3 ms·

I’m not sure if I agree with any of the claims in the article you linked. > Each year, about 4,500 hospitalizations in Canada occur due to acetaminophen overdo

I’m not sure if I agree with any of the claims in the article you linked. > Each year, about 4,500 hospitalizations in Canada occur due to acetaminophen overdose, and about 16 per cent of these are accidental, Health Canada says. So this affects only a tiny minority. It’s absurd that the tens of millions of people who use acetaminophen without an issue need to have their access to the drug restricted because of these 700 people. To be absolutely clear, the maximum recommended dose is 4000mg over 24 hours. That’s eight extra strength pills. According to your article, the people who still accidentally overdose apparently take two pills every 2-3 hours and then forget how many they took. No wonder the vast majority avoid this fate, we simply take one pill instead. It annoys me to no end when some folks trying to win the Darwin Award make medical professionals change guidelines in a misguided attempt to “protect” us. No, we don’t need that protection. Just keep it available while educating people about concerns around pregnancy and lower doses for younger children. Everyone involved with writing, editing or contributing to this nothing burger of an article should be ashamed of themselves.

slavik81 5y ago
> To be absolutely clear, the maximum recommended dose is 4000mg over 24 hours. That’s eight extra strength pills. It's also included as a secondary ingredient in a lot of other medicines, which makes it easy to take more than you thought. Additionally, other common drugs (like alcohol) use the same metabolic pathways, so they can dramatically lower the safe limit for acetaminophen. When you look at the rate of death and serious injury due to overdose, acetaminophen comes out very badly. The only medicines that kill more are opioids.
touisteur 5y ago
A more charitable interpretation of the overdose on acetaminophen is that people are bad at handling pain and we should help with that. And also when in a flu-like state, people (me included) have trouble keeping up with their dosage. One other thing is that many compound otc drugs (marketed as 'get through this' for ) also have acetaminophen... I'll also say that being pregnant is the medical wild card. You shouldn't do, eat, take, catch anything. It doesn't help discriminating between the level of risks you're taking when anything you do is forbidden. Having such a risky drug at hand mechanically increases the risk of overdose and we should strive to find better alternatives, I think. It doesn't have to be more control, since it won't help you at home and will just make suffering people more miserable, but tech could help here, with delivery or packaging for example. 700 dead people isn't nothing. And putting a 'Darwin Awards' tag on them feels the same as 'pilot blaming' in aviation: not likely to increase safety.
pantulis 5y ago
> To be absolutely clear, the maximum recommended dose is 4000mg over 24 hours. That’s eight extra strength pills. In Spain you can get 1000mg paracetamol pills OTC, so that's 4 of them. It's not that unusual doctors prescripting "one every 8 hours" for acute cases. People are probably not aware that hitting themselves with that dosage could probably hurt them in the long term: next time, you self medicate again.
Gene_Parmesan 5y ago
The problem is education won't reach everyone, and the broad, easy availability of the drug gives people the incorrect feeling that it is much safer than it actually is. ("If they let you just buy it, how dangerous can it possibly be?") Any drug where the toxic dose is that close to the suggested dose is going to be dicey when we let people buy it OTC. Notice I'm not saying we should prevent it from being OTC -- as someone who is not a doctor I have no clue on that. Just saying that I don't think it's fair to categorize people who take took much Tylenol without realizing the potential deadliness Darwin Award candidates. * I'm also going to make an edit to say, you suggest education, but isn't that exactly what this article is doing? If you want people to take warnings seriously, the warnings need to be serious.
aaron695 5y ago
> access to the drug restricted because of these 700 people. Less, "In about 6% of hospitalizations for overdose, patients develop liver injuries" Different US study "In many instances, individuals are using alcohol, hypnotics, or illicit drugs in combination, undoubtedly clouding judgment and often delaying hospitalization. More than 60% of unintentional cases in our study used a narcotic combination, such as hydrocodone and acetaminophen (Vicodin and others). Excessive use (up to 40 or more tablets per day) appears to occur over weeks prior to onset of liver injury, suggesting addiction to the narcotic component and the development of tolerance to the narcotic and to the acetaminophen" > some folks trying to win the Darwin Award It's good you acknowledged intelligence in inherited. It's good to want to increase the general IQ. But I don't agree killing people is a solution. Other than ethics, a lot of people killed in the Darwin Award already had children, which have lower IQ's (per Darwin) and now no parent/parents, which often means they actually breed more. A lot of average/low IQ people are also quite nice. They won't cure cancer but they often are good to have in the community. And when I tried the cold water extraction of codeine/paracetamol, even with low level university chemistry it was all a bit dodgy. It wouldn't have been impossible I made a mistake from the guide on Erowid - https://pubmed.ncbi.nlm.nih.gov/31081395/ https://pubmed.ncbi.nlm.nih.gov/31081395/
mkr-hn 5y ago
I don't see why I shouldn't run out into a lightning storm when lightning strikes on people are so rare. Consider that maybe the restriction is why overdoses are so are.

slavik81 5y ago

> To be absolutely clear, the maximum recommended dose is 4000mg over 24 hours. That’s eight extra strength pills. It's also included as a secondary ingredient in a lot of other medicines, which makes it easy to take more than you thought. Additionally, other common drugs (like alcohol) use the same metabolic pathways, so they can dramatically lower the safe limit for acetaminophen. When you look at the rate of death and serious injury due to overdose, acetaminophen comes out very badly. The only medicines that kill more are opioids.

touisteur 5y ago

A more charitable interpretation of the overdose on acetaminophen is that people are bad at handling pain and we should help with that. And also when in a flu-like state, people (me included) have trouble keeping up with their dosage. One other thing is that many compound otc drugs (marketed as 'get through this' for ) also have acetaminophen... I'll also say that being pregnant is the medical wild card. You shouldn't do, eat, take, catch anything. It doesn't help discriminating between the level of risks you're taking when anything you do is forbidden. Having such a risky drug at hand mechanically increases the risk of overdose and we should strive to find better alternatives, I think. It doesn't have to be more control, since it won't help you at home and will just make suffering people more miserable, but tech could help here, with delivery or packaging for example. 700 dead people isn't nothing. And putting a 'Darwin Awards' tag on them feels the same as 'pilot blaming' in aviation: not likely to increase safety.

pantulis 5y ago

> To be absolutely clear, the maximum recommended dose is 4000mg over 24 hours. That’s eight extra strength pills. In Spain you can get 1000mg paracetamol pills OTC, so that's 4 of them. It's not that unusual doctors prescripting "one every 8 hours" for acute cases. People are probably not aware that hitting themselves with that dosage could probably hurt them in the long term: next time, you self medicate again.

Gene_Parmesan 5y ago

The problem is education won't reach everyone, and the broad, easy availability of the drug gives people the incorrect feeling that it is much safer than it actually is. ("If they let you just buy it, how dangerous can it possibly be?") Any drug where the toxic dose is that close to the suggested dose is going to be dicey when we let people buy it OTC. Notice I'm not saying we should prevent it from being OTC -- as someone who is not a doctor I have no clue on that. Just saying that I don't think it's fair to categorize people who take took much Tylenol without realizing the potential deadliness Darwin Award candidates. * I'm also going to make an edit to say, you suggest education, but isn't that exactly what this article is doing? If you want people to take warnings seriously, the warnings need to be serious.

aaron695 5y ago

> access to the drug restricted because of these 700 people. Less, "In about 6% of hospitalizations for overdose, patients develop liver injuries" Different US study "In many instances, individuals are using alcohol, hypnotics, or illicit drugs in combination, undoubtedly clouding judgment and often delaying hospitalization. More than 60% of unintentional cases in our study used a narcotic combination, such as hydrocodone and acetaminophen (Vicodin and others). Excessive use (up to 40 or more tablets per day) appears to occur over weeks prior to onset of liver injury, suggesting addiction to the narcotic component and the development of tolerance to the narcotic and to the acetaminophen" > some folks trying to win the Darwin Award It's good you acknowledged intelligence in inherited. It's good to want to increase the general IQ. But I don't agree killing people is a solution. Other than ethics, a lot of people killed in the Darwin Award already had children, which have lower IQ's (per Darwin) and now no parent/parents, which often means they actually breed more. A lot of average/low IQ people are also quite nice. They won't cure cancer but they often are good to have in the community. And when I tried the cold water extraction of codeine/paracetamol, even with low level university chemistry it was all a bit dodgy. It wouldn't have been impossible I made a mistake from the guide on Erowid - https://pubmed.ncbi.nlm.nih.gov/31081395/ https://pubmed.ncbi.nlm.nih.gov/31081395/

mkr-hn 5y ago

I don't see why I shouldn't run out into a lightning storm when lightning strikes on people are so rare. Consider that maybe the restriction is why overdoses are so are.