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In study, acetaminophen makes risky moves seem less dangerous
- woleium 6y agoThere is evidence to suggest that it suppresses empathy as well https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015806/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015806/
- xwdv 6y agoI wonder if people with a high tolerance for pain are also less empathetic.
- shadowmore 6y agoI can confirm this anecdotally. I've always had near zero empathy for anyone who isn't a close friend or family member, and I have very high pain tolerance, to the point of outright ignoring minor wounds on a regular basis and then finding them later (sounds edgy, actually majorly annoying finding unexpected blood stains on clothing or furniture, or realizing I have an eyesore of a bruise somewhere).
- meowface 6y agoDon't know why you're being downvoted. Of course this is all anecdotal and armchair psychology/psychiatry/neuroscience/neuropharmacology, but there could plausibly be some kind of correlation, here, and every anecdote adds to the discussion, even if of course they shouldn't be taken as empirical support for the hypothesis. I've seen research about how opiates seem to reduce perception of both physical and emotional pain, which may partly explain why some people in unfortunate situations may become addicted. Emotional pain isn't adjacent to empathy but isn't necessarily orthogonal, either. If there's anything to this, it makes me wonder if there could also be some correlation between opioid receptors and empathy, or even some sort of correlation between pain and emotions in general.
- jrumbut 6y agoWhile we're talking anecdata, for the first ~30 years of my life I found absolutely no relief from acetaminophen for anything from illness to injury to random headaches. A couple years ago my wife cajoled me to try taking it again, and I went from bed ridden to feeling poorly but able to function. Not a miracle cure but really helpful a few times a year. Is there any known association of age and acetaminophen effectiveness?
- tomcam 6y agoWould someone inclined to downvote the parent comment explain why?
- emerged 6y agoMy first instinct is it's people who have a high threshold for pain who don't appreciate being called out for a lack of empathy. But perhaps didn't have a rational defense to jump in and comment. It would be interesting to hear a response from a downvoter contradicting this instinct.
- xwdv 6y agoMore likely, the people doing the downvoting have low thresholds for pain and do not want to see people with low empathy become normalized, as it would make their pains feel even worse.
- rootusrootus 6y ago> ignoring minor wounds on a regular basis and then finding them later In my experience that's pretty common, especially among guys. It's a running joke with my wife that I'll be leaking blood without even knowing I cut myself. Or I know, and just don't really care. Several of my friends are similar. It does lead to awkward explanations sometimes. My wife still doesn't really understand how I can have a great big scabbed over wound or a nice big purple bruise with not the faintest idea when/where I did it. I wouldn't say I'm low on empathy, either. But I hide it pretty well, bury it quite deep.
- 3131s 6y agoAnecdotally I used to be less empathetic but I took some steps to change that long ago. But, high pain tolerance would still describe me even after that point... I've had broken ribs, broken fingers and toes, broken hand and wrist, chipped teeth, broken nose, seriously infected abrasions, large boils (now these fucking hurt), torn labrum on left shoulder, surgery on right shoulder with a really uncomfortable elastomeric pump, a few minor head injuries, minor fracture in one foot, cigarette tattoos, high-speed bike crashes with no protective gear, a perplexing squishy fluid sac under the sole of my foot from sprinting, etc. I still feel pain but I would have to imagine that a pain-sensitive person might not get up to the same stuff that I do. It really depends on the type of pain. The two most excruciating were dengue fever and a couple bouts with moderately-sized kidney stones. Dengue was worse, definitely earning its local name here of "bone-break fever" due to the intense and constant aching. Near the end there is a characteristic rash, which is mercy compared to the first 3-4 days. The whole experience left me physically destroyed for months! I returned to lifting weights after I thought I had recovered, but my one-rep max lifts were halved on every single movement and it took another month to return to the level I was at before.
- deleted 6y ago[deleted]
- wolco2 6y agoStrangely true in my experience. But it makes sense..
- xwdv 6y agoYes, I have low empathy and a high pain threshold even when I broke a collarbone. I only have harsh words for those with low thresholds for pain.
- deleted 6y ago[deleted]
- shadowmore 6y agoIt's usually prescribed specifically for fever, not just for any pain. Could this be why so many people (myself included) report feeling a sense of wanting to live a more proactive life when sick with a fever? You'd think it would just be because you're feeling a sense of contrast from your usual more energized state and want to avoid wasting energy on unproductive things once you get it back, but could it actually be because the Acetominophen reduces our overall sense of anxiety? The article talks about how there have been studies that show it dampens all emotions, but to feel more sure about long-term efforts, you don't strictly need to be emotionally charged or inspired, you just need to be less anxious about the potential failure of such efforts.
- dragonwriter 6y ago> It's usually prescribed specifically for fever, not just for any pain. It is regularly prescribed (alone or as part of a compounded drug with opioids) for post surgical pain; as I understand it's the most effective common non-narcotic painkiller for traumatic injury, but not as effective as NSAIDs (or steroids) for inflammatory pain, because it doesn't specifically target inflammation.
- thinkingemote 6y ago> report feeling a sense of wanting to live a more proactive life when sick with a fever? There is (very weak) theory that, given that viruses want to spread to more hosts, and given that certain infections like toxoplasma or rabies can change the hosts behaviours, that a virus wants us to get out more and be more socialable. The urge to live a life when we feel when sick with fever could be part of the infection changing our behaviour to make it spread! Viruses and other things exploit our behaviours of sneezing and coughing to spread after all, so why not increase the chances some more. There was one study done that showed that those who were just injected with the flu vaccine (as a safer way than actually infecting people with the flu) that they became more gregarious and went out socialising more. The science is pretty weak and can be explained that those who had the vaccine felt more protected and invulnerable, so it does not prove anything. The researchers theorised that sexually transmitted diseases may also want to spread. Its possible that being infected by STDs could make you more promiscuous therfore. There's no studies done on covid infections and change of host behaviour. Suggesting that people might not be fully free in their decisions when pre-symptomatic and infectious would mainly be not helpful, useful and also dangerous. To me, the idea that viruses could affect our mental state is so out there its similar to the idea that the bacteria in our guts could affect our mental state 20 years ago.
- lucb1e 6y agoFor those not recognizing the title, I know it as paracetamol (or tylenol in movies). The article reports on several studies of various sizes where, indeed, people all took a pill (some placebo and some not) and those with the real thing rate activities as less risky or underestimate the risk of the balloon bursting by adding one more pump. Of course, the article mentions the ongoing pandemic where those on this drug may perceive meeting people to be less risky. Another thing I found interesting in the article is that "nearly 25 percent of the population in the U.S. [takes] acetaminophen each week". I wouldn't know where to find numbers for other countries, I'm curious if it follows a similar pattern as opioid usage (or even the "opioid epidemic", as Wikipedia's article is titled) in the USA versus other countries, but regardless, this stuns me.
- hliyan 6y agoI too come from a country where this is called paracetamol, and here too, over the counter usage is very common. I'm surprised more people are not worried about the alcohol interaction.
- lucb1e 6y agoIn Germany they always (n=2) act surprised when I ask for more than a single box. I don't even take it myself, my girlfriend uses one dose (usually 2x0.5g before going to sleep) maybe every tenth day or so; I myself might use it once a year. But the stuff lasts for years and I don't fancy running out or not having some with me when I (or someone near me) needs it, so we just buy it in bulk and replace when empty or after the expiry has sufficiently passed. I get a lecture from the apothecary every time. Does nobody else buy ahead, especially in the pandemic?
- code-is-code 6y agoThey just want to protect you from yourself, do not take it personal.
- lucb1e 6y ago
- krosaen 6y agoInteresting. How did they think to test this hypothesis in the first place?
- techbio 6y agoAnother discovery brought to you by big aspirin. Edit: It was a joke. Aspirin isn't trying to take down Tylenol, but to not compare this result with a wider selection of painkillers reads to me like a PR play.
- techbio 6y agoIf it's a question with food, why not every product we ingest? https://news.ycombinator.com/item?id=25551877 https://news.ycombinator.com/item?id=25551877
- jl2718 6y agoFrom Wikipedia: Paracetamol apparently might modulate the endogenous cannabinoid system in the brain through its metabolite, AM404, which appears to inhibit the reuptake of the endogenous cannabinoid/vanilloid anandamide by neurons, making it more available to reduce pain. AM404 also appears to be able to directly activate the TRPV1 (older name: vanilloid receptor), which also inhibits pain signals in the brain.[24]
- hirundo 6y agoExogenous cannabinoids are also associated with greater risk taking: https://www.researchgate.net/publication/7958920_Acute_Marijuana_Effects_on_Human_Risk_Taking https://www.researchgate.net/publication/7958920_Acute_Marij...
- AlbinoDrought 6y agoAnother somewhat-related rabbit hole: > A Scottish woman with a previously unreported genetic mutation (dubbed FAAH-OUT) in her FAAH gene with resultant elevated anandamide levels was reported in 2019 to be immune to anxiety, unable to experience fear, and insensitive to pain. The frequent burns and cuts she suffered due to her hypoalgesia healed quicker than average [1] Acetaminophen can elevate anandamide levels [2]. It would be interesting to know if the altered perception of risk could be related to the "immune to anxiety" effect experienced above. [1] https://en.wikipedia.org/wiki/Fatty_acid_amide_hydrolase#Function https://en.wikipedia.org/wiki/Fatty_acid_amide_hydrolase#Fun... [2] https://en.wikipedia.org/wiki/Anandamide#Synthesis_and_degradation https://en.wikipedia.org/wiki/Anandamide#Synthesis_and_degra...
- kylebenzle 6y agoMy wife is like this in BOTH regards and I have been baffled by her for over a decade! I tell everyone, I have never met ANYONE like her, I honestly thought she was completely unique. By all accounts she seems to be utterly immune to both physical pain and does not experience fear. (1) She was a glass blower in college and would regularly get large burns that did not seem to bother her at all. She has multiple tattoos that she says caused no discomfort, gave birth to both our children without any drugs and to this day says it caused her no pain. She is aware of things happening but they do not bother her. Not in a bad way, I have often told people, she does not feel anything. (2) She can say anything to anyone, anywhere and feel nothing like anxiety. This has also baffled me but I NEVER would have thought the two were somehow connected. I've asked many times if she ever gets nervous or anxious talking to people and says she does not and it is clearly true. In ten years I've never seen her cry or so much as tear up. When we lived on a farm she was our go to for any slaughtering, she sliced our goats throat without even wincing and I saw her once stand up to a 1,000+ pound charging heifer without thinking twice and made nothing of it. It blows my mind but makes so much sense that this could be a single DNA mutation! Hopefully it is one 23 And Me can check for!
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- sillysaurusx 6y agoDoes anyone know if ibuprofen is risky with sustained, long-term usage of the recommended dose? I have a relative who uses it habitually, and I can’t help but worry. It seems safer than Tylenol, but I don’t understand why it would be safer. They recently had a toothache, and they took 4 right away and more several hours later. When I expressed concern, they said the doctor told them to go ahead and take 4 immediately when in severe pain. But it feels like more and more studies and anecdata are casting suspicions on Tylenol, so I wanted to ask if anyone knew the central reason why ibuprofen might be safe in comparison.
- Spooky23 6y agoYes. Google “ibuprofen kidneys”. All of the nsaid drugs have risks if chronically overused. End of the day, if you’re taking otc pain relievers for more than a week, you should look at treating root cause.
- sillysaurusx 6y agoThanks!
- kazinator 6y agoNaproxen, ibuprofen, acetaminophen, aspirin are all ototoxic (damaging to hearing), so that is one concern. I almost never use pain killers, but if I have to reach for one, it will be naproxen. Naproxen is longer-lasting. It has a metabolic half life of as much as 17 hours in the body, compared to just around two hours for those others. This has advantages, one of which is simple economics. One naproxen pill works like 4 consecutive ibuprofens or acetaminophens. I was prescribed naproxen in the early 1990's, at the University of British Columbia sports medicine clinic for some wrist tendinitis. Stuff worked, so I remembered the name well. I didn't know that just a few years after that, it had become over-the-counter. One day I googled it by name and so it goes. One down side of naproxen, sort of, is that it's not recommended for children. You will not find a children's naproxen.
- wolco2 6y ago
- peteforde 6y agoIt's a fascinating article. Even more fascinating: nobody here in the comments on the most skeptical site I know has pointed out that the article fails to provide even a hint of the degree to which it alters those perceptions. Is it 1%? 10%? 30%? 80%? Kind of an important detail.
- ordu 6y agoHow to measure the degree? You've wrote percentages as an example, how they should be understood? The frequency of altered behavior? But there are tons of different factors altering behavior, as personal so situational factors. They somehow also should be measured. I would be much more skeptical, if they provided measurements outside of ordinal scale of measurement[1]. One can compare two setups on basis less/greater, but not to measure them in absolute scale. [1] https://en.wikipedia.org/wiki/Level_of_measurement https://en.wikipedia.org/wiki/Level_of_measurement
- aidenn0 6y agoUsing standard-deviations would be good, assuming risk-assessment is a normal distribution.
- ordu 6y agoIt would be standard deviations in some specific situation. Maybe in 2-3 situations. Like answering questions of a psychologist and inflating a balloon in a kind of a computer game. Does it influence a driving style of a person? People could overcome biases, and possibly driving as a habit would be more strong than acetaminophen. The only reason to go numeric with this study is to measure statistical significance of their findings. I'm sure they did it, but their numbers have no meaning outside of their study.
- aidenn0 6y agoNumeric is also a good sanity check. If they claim e.g. 3 standard deviations of risk-taking increase on typical doses of paracetamol, then there's something wrong with the study, because we would have noticed that already.
- unixhero 6y agoI ask myself: Could any pf these findings be conflated with psychopathy? And or are any of the anecdotal evidence provided here by commenters actually not due do acetaminophem/paracetamol, but rather psycopathic personality distortions? I am genuinely curious. We will never know of course, at least not about my second point. The first can be tested with more rigprous science.
- aaron695 6y agoI don't for a second believe the implications of this article for acetaminophen/paracetamol/Tylenol. But I do want a drug that does this. I haven't seen anything like it mentioned on HN. Wouldn't this be exactly what startups want?
- stevespang 6y agoAcetaminophen is a destroyer of the body's main antioxidant tripeptide glutathione. Injectable N acetylcysteine is antidotal. https://www.acetadote.com/about.php https://www.acetadote.com/about.php https://www.medicalnewstoday.com/articles/323936 https://www.medicalnewstoday.com/articles/323936
- peteretep 6y agoI would love to permanently down-regulate my anxiety. I do not find it a useful emotion. Standard anxiolytics have helped a fair amount, but I’d love to just kill it off as an emotion.
- stupidcar 6y agoIsn't this is what meditation is for?
- fab1an 6y agoThis is very interesting - I had recently read about the empathy lowering effect of Paracetamol and the cynic in me could not help but wonder if any corporate folks may have (ab)used it to become more sociopathic (which is a requirement for success in many of the more dysfunctional corporate contexts)
- stupidcar 6y agoI occasionally take some paracetamol if I've suffered some upsetting emotional event, like a bad argument at work. It's most likely just a placebo effect, but I do feel like it numbs my emotions a bit and helps me stop fixating on the memory. I'm well aware it's not the healthiest behaviour, but I consider it better than the other ways I know I would likely respond, by either sinking into a mild depression, or using alcohol and/or other intoxicants.
- ianai 6y agoSo the anxiety and really all parts of our psyches serve important purposes. But sleep, for instance, is possibly the most important physiological thing we do in a day. It’s also common for anxiety and the like stress responses to disrupt or even negate the possibility of sleep. So in those cases, it’s definitely worth dialing the anxiety and stress processes “back” with external aide.
- haltingproblem 6y agoAny estimate of how many deaths result for increased risk taking due to acetaminophen? I guess that would be extremely hard to quantify and might require running a RCT. Or finding a natural RCT - e.g. two similar regions or countries - one where acetaminophen is widely used and another where it is not.