6 ms·

I think OP made that comparison because in Australia even a kid can get a pack of paracetamol for $1 over the counter at most grocery shops.

by e1g 6y ago

TheSpiceIsLife 6y ago
20 x 500mg tables $0.70 at Coles. Two packs will end the average teen, formanent liver failure takes about 5 days though, quite uncomfortable I'm told. The antidote is n-acytel-cysteine, available from most sport supplement type places, I always keep 100g or so around cos early / immediate oral treatment can make the difference until medical intervention arrives, where they give the n-acytel-cysteine intravenously.
- laurent92 6y ago
  Hi, It may be better not to publish exactly the dosage that is dangerous. For example, I tried not to read this part, because I know I’m tempted, and sometimes ignorance is bliss. I know you seek to share excellent knowledge, I’m myself passionate about air crashes and causes which is a topic a lot of people don’t like to hear about ;) It’s just, it’s very interesting to know for a public health perspective that lethal doses are possible to get at the local supermarket, perhaps the exact quantity is one detail too much. Cheers.
  - TheSpiceIsLife 6y ago
    Don't do it! This is a good point and something I consider every time I bring it up. I don't have a perfect response though sorry. I try to put people of this particular method by noting it's painful and takes a long time. Do you have someone(s) you can talk to? Support people?
    - laurent92 6y ago
      Yes, don’t worry too much for me, I have a psychologist and we got several things rolling recently, so I’ll be fine for a couple of months already. Thank you for your concern ;)
  - gambiting 6y ago
    That's such a weird perspective to take. No information, including the exact dosage that will kill you, should be hidden "just in case". It's like security by obscurity of medical world. In fact I'd advocate that every paracetamol packet should say, in big letters in the back "TAKING X OF TABLETS WILL KILL YOU WITH NO KNOWN TREATMENT, AND IT WILL HURT ALL THE TIME AS YOU'RE DYING". There's so many people who don't realize how easily taking too much paracetamol can kill it's crazy.
    - dkersten 6y ago
      Yeah, exact dosage is irrelevant. If you're going to kill yourself, you just take a few packs. As you say and has been said elsewhere in here, the dosage difference between therapeutic and fatal is really small, so if you take multiple times the normal dosage, well... you don't need exact dosage for that.
    - ohgodplsno 6y ago
      France: buying paracetamol can be done freely here ,but it has to be asked for at pharmacies, and the dangerous dosage (4000mg/day) is heavily stressed. Also, it is written on the instruction manual, in quite big letters.
  - srtjstjsj 6y ago
    Anything you consume to the point of unconsciousness is likely to kill you. Your world is full of intentional poisons (we use them to kill the things we don't like, germs and bugs) and dangerous things you aren't supposed to eat. The numbers don't matter. Please don't end your life. Almost everyone who tries regrets it. Get help with your dark thoughts and keep on being a part to your communities.
- skissane 6y ago
  I personally think paracetamol should be prescription only. The risk and consequences of overdose (whether suicidal or accidental) are too severe. A lot of far safer drugs are prescription only (or even completely illegal) yet deadly paracetamol is sold in the supermarket.
  - nmfisher 6y ago
    > I personally think paracetamol should be prescription only. The risk and consequences of overdose (whether suicidal or accidental) are too severe. A lot of far safer drugs are prescription only (or even completely illegal) yet deadly paracetamol is sold in the supermarket. I can't tell if you're joking or not.
    - skissane 6y ago
      I'm being completely serious, why would I be joking?
      - consp 6y ago
        I'm going on a stretch here but it was probably implied all NSAIDs have side effects which are all severe. Stomach bleeds, reduction of blood clotting or other problems related to thrombosis or kidney failure depending on the type. Highly unlikely when used by the book but deadly in overdosis or prolonged uses. Just like paracetamol. Taking away people's pain medication is not a winning move I'm certain of.
        skissane 6y ago
        At my local Coles supermarket, AUD 1.40 (USD 0.99) buys 2 packets of 20 tablet 500mg paracetamol. Swallow 40 tablets, take a 20 gram overdose. For a person who weighs 80kg, that's 250 mg/kg. That kind of overdose is likely to lead to acute liver injury; prompt treatment with NAC will avoid it, but without prompt treatment, acute liver failure is a likely outcome. At the same supermarket, AUD 3.10 (USD 2.19) buys 2 packets of 24 tablet 200mg ibuprofen. Swallow 48 tablets, take a 9.6 gram overdose. For a person who weighs 80kg, that's 120 mg/kg. [1] reports that level of ibuprofen overdose is likely to produce mild CNS and GI symptoms. Fatalities have occurred with >300 mg/kg, so an 80 kg person would need to take over 24 grams, which is 120 tablets, 5 packets worth (cost AUD 7.75, USD 5.48). So you can immediately see how ibuprofen is safer than paracetamol, in that you have to swallow a lot more tablets to take a potentially fatal overdose. Given that, I think a case could be made for withdrawing over-the-counter paracetamol while continuing to allow over-the-counter ibuprofen. Cannabinoids such as THC and CBD also provide pain relief, and certainly if we are just looking at overdose acute toxicity are far safer than either ibuprofen and paracetamol – indeed, there is no record of any fatal overdose ever happening from either. And yet, where I live they are only legally available on prescription, and prescribers face regulatory hurdles which do not apply to other drugs. If we are only thinking about safety in overdose, we'd make both ibuprofen and paracetamol prescription only, and allow THC and CBD over-the-counter instead. [1] https://litfl.com/nsaids-toxicity/ https://litfl.com/nsaids-toxicity/

I think OP made that comparison because in Australia even a kid can get a pack of paracetamol for $1 over the counter at most grocery shops.

by e1g 6y ago

I think OP made that comparison because in Australia even a kid can get a pack of paracetamol for $1 over the counter at most grocery shops.

TheSpiceIsLife 6y ago

20 x 500mg tables $0.70 at Coles. Two packs will end the average teen, formanent liver failure takes about 5 days though, quite uncomfortable I'm told. The antidote is n-acytel-cysteine, available from most sport supplement type places, I always keep 100g or so around cos early / immediate oral treatment can make the difference until medical intervention arrives, where they give the n-acytel-cysteine intravenously.

laurent92 6y ago
Hi, It may be better not to publish exactly the dosage that is dangerous. For example, I tried not to read this part, because I know I’m tempted, and sometimes ignorance is bliss. I know you seek to share excellent knowledge, I’m myself passionate about air crashes and causes which is a topic a lot of people don’t like to hear about ;) It’s just, it’s very interesting to know for a public health perspective that lethal doses are possible to get at the local supermarket, perhaps the exact quantity is one detail too much. Cheers.
- TheSpiceIsLife 6y ago
  Don't do it! This is a good point and something I consider every time I bring it up. I don't have a perfect response though sorry. I try to put people of this particular method by noting it's painful and takes a long time. Do you have someone(s) you can talk to? Support people?
  - laurent92 6y ago
    Yes, don’t worry too much for me, I have a psychologist and we got several things rolling recently, so I’ll be fine for a couple of months already. Thank you for your concern ;)
- gambiting 6y ago
  That's such a weird perspective to take. No information, including the exact dosage that will kill you, should be hidden "just in case". It's like security by obscurity of medical world. In fact I'd advocate that every paracetamol packet should say, in big letters in the back "TAKING X OF TABLETS WILL KILL YOU WITH NO KNOWN TREATMENT, AND IT WILL HURT ALL THE TIME AS YOU'RE DYING". There's so many people who don't realize how easily taking too much paracetamol can kill it's crazy.
  - dkersten 6y ago
    Yeah, exact dosage is irrelevant. If you're going to kill yourself, you just take a few packs. As you say and has been said elsewhere in here, the dosage difference between therapeutic and fatal is really small, so if you take multiple times the normal dosage, well... you don't need exact dosage for that.
  - ohgodplsno 6y ago
    France: buying paracetamol can be done freely here ,but it has to be asked for at pharmacies, and the dangerous dosage (4000mg/day) is heavily stressed. Also, it is written on the instruction manual, in quite big letters.
- srtjstjsj 6y ago
  Anything you consume to the point of unconsciousness is likely to kill you. Your world is full of intentional poisons (we use them to kill the things we don't like, germs and bugs) and dangerous things you aren't supposed to eat. The numbers don't matter. Please don't end your life. Almost everyone who tries regrets it. Get help with your dark thoughts and keep on being a part to your communities.
skissane 6y ago
I personally think paracetamol should be prescription only. The risk and consequences of overdose (whether suicidal or accidental) are too severe. A lot of far safer drugs are prescription only (or even completely illegal) yet deadly paracetamol is sold in the supermarket.
- nmfisher 6y ago
  > I personally think paracetamol should be prescription only. The risk and consequences of overdose (whether suicidal or accidental) are too severe. A lot of far safer drugs are prescription only (or even completely illegal) yet deadly paracetamol is sold in the supermarket. I can't tell if you're joking or not.
  - skissane 6y ago
    I'm being completely serious, why would I be joking?
    - consp 6y ago
      I'm going on a stretch here but it was probably implied all NSAIDs have side effects which are all severe. Stomach bleeds, reduction of blood clotting or other problems related to thrombosis or kidney failure depending on the type. Highly unlikely when used by the book but deadly in overdosis or prolonged uses. Just like paracetamol. Taking away people's pain medication is not a winning move I'm certain of.
      - skissane 6y ago
        At my local Coles supermarket, AUD 1.40 (USD 0.99) buys 2 packets of 20 tablet 500mg paracetamol. Swallow 40 tablets, take a 20 gram overdose. For a person who weighs 80kg, that's 250 mg/kg. That kind of overdose is likely to lead to acute liver injury; prompt treatment with NAC will avoid it, but without prompt treatment, acute liver failure is a likely outcome. At the same supermarket, AUD 3.10 (USD 2.19) buys 2 packets of 24 tablet 200mg ibuprofen. Swallow 48 tablets, take a 9.6 gram overdose. For a person who weighs 80kg, that's 120 mg/kg. [1] reports that level of ibuprofen overdose is likely to produce mild CNS and GI symptoms. Fatalities have occurred with >300 mg/kg, so an 80 kg person would need to take over 24 grams, which is 120 tablets, 5 packets worth (cost AUD 7.75, USD 5.48). So you can immediately see how ibuprofen is safer than paracetamol, in that you have to swallow a lot more tablets to take a potentially fatal overdose. Given that, I think a case could be made for withdrawing over-the-counter paracetamol while continuing to allow over-the-counter ibuprofen. Cannabinoids such as THC and CBD also provide pain relief, and certainly if we are just looking at overdose acute toxicity are far safer than either ibuprofen and paracetamol – indeed, there is no record of any fatal overdose ever happening from either. And yet, where I live they are only legally available on prescription, and prescribers face regulatory hurdles which do not apply to other drugs. If we are only thinking about safety in overdose, we'd make both ibuprofen and paracetamol prescription only, and allow THC and CBD over-the-counter instead. [1] https://litfl.com/nsaids-toxicity/ https://litfl.com/nsaids-toxicity/