6 ms·

Acetaminophen and the War on Drugs (2009)

154 points by hachiya 16y ago

j_baker 16y ago
It's worth pointing out that the FDA has since voted to reduce the levels of acetaminophen in vicodin. http://abcnews.go.com/m/story?id=12607415 http://abcnews.go.com/m/story?id=12607415
- blhack 16y ago
  Maybe I'm just in a strange mood, but that is one of the most bizzare statements (with context) that I've ever heard. It's like something directly out of George Orwell. "Party officials recently voted to approve a measure that would decrease the amount of poison included in medicine." ahem "New techniques developed by party scientists have caused medicinal purities to reach an all time high!"
  - Alex3917 16y ago
    "Your weekly chocolate rations have been increased from 100 grams to 80 grams." It's actually even more accurate than you might think, because APAP works by acting on the endocannabinoid system. Essentially acetaminophen works exactly the same as weed, the only difference between tylenol and weed is that one kills several thousand Americans per year and the other kills zero. Well actually there is one more difference: weed actually works amazingly well as an analgesic, whereas tylenol doesn't do anything. (Except kill people.) http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T1J-4J3WSHD-7&_user=10&_coverDate=02/15/2006&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=43c4235e76475c360ce2e9f74a168f50&searchtype=a http://www.sciencedirect.com/science?_ob=ArticleURL&_udi...
    - tokenadult 16y ago
      Your statements about weed are very likely exaggerated in one direction, while the statements about acetaminophen are exaggerated in another. The cited journal article does not give full backup to the statements in your post.
      - Alex3917 16y ago
        From Wikipedia: "Paracetamol also modulates the endogenous cannabinoid system.[44] Paracetamol is metabolized to AM404, a compound with several actions; most importantly, it inhibits the uptake of the endogenous cannabinoid/vanilloid anandamide by neurons. Anandamide uptake would result in the activation of the main pain receptor (nociceptor) of the body, the TRPV1 (older name: vanilloid receptor). Furthermore, AM404 inhibits sodium channels, as do the anesthetics lidocaine and procaine.[45] Either of these actions by themselves has been shown to reduce pain, and are a possible mechanism for paracetamol. However, it has been demonstrated that, after blocking cannabinoid receptors with synthetic antagonists, paracetamol's analgesic effects are prevented, suggesting its pain-relieving action involves activation of the endogenous cannabinoid system.[46]" And as I have posted before, marijuana is an anxiolytic, anti-inflammatory, anti-angiogenic, anti-viral, antibacterial, neuroprotective, and pro-neurogenesis. It's down the most important of any drug there is. Plus it increases your IQ by an average of 6 points, decreases your diabetes risk by 66%, and can be used to treat everything from Parkinson's to cancer. There is even some research suggesting that up to 50% of all infant mortality may be the result of marijuana deficiency. http://news.ycombinator.com/item?id=1979857 http://news.ycombinator.com/item?id=1979857 http://www.matrixmasters.net/salon/?p=258 http://www.matrixmasters.net/salon/?p=258 http://www.mediafire.com/?4s8s6w9bwpmg24u http://www.mediafire.com/?4s8s6w9bwpmg24u http://www.safeaccessnow.org/section.php?id=125 http://www.safeaccessnow.org/section.php?id=125 http://norml.org/index.cfm?Group_ID=7002 http://norml.org/index.cfm?Group_ID=7002 http://www.matrixmasters.net/salon/?p=153 http://www.matrixmasters.net/salon/?p=153 http://www.matrixmasters.net/blogs/?p=212 http://www.matrixmasters.net/blogs/?p=212
        j_baker 16y ago
        > There is even some research suggesting that up to 50% of all infant mortality may be the result of marijuana deficiency. I was going to ask what you're smoking, but then I realized that was a dumb question. :-) I'm all for using pot for medicinal (and recreational) uses, but I think you've crossed the line from advocacy to cheerleading. Believe me when I say that if pot did all of the things you claim, I'd be in perfect health.
    - blhack 16y ago
      "Increased from a measly .1 kilgrams to a full 80 grams!"
MichaelGG 16y ago
The sillier part of adding acetaminophen to hydrocodone and other opiates is that it's easy to remove the acetaminophen via cold water extraction. Thus, anyone looking to seriously abuse Vicodin can avoid the damage with just a bit of work.
- Alex3917 16y ago
  Exactly. Anyone who wants to abuse opiates can do a simple cold water extraction to almost completely remove the acetaminophen in less than five minutes, or else they can potentiate them using the techniques here so they only need a tiny dosage: http://www.hipforums.com/newforums/showthread.php?t=305596 http://www.hipforums.com/newforums/showthread.php?t=305596 What this means is that the vast majority of those dying are those using these drugs for legitimate medical problems. And it's not a small number of people either; 7,500 people in the US die each year from NSAIDs, and countless more survive but are permanently crippled. The new government guidelines do absolutely nothing to fix the problem, they're just propaganda to support what is essentially a government campaign to poison the elderly and chronic pain patients.
  - cynicalkane 16y ago
    they're just propaganda to support what is essentially a government campaign to poison the elderly and chronic pain patients. The government is trying to murder the elderly with drug programs? This is almost a Godwin, but much more silly.
    - Alex3917 16y ago
      "This is almost a Godwin, but much more silly." You want me to link to the obituaries? Almost 1 in 3 Americans die from drug use or drug-related causes, and I really don't find that silly at all. 500,000 from tobacco and second-hand smoke. 106,000 from adverse reactions to prescription drugs in hospitals. 85,000 from alcohol and alcohol-related fatalities. 17,000 from illicit drugs. 7,500 from NSAIDs. 4,000 from HIV acquired from needle sharing, etc. That means if we keep doing what we're doing now, if we don't change our policy on drugs, then of the 310 million Americans currently alive, at least 93 million will die from drug use. Given the average US lifespan of 77, that's a full holocaust every 7.5 years. Obviously not every last death is avoidable, but the overwhelming majority of them are. The ONLY solution is real education based on science, not propaganda. The drug war makes this completely impossible by A) banning science B) banning education C) banning treatment. The fact is that drug addiction has nothing to do with the molecule, and so the way we are treating 'addiction' actually makes the problem vastly worse: http://www.wpr.org/book/100307a.cfm http://www.wpr.org/book/100307a.cfm http://www.nijc.org/pdfs/Subject%20Matter%20Articles/Drugs%20and%20Alc/ACE%20Study%20-%20OriginsofAddiction.pdf http://www.nijc.org/pdfs/Subject%20Matter%20Articles/Drugs%2... So if this sounds like a Godwin argument, that's probably because the war on drugs is responsible for vastly more deaths than the holocaust.
deleted 16y ago
[deleted]
ojbyrne 16y ago
So total aside, inspired by the mention of denatured alcohol. How come you can buy bitters, which are up to 50% alcohol (i.e. 100 proof), without having to be of legal age?
- code_duck 16y ago
  I tried to buy bitters at 4 am the other day and they wouldn't let me due to the alcohol content. Pretty stupid, since getting intoxicated from bitters would be about as much fun as drinking cooking wine.
  - kjhgtfbn 16y ago
    A UK supermarket was banned from selling liquor chocolates outside licencing hours!
- defen 16y ago
  During prohibition, certain bitters were legal because they were considered "nonpotable". Angostura falls under this category, whereas something like Campari or Fernet Branca would be considered potable. Basically they didn't think anyone would be able to drink enough to get drunk from it. I assume a similar logic applies today.
InclinedPlane 16y ago
A bit like shooting someone who is attempting suicide. Prohibition v. 2 has proven to be just as disastrous as v. 1, when will there finally be enough political momentum behind ending it?
- MichaelGG 16y ago
  Not quite. It's more like shooting anyone crossing a bridge, would it be to get to a hospital, sightseeing, or bungee jumping off it.
- tsotha 16y ago
  >...when will there finally be enough political momentum behind ending it? I keep thinking next year... next year... but the reality is as people get older and have kids they start to view any sort of recreational drug as a threat to little Johnny. So that pot-head you knew in college? He's voting against every attempt to soften drug laws.
code_duck 16y ago
One alternative he doesn't mention is Vicoprofen, which contains ibuprofen rather than acetaminophen.
- defen 16y ago
  Ibuprofen is also not-so-great for your kidneys, although not nearly as bad as acetaminophen is for your liver.
- SoftwareMaven 16y ago
  So you can strip the lining in your stomach and intestinal track instead of blowing your liver. The article is correct: there is no value in adding anything to the hydrocodone and many possible down-sides.
  - code_duck 16y ago
    No, of course there isn't any value. But ibuprofen isn't as harmful as acetaminophen.
- tomjen3 16y ago
  That's not really worth posting, since it is also toxic. We need something that can remove the toxins from the drug and the politicians from any power they have in this world.
mynameishere 16y ago
This is why you always, always, buy your dope from hillbillies.
apu 16y ago
Completely off-topic, but: There is a better review in the WSJ today but I can't link to it.
sguelich 16y ago
Sad to see an HN thread full of conspiracy theories and so little actual science. Believe it or not, acetaminophen is an effective analgesic, and combined with hydrocodone it provides synergistic pain relief without any increase in side effects over the use of either agent alone. Here's a peer-reviewed 1980 study from the UK showing just that: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1430165/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1430165/ Private drug companies didn't pursue testing & selling hydrocodone/APAP in combined form because the government hates drug users. They did so because they can market a highly potent form of pain control. Not everything in life is a government conspiracy!
- kennywinker 16y ago
  Nobody is saying acetaminophen is ineffective, just that it's effects come with hepatotoxicity. A larger dosage of hydrocodone could have the same net analgesic effect without the huge negative effects.
  - arn 16y ago
    "Nobody is saying acetaminophen is ineffective" Actually, the linked article is saying exactly that: "I remember being annoyed that in order to get narcotic pain relief I was being forced to take a hepatotoxin that added little to the pain relieving efficacy of the opiate."
    - defilade 16y ago
      It was ineffective for the author of the article. That doesn't mean it's ineffective for everyone.
      - duncanj 16y ago
        It's not like he did an n=1 study. He just assumed it wasn't going to work for him. My impression of the article, given that it doesn't really bring up data beyond the total number of acetaminophen-related cases of liver toxicity, is that the author believes he should be able to buy the drugs separately, and is denied this opportunity by the government. After that, he says everything he can to support his beliefs, and pooh-poohs arguments against it. Oxycodone is a very good opioid and, if you aren't abusing it, it is affordable for most people, even if you don't have insurance (http://www.rxassist.org/Search/Prog_Details.cfm?program_Id=178&PD_Id=518&Drug_Id=1158&Company_Id=103&search_type=2&CFID=6401022&CFTOKEN=18279899 http://www.rxassist.org/Search/Prog_Details.cfm?program_Id=1...). But if you need it every day to support your habit, it's too expensive, so vicodin and its friends are the drugs of choice.
deleted 16y ago
[deleted]
jberryman 16y ago
He mentions denatured alcohol which has been around for a century and includes chemicals to make it toxic or foul tasting. He doesn't mention that during prohibition, the government attempted to discourage the redistilling of industrial alcohol by adding poison or upping the concentration of toxic denaturing chemicals, killing thousands of Americans. http://www.slate.com/id/2245188/ http://www.slate.com/id/2245188/ Edit: I'm not sure what the entire story is. It seems as though 10% methanol is standard for denatured alcohol. Not sure if that was the case before prohibition.
- zalew 16y ago
  > "Denatured" implies there has been some chemical alteration of the alcohol, but in fact it is just intentionally contaminated with toxic solvents like methanol or acetone. That's not true anymore, at least in Poland and probably other eastern European (heavy drinking) countries. Due to denaturate usage by very poor alcoholics (they drink it through a slice of bread to filter the taste-altering substances), it's no longer intoxinated with deadly liquids. So it seems our alcohol regulators understood the issue described in the article many years before.
  - zurn 16y ago
    Other way around here in Finland: in mid-90s, on joining the EU, their free market regulations dictated lethal denaturation agents could no longer be banned by national regulations, and deaths of destitute alcoholics spiked. (reference in finnish medical journal, google translate might work: http://tinyurl.com/6h5gf5o http://tinyurl.com/6h5gf5o)
ThomPete 16y ago
In a hundred years from now. People will look back at the war on drugs and what else it's called in the various countries as a primitive and barbaric method.
- beagle3 16y ago
  You are aware that it is over 100 years now from the beginning of the war on recreative drug use? IIRC, the first restrictions were put in effect in the US in 1906.
Zakharov 16y ago
> Does anyone think cannabis is deadlier than Jim Beam? I think the vast majority of the population of America thinks that, which is why cannabis is much more highly regulated. What he should have said was, "cannabis is less deadly than Jim Bean", and provided the evidence to back it up.
- TGJ 16y ago
  Then he basically turns into another pro-pot whackjob that the public ignores even if he is completely genuine and right.
- Dylan16807 16y ago
  Wait, they do? I can easily understand thinking it's more harmful, but deadlier? In what way would someone think it's deadly?
lotics2 16y ago
Really glad to see the HN crowd knows what's up regarding the War on Drugs. If you want daily news on the subject, the best site I can suggest is http://drugwarrant.com http://drugwarrant.com. I've read this site obsessively for nearly two years, as it is hands down the best at what it does. Excellent writing with that goes beyond the media's lazy parroting of press releases without any thought or analysis. You may also be surprised to learn that the Drug Czar and anyone who is funded by their office (such as researchers or propaganda campaigns) are legally required by law to oppose legalization of any Schedule 1 drug for any reason, even for medicinal use. Even in the face of obvious acceptance of medical use of cannabis (such as what the DEA is doing right now by rescheduling natural THC to the same position as synthetic THC) they must oppose giving up any ground or even stating that it might be a good idea. They have actively blocked attempts at research or rescheduling in an undemocratic way, which is why the issue is currently working out at the State level. There are also some articles on this site that are widely regarded as the best pages to link to get people up to speed on the true nature of the war on drugs. May I suggest: http://www.drugwarrant.com/articles/why-is-marijuana-illegal/ http://www.drugwarrant.com/articles/why-is-marijuana-illegal... http://www.drugwarrant.com/articles/drug-czar-required/ http://www.drugwarrant.com/articles/drug-czar-required/ http://www.drugwarrant.com/articles/drug-war-victim/ http://www.drugwarrant.com/articles/drug-war-victim/ Please, if you think this issue does not affect you, it does. Learn why you should oppose the war on drugs if you do not already.
morganw 16y ago
Gah! I shared my concern with APAP with me doctor and she prescribed Norco which has a higher hydrocodone to APAP ratio. Not sure it's still Schedule III in the USA, but if so, there ARE alternatives which Gregory House (who should be dead by now) and those concerned with liver failure deaths should know about.
mannicken 16y ago
Not just opiates, cough syrup (with dextromethorphan) too. It's very dangerous for kids who heard of Robotripping but haven't had resources/time to learn that while DXM overdose will make you trip, acetaminophen overdose will slowly and painfully kill you.

154 points by hachiya 16y ago

It's worth pointing out that the FDA has since voted to reduce the levels of acetaminophen in vicodin. http://abcnews.go.com/m/story?id=12607415 http://abcnews.go.com/m/story?id=12607415

blhack 16y ago
Maybe I'm just in a strange mood, but that is one of the most bizzare statements (with context) that I've ever heard. It's like something directly out of George Orwell. "Party officials recently voted to approve a measure that would decrease the amount of poison included in medicine." ahem "New techniques developed by party scientists have caused medicinal purities to reach an all time high!"
- Alex3917 16y ago
  "Your weekly chocolate rations have been increased from 100 grams to 80 grams." It's actually even more accurate than you might think, because APAP works by acting on the endocannabinoid system. Essentially acetaminophen works exactly the same as weed, the only difference between tylenol and weed is that one kills several thousand Americans per year and the other kills zero. Well actually there is one more difference: weed actually works amazingly well as an analgesic, whereas tylenol doesn't do anything. (Except kill people.) http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T1J-4J3WSHD-7&_user=10&_coverDate=02/15/2006&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=43c4235e76475c360ce2e9f74a168f50&searchtype=a http://www.sciencedirect.com/science?_ob=ArticleURL&_udi...
  - tokenadult 16y ago
    Your statements about weed are very likely exaggerated in one direction, while the statements about acetaminophen are exaggerated in another. The cited journal article does not give full backup to the statements in your post.
    - Alex3917 16y ago
      From Wikipedia: "Paracetamol also modulates the endogenous cannabinoid system.[44] Paracetamol is metabolized to AM404, a compound with several actions; most importantly, it inhibits the uptake of the endogenous cannabinoid/vanilloid anandamide by neurons. Anandamide uptake would result in the activation of the main pain receptor (nociceptor) of the body, the TRPV1 (older name: vanilloid receptor). Furthermore, AM404 inhibits sodium channels, as do the anesthetics lidocaine and procaine.[45] Either of these actions by themselves has been shown to reduce pain, and are a possible mechanism for paracetamol. However, it has been demonstrated that, after blocking cannabinoid receptors with synthetic antagonists, paracetamol's analgesic effects are prevented, suggesting its pain-relieving action involves activation of the endogenous cannabinoid system.[46]" And as I have posted before, marijuana is an anxiolytic, anti-inflammatory, anti-angiogenic, anti-viral, antibacterial, neuroprotective, and pro-neurogenesis. It's down the most important of any drug there is. Plus it increases your IQ by an average of 6 points, decreases your diabetes risk by 66%, and can be used to treat everything from Parkinson's to cancer. There is even some research suggesting that up to 50% of all infant mortality may be the result of marijuana deficiency. http://news.ycombinator.com/item?id=1979857 http://news.ycombinator.com/item?id=1979857 http://www.matrixmasters.net/salon/?p=258 http://www.matrixmasters.net/salon/?p=258 http://www.mediafire.com/?4s8s6w9bwpmg24u http://www.mediafire.com/?4s8s6w9bwpmg24u http://www.safeaccessnow.org/section.php?id=125 http://www.safeaccessnow.org/section.php?id=125 http://norml.org/index.cfm?Group_ID=7002 http://norml.org/index.cfm?Group_ID=7002 http://www.matrixmasters.net/salon/?p=153 http://www.matrixmasters.net/salon/?p=153 http://www.matrixmasters.net/blogs/?p=212 http://www.matrixmasters.net/blogs/?p=212
      - j_baker 16y ago
        > There is even some research suggesting that up to 50% of all infant mortality may be the result of marijuana deficiency. I was going to ask what you're smoking, but then I realized that was a dumb question. :-) I'm all for using pot for medicinal (and recreational) uses, but I think you've crossed the line from advocacy to cheerleading. Believe me when I say that if pot did all of the things you claim, I'd be in perfect health.
  - blhack 16y ago
    "Increased from a measly .1 kilgrams to a full 80 grams!"

MichaelGG 16y ago

The sillier part of adding acetaminophen to hydrocodone and other opiates is that it's easy to remove the acetaminophen via cold water extraction. Thus, anyone looking to seriously abuse Vicodin can avoid the damage with just a bit of work.

Alex3917 16y ago
Exactly. Anyone who wants to abuse opiates can do a simple cold water extraction to almost completely remove the acetaminophen in less than five minutes, or else they can potentiate them using the techniques here so they only need a tiny dosage: http://www.hipforums.com/newforums/showthread.php?t=305596 http://www.hipforums.com/newforums/showthread.php?t=305596 What this means is that the vast majority of those dying are those using these drugs for legitimate medical problems. And it's not a small number of people either; 7,500 people in the US die each year from NSAIDs, and countless more survive but are permanently crippled. The new government guidelines do absolutely nothing to fix the problem, they're just propaganda to support what is essentially a government campaign to poison the elderly and chronic pain patients.
- cynicalkane 16y ago
  they're just propaganda to support what is essentially a government campaign to poison the elderly and chronic pain patients. The government is trying to murder the elderly with drug programs? This is almost a Godwin, but much more silly.
  - Alex3917 16y ago
    "This is almost a Godwin, but much more silly." You want me to link to the obituaries? Almost 1 in 3 Americans die from drug use or drug-related causes, and I really don't find that silly at all. 500,000 from tobacco and second-hand smoke. 106,000 from adverse reactions to prescription drugs in hospitals. 85,000 from alcohol and alcohol-related fatalities. 17,000 from illicit drugs. 7,500 from NSAIDs. 4,000 from HIV acquired from needle sharing, etc. That means if we keep doing what we're doing now, if we don't change our policy on drugs, then of the 310 million Americans currently alive, at least 93 million will die from drug use. Given the average US lifespan of 77, that's a full holocaust every 7.5 years. Obviously not every last death is avoidable, but the overwhelming majority of them are. The ONLY solution is real education based on science, not propaganda. The drug war makes this completely impossible by A) banning science B) banning education C) banning treatment. The fact is that drug addiction has nothing to do with the molecule, and so the way we are treating 'addiction' actually makes the problem vastly worse: http://www.wpr.org/book/100307a.cfm http://www.wpr.org/book/100307a.cfm http://www.nijc.org/pdfs/Subject%20Matter%20Articles/Drugs%20and%20Alc/ACE%20Study%20-%20OriginsofAddiction.pdf http://www.nijc.org/pdfs/Subject%20Matter%20Articles/Drugs%2... So if this sounds like a Godwin argument, that's probably because the war on drugs is responsible for vastly more deaths than the holocaust.

deleted 16y ago

[deleted]

ojbyrne 16y ago

So total aside, inspired by the mention of denatured alcohol. How come you can buy bitters, which are up to 50% alcohol (i.e. 100 proof), without having to be of legal age?

code_duck 16y ago
I tried to buy bitters at 4 am the other day and they wouldn't let me due to the alcohol content. Pretty stupid, since getting intoxicated from bitters would be about as much fun as drinking cooking wine.
- kjhgtfbn 16y ago
  A UK supermarket was banned from selling liquor chocolates outside licencing hours!
defen 16y ago
During prohibition, certain bitters were legal because they were considered "nonpotable". Angostura falls under this category, whereas something like Campari or Fernet Branca would be considered potable. Basically they didn't think anyone would be able to drink enough to get drunk from it. I assume a similar logic applies today.

InclinedPlane 16y ago

A bit like shooting someone who is attempting suicide. Prohibition v. 2 has proven to be just as disastrous as v. 1, when will there finally be enough political momentum behind ending it?

MichaelGG 16y ago
Not quite. It's more like shooting anyone crossing a bridge, would it be to get to a hospital, sightseeing, or bungee jumping off it.
tsotha 16y ago
>...when will there finally be enough political momentum behind ending it? I keep thinking next year... next year... but the reality is as people get older and have kids they start to view any sort of recreational drug as a threat to little Johnny. So that pot-head you knew in college? He's voting against every attempt to soften drug laws.

code_duck 16y ago

One alternative he doesn't mention is Vicoprofen, which contains ibuprofen rather than acetaminophen.

defen 16y ago
Ibuprofen is also not-so-great for your kidneys, although not nearly as bad as acetaminophen is for your liver.
SoftwareMaven 16y ago
So you can strip the lining in your stomach and intestinal track instead of blowing your liver. The article is correct: there is no value in adding anything to the hydrocodone and many possible down-sides.
- code_duck 16y ago
  No, of course there isn't any value. But ibuprofen isn't as harmful as acetaminophen.
tomjen3 16y ago
That's not really worth posting, since it is also toxic. We need something that can remove the toxins from the drug and the politicians from any power they have in this world.

mynameishere 16y ago

This is why you always, always, buy your dope from hillbillies.

apu 16y ago

Completely off-topic, but: There is a better review in the WSJ today but I can't link to it.

sguelich 16y ago

Sad to see an HN thread full of conspiracy theories and so little actual science. Believe it or not, acetaminophen is an effective analgesic, and combined with hydrocodone it provides synergistic pain relief without any increase in side effects over the use of either agent alone. Here's a peer-reviewed 1980 study from the UK showing just that: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1430165/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1430165/ Private drug companies didn't pursue testing & selling hydrocodone/APAP in combined form because the government hates drug users. They did so because they can market a highly potent form of pain control. Not everything in life is a government conspiracy!

kennywinker 16y ago
Nobody is saying acetaminophen is ineffective, just that it's effects come with hepatotoxicity. A larger dosage of hydrocodone could have the same net analgesic effect without the huge negative effects.
- arn 16y ago
  "Nobody is saying acetaminophen is ineffective" Actually, the linked article is saying exactly that: "I remember being annoyed that in order to get narcotic pain relief I was being forced to take a hepatotoxin that added little to the pain relieving efficacy of the opiate."
  - defilade 16y ago
    It was ineffective for the author of the article. That doesn't mean it's ineffective for everyone.
    - duncanj 16y ago
      It's not like he did an n=1 study. He just assumed it wasn't going to work for him. My impression of the article, given that it doesn't really bring up data beyond the total number of acetaminophen-related cases of liver toxicity, is that the author believes he should be able to buy the drugs separately, and is denied this opportunity by the government. After that, he says everything he can to support his beliefs, and pooh-poohs arguments against it. Oxycodone is a very good opioid and, if you aren't abusing it, it is affordable for most people, even if you don't have insurance (http://www.rxassist.org/Search/Prog_Details.cfm?program_Id=178&PD_Id=518&Drug_Id=1158&Company_Id=103&search_type=2&CFID=6401022&CFTOKEN=18279899 http://www.rxassist.org/Search/Prog_Details.cfm?program_Id=1...). But if you need it every day to support your habit, it's too expensive, so vicodin and its friends are the drugs of choice.

deleted 16y ago

[deleted]

jberryman 16y ago

He mentions denatured alcohol which has been around for a century and includes chemicals to make it toxic or foul tasting. He doesn't mention that during prohibition, the government attempted to discourage the redistilling of industrial alcohol by adding poison or upping the concentration of toxic denaturing chemicals, killing thousands of Americans. http://www.slate.com/id/2245188/ http://www.slate.com/id/2245188/ Edit: I'm not sure what the entire story is. It seems as though 10% methanol is standard for denatured alcohol. Not sure if that was the case before prohibition.

zalew 16y ago
> "Denatured" implies there has been some chemical alteration of the alcohol, but in fact it is just intentionally contaminated with toxic solvents like methanol or acetone. That's not true anymore, at least in Poland and probably other eastern European (heavy drinking) countries. Due to denaturate usage by very poor alcoholics (they drink it through a slice of bread to filter the taste-altering substances), it's no longer intoxinated with deadly liquids. So it seems our alcohol regulators understood the issue described in the article many years before.
- zurn 16y ago
  Other way around here in Finland: in mid-90s, on joining the EU, their free market regulations dictated lethal denaturation agents could no longer be banned by national regulations, and deaths of destitute alcoholics spiked. (reference in finnish medical journal, google translate might work: http://tinyurl.com/6h5gf5o http://tinyurl.com/6h5gf5o)

ThomPete 16y ago

In a hundred years from now. People will look back at the war on drugs and what else it's called in the various countries as a primitive and barbaric method.

beagle3 16y ago
You are aware that it is over 100 years now from the beginning of the war on recreative drug use? IIRC, the first restrictions were put in effect in the US in 1906.

Zakharov 16y ago

> Does anyone think cannabis is deadlier than Jim Beam? I think the vast majority of the population of America thinks that, which is why cannabis is much more highly regulated. What he should have said was, "cannabis is less deadly than Jim Bean", and provided the evidence to back it up.

TGJ 16y ago
Then he basically turns into another pro-pot whackjob that the public ignores even if he is completely genuine and right.
Dylan16807 16y ago
Wait, they do? I can easily understand thinking it's more harmful, but deadlier? In what way would someone think it's deadly?

lotics2 16y ago

Really glad to see the HN crowd knows what's up regarding the War on Drugs. If you want daily news on the subject, the best site I can suggest is http://drugwarrant.com http://drugwarrant.com. I've read this site obsessively for nearly two years, as it is hands down the best at what it does. Excellent writing with that goes beyond the media's lazy parroting of press releases without any thought or analysis. You may also be surprised to learn that the Drug Czar and anyone who is funded by their office (such as researchers or propaganda campaigns) are legally required by law to oppose legalization of any Schedule 1 drug for any reason, even for medicinal use. Even in the face of obvious acceptance of medical use of cannabis (such as what the DEA is doing right now by rescheduling natural THC to the same position as synthetic THC) they must oppose giving up any ground or even stating that it might be a good idea. They have actively blocked attempts at research or rescheduling in an undemocratic way, which is why the issue is currently working out at the State level. There are also some articles on this site that are widely regarded as the best pages to link to get people up to speed on the true nature of the war on drugs. May I suggest: http://www.drugwarrant.com/articles/why-is-marijuana-illegal/ http://www.drugwarrant.com/articles/why-is-marijuana-illegal... http://www.drugwarrant.com/articles/drug-czar-required/ http://www.drugwarrant.com/articles/drug-czar-required/ http://www.drugwarrant.com/articles/drug-war-victim/ http://www.drugwarrant.com/articles/drug-war-victim/ Please, if you think this issue does not affect you, it does. Learn why you should oppose the war on drugs if you do not already.

morganw 16y ago

Gah! I shared my concern with APAP with me doctor and she prescribed Norco which has a higher hydrocodone to APAP ratio. Not sure it's still Schedule III in the USA, but if so, there ARE alternatives which Gregory House (who should be dead by now) and those concerned with liver failure deaths should know about.

mannicken 16y ago

Not just opiates, cough syrup (with dextromethorphan) too. It's very dangerous for kids who heard of Robotripping but haven't had resources/time to learn that while DXM overdose will make you trip, acetaminophen overdose will slowly and painfully kill you.