriate treatment plans. At the same time, it highlights the importance of careful evaluation. Are behaviors persistent over months or years? Do they interfere with relationships, school performance, or emotional well-being? Or are they situational and tied to temporary physical needs?
Ultimately, this debate is a reminder that not all repetitive or high-frequency behaviors should be classified as addictions. As schools continue to address student well-being in increasingly complex environments, maintaining clear, evidence-based distinctions is essential. Careful thinking about diagnosis not only improves accuracy but also ensures that students receive the right kind of support at the right time.
