5 ms·

What makes you say the FDA is actively adding poison to other drugs, are there first hand sources from them? This sounds like it could also be a case where they

What makes you say the FDA is actively adding poison to other drugs, are there first hand sources from them? This sounds like it could also be a case where they want to lower opiate consumption, and so adding some Tylenol increases pain relief without increasing opiate intake. I am not sure that’s wise policy, but if you don’t think Tylenol is all that bad (again, I’m not sufficiently informed to say this, but the FDA obviously thinks it’s safe), then it’s not a bad overall policy. It sounds like it could be either situation, I’m just looking for more evidence before making up my mind. (Yes, I am aware the US government poisoned people during prohibition in this exact manner, but I dispute that has any relevance as the decision makers and cultural awareness is very different now. We’ve come a long way since the 30s)

samtho 5y ago
Why can you go to the store and buy rubbing alcohol to drink? It’s primary ingredient is just ethanol. The FDA literally mandates that the ethanol is not able to be safely consumed and is cut with poison that is not easily separated from ethanol. Similarly, cutting opioids with Tylenol is not actually intended to be a deterrent to someone who gets their hands on the pills rather it deters people involved with illicit drug manufacture and distribution from using it as a base to grind up and sell. Tylenol is really not super safe, at least by todays approval standards. Most official sources, which unsurprisingly have a huge bias towards Tylenol’s safety, state that allergic reactions are very uncommon, but recent meta-analysis’ are beginning to uncover that mild to moderate allergic reactions to acetaminophen is more common that originally thought. It does not get reported because if you’re already feeling like crap when you take it, some mild itchiness, redness, and discomfort would not be out of the ordinary without the Tylenol. As mentioned before, the toxic dose is much too close to the effective dose, I’ve heard from medical professionals that doubling a single recommended dose on extra strength Tylenol is enough to cause long-term damage to your liver. On top of all that, the fact that it is a weak pain reliever at best would solidly put this as a drug that’s not super useful. I have a very low opinion of how we go about drug policy in the US. I am on a very controlled medication due to a sleep disorder (that causes hypersomnia) which I cannot go off for safety reasons. I also cannot get it filled more than 24 in advance without complicated authorization procedures that must be completed in the correct order. It’s a goddamn mess and serves only as a punishment to law-abiding patients for needing this medication. It also does nothing to curb illicit use because synthesis of a more potent product is so trivial. This is an example of poorly targeted legislation, which was put into place because it’s the only thing they could exert control over. It does not further the stated goals of drug enforcement because it’s so easy to manufacture this stuff and the resulting product is so easy to move, bad actors can simply avoid this system. While I’m spending 3 hours every month orchestrating the complicated dance of my prescription between my providers, the pharmacy, and my insurance, someone is making a batch of shake-and-bake meth in about 3 minutes.
- rootusrootus 5y ago
  > Why can you go to the store and buy rubbing alcohol to drink? It’s primary ingredient is just ethanol. AFAIK most/all rubbing alcohol (at least that which is sold in the US) is isopropanol, not ethanol. You can buy ethanol in not-for-consumption form, as denatured alcohol.
  - wombatpm 5y ago
    And it’s chemistry that forces the additional benzene in denatured alcohol. Water- ethanol forms an Azeotrope at 95% ethanol. Benzene is added to break the azeotrope and get to 99.99% ethanol. Chemistry not a conspiracy
    - ac29 5y ago
      No one is selling 99.99% grade alcohol as an antiseptic in the US. Its usually 70%. There are additives in ethanol sold as an antiseptic to discourage drinking (various bitterants, not benzene).
      - MertsA 5y ago
        No one is selling 70% ethanol as an antiseptic, it's isopropyl alcohol. Those additives in ethanol not intended for consumption are 8 parts acetone and 1.5 parts methyl isobutyl ketone to 100 parts ethanol. There are some rare ethanol based rubbing alcohols sold but the vast majority is isopropyl because it's not just denatured with bitterants, they add toxic substances as well. Here's the actual formula they have to use that's enshrined in the law. https://www.law.cornell.edu/cfr/text/27/21.49 https://www.law.cornell.edu/cfr/text/27/21.49
        ac29 5y ago
        Ethanol as an antiseptic is less common, but its definitely a thing: https://www.amazon.com/Amazon-Brand-Rubbing-Alcohol-Antiseptic/dp/B07RB7XYQ1 https://www.amazon.com/Amazon-Brand-Rubbing-Alcohol-Antisept... Its general sold as "ethyl alcohol" not ethanol, but its the same thing.
CamperBob2 5y ago
What makes you say the FDA is actively adding poison to other drugs, are there first hand sources from them? "Not everyone thought it was a good idea to make alcohol deadly, when making it illegal hadn’t stopped drinkers, and New Jersey Senator Edward I. Edwards called it “legalized murder.” However, the Anti-Saloon League persisted, arguing that legal alcohol had killed many more in its day than denatured alcohol would kill during the transition to a teetotaling world. “The Government is under no obligation to furnish the people with alcohol that is drinkable when the Constitution prohibits it,” said advocate Wayne B. Wheeler. “The person who drinks this industrial alcohol is a deliberate suicide… To root out a bad habit costs many lives and long years of effort…”" https://time.com/3665643/deadly-drinking/ https://time.com/3665643/deadly-drinking/
- drdeca 5y ago
  This makes me wonder if it would have been possible to, instead of using something that causes significant harms to health, instead something which just causes a rather unpleasant experience. But, I guess one important thing is whether such an additive is compatible with the altered substance still being usable for the purpose for which it is being made available. Now, presumably something as simple as “dissolve large amounts of capsaicin in it” wouldn’t work (I’m not even sure if capsaicin can be dissolved in alcohol), but, what about something along those lines? Or something that just causes headaches, or vomiting?
  - CamperBob2 5y ago
    I think that's what they ended up doing, post-Prohibition. A bottle of rubbing alcohol from the drugstore is either isopropyl alcohol, which is toxic by itself but not intentionally so, or ethanol mixed with a denaturing agent that's more benign than methanol or whatever they were using back in the day.
    - fuzzfactor 5y ago
      Different denaturants for different purposes. Choose your poison: 27 CFR § 21.151 - List of denaturants authorized for denatured spirits. https://www.law.cornell.edu/cfr/text/27/21.151 https://www.law.cornell.edu/cfr/text/27/21.151
rootusrootus 5y ago
I also wonder where the idea that the FDA 'denatures' hydrocodone with acetaminophen comes from. AFAICT, if you overdose on vicodin it's more likely the hydrocodone will kill you before the acetaminophen.
- netizen-936824 5y ago
  This is entirely false. You can overdose from ~4 grams of APAP which you can ingest by taking 6 7.5/750 hydrocodone/APAP tablets That's not nearly enough hydrocodone to kill you
  - rootusrootus 5y ago
    That seems low -- 4 grams is the max daily dose for OTC acetaminophen. According to this [1] the minimum single dose toxicity for APAP is more like 7.5 to 12 grams. Finding a value for a lethal hydrocodone dose is more difficult, but I did see 90 mg mentioned. For the dose of Vicodin you specified, 90mg of hydrocodone would correspond to 9 grams of APAP. So it's a race that it looks like either one could win. [1] https://www.uspharmacist.com/article/acetaminophen-intoxication-a-criticalcare-emergency https://www.uspharmacist.com/article/acetaminophen-intoxicat...
    - TylerE 5y ago
      The difference is you can build a tolerance to opioids, so the LD of hydrocodone in an addict (or even just someone using for an extended period medically) will be FAR higher than in an opiod-naive person. Opioids kill via respiratory depression, not by destroying your organs.
    - netizen-936824 5y ago
      >The United States FDA clearly states “severe liver damage may occur if you take more than 4000 mg of acetaminophen in 24 hours.” >There is no question that the upper threshold on the maximum daily allowed dose of APAP has been the subject of controversy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4913076/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4913076/
salawat 5y ago
Look up DXM. You will never find it without either Gualfenisin or acetaminophen. Does DXM need either of those to do what it does? No. Would it simplify dosing to be sold alone so that laymen didn't have to worry about potentially overdosing on three drugs at once instead of just one? Yes. However, from the war on drugs perspective, that makes it "easier to abuse" to achieve it's hallucinogenic side effect. Bundled with acetaminophen or gualfenisin however, you'd have to be a chemist intimately familiar with how to seperate the other two components to distill DXM in any amount with abuse potential, and the naive non-chemist trying to get high will either end up puking their guts out (Gualfenisin OD) or burning out their liver (Tylenol OD, which is exacerbated by alcohol consumption as well). The Tylenol one is particularly problematic, because acetaminophen is also commonly prescribed with other common multi-drug formulations that people may not realize are additive. When you take the route of adding a substance that does harm to discourage a pattern of behavior, you are poisoning. Poisoning being the act of artificially and with intent increasing the toxicity of an imbibed substance to disincent some pattern of behavior. This is actually based on a natural pattern of behavior by the way. There is a mushroom that is generally completely harmless... Until you drink alcohol. Metabolizing the mushroom depletes the supply of the same enzymes that detoxify alcohol (and Tylenol). https://en.m.wikipedia.org/wiki/Coprinopsis_atramentaria https://en.m.wikipedia.org/wiki/Coprinopsis_atramentaria So to be clear... If you call this mushroom poisonous, and it targets the same enzyme that alcohol does, then adding something like tylenol to something that doesn't need it to do it's job, you are poisoning. It just happens to be handwaved because in the establishment's mind, those damn druggies aren't worth caring about anyway. Not a partaker of DXM, but very concerned with the ethical implications, and the adverse contribution to trust in public health measures that this practice entails.
- lr4444lr 5y ago
  Dextromethorphan HBr? It's definitely sold on its own in the US.
- throwaway48375 5y ago
  https://www.amazon.com/dp/B005E74U3W/ https://www.amazon.com/dp/B005E74U3W/ https://www.amazon.com/dp/B09LKLNKZ7/ https://www.amazon.com/dp/B09LKLNKZ7/
deleted 5y ago
[deleted]

samtho 5y ago

Why can you go to the store and buy rubbing alcohol to drink? It’s primary ingredient is just ethanol. The FDA literally mandates that the ethanol is not able to be safely consumed and is cut with poison that is not easily separated from ethanol. Similarly, cutting opioids with Tylenol is not actually intended to be a deterrent to someone who gets their hands on the pills rather it deters people involved with illicit drug manufacture and distribution from using it as a base to grind up and sell. Tylenol is really not super safe, at least by todays approval standards. Most official sources, which unsurprisingly have a huge bias towards Tylenol’s safety, state that allergic reactions are very uncommon, but recent meta-analysis’ are beginning to uncover that mild to moderate allergic reactions to acetaminophen is more common that originally thought. It does not get reported because if you’re already feeling like crap when you take it, some mild itchiness, redness, and discomfort would not be out of the ordinary without the Tylenol. As mentioned before, the toxic dose is much too close to the effective dose, I’ve heard from medical professionals that doubling a single recommended dose on extra strength Tylenol is enough to cause long-term damage to your liver. On top of all that, the fact that it is a weak pain reliever at best would solidly put this as a drug that’s not super useful. I have a very low opinion of how we go about drug policy in the US. I am on a very controlled medication due to a sleep disorder (that causes hypersomnia) which I cannot go off for safety reasons. I also cannot get it filled more than 24 in advance without complicated authorization procedures that must be completed in the correct order. It’s a goddamn mess and serves only as a punishment to law-abiding patients for needing this medication. It also does nothing to curb illicit use because synthesis of a more potent product is so trivial. This is an example of poorly targeted legislation, which was put into place because it’s the only thing they could exert control over. It does not further the stated goals of drug enforcement because it’s so easy to manufacture this stuff and the resulting product is so easy to move, bad actors can simply avoid this system. While I’m spending 3 hours every month orchestrating the complicated dance of my prescription between my providers, the pharmacy, and my insurance, someone is making a batch of shake-and-bake meth in about 3 minutes.

rootusrootus 5y ago
> Why can you go to the store and buy rubbing alcohol to drink? It’s primary ingredient is just ethanol. AFAIK most/all rubbing alcohol (at least that which is sold in the US) is isopropanol, not ethanol. You can buy ethanol in not-for-consumption form, as denatured alcohol.
- wombatpm 5y ago
  And it’s chemistry that forces the additional benzene in denatured alcohol. Water- ethanol forms an Azeotrope at 95% ethanol. Benzene is added to break the azeotrope and get to 99.99% ethanol. Chemistry not a conspiracy
  - ac29 5y ago
    No one is selling 99.99% grade alcohol as an antiseptic in the US. Its usually 70%. There are additives in ethanol sold as an antiseptic to discourage drinking (various bitterants, not benzene).
    - MertsA 5y ago
      No one is selling 70% ethanol as an antiseptic, it's isopropyl alcohol. Those additives in ethanol not intended for consumption are 8 parts acetone and 1.5 parts methyl isobutyl ketone to 100 parts ethanol. There are some rare ethanol based rubbing alcohols sold but the vast majority is isopropyl because it's not just denatured with bitterants, they add toxic substances as well. Here's the actual formula they have to use that's enshrined in the law. https://www.law.cornell.edu/cfr/text/27/21.49 https://www.law.cornell.edu/cfr/text/27/21.49
      - ac29 5y ago
        Ethanol as an antiseptic is less common, but its definitely a thing: https://www.amazon.com/Amazon-Brand-Rubbing-Alcohol-Antiseptic/dp/B07RB7XYQ1 https://www.amazon.com/Amazon-Brand-Rubbing-Alcohol-Antisept... Its general sold as "ethyl alcohol" not ethanol, but its the same thing.

CamperBob2 5y ago

What makes you say the FDA is actively adding poison to other drugs, are there first hand sources from them? "Not everyone thought it was a good idea to make alcohol deadly, when making it illegal hadn’t stopped drinkers, and New Jersey Senator Edward I. Edwards called it “legalized murder.” However, the Anti-Saloon League persisted, arguing that legal alcohol had killed many more in its day than denatured alcohol would kill during the transition to a teetotaling world. “The Government is under no obligation to furnish the people with alcohol that is drinkable when the Constitution prohibits it,” said advocate Wayne B. Wheeler. “The person who drinks this industrial alcohol is a deliberate suicide… To root out a bad habit costs many lives and long years of effort…”" https://time.com/3665643/deadly-drinking/ https://time.com/3665643/deadly-drinking/

drdeca 5y ago
This makes me wonder if it would have been possible to, instead of using something that causes significant harms to health, instead something which just causes a rather unpleasant experience. But, I guess one important thing is whether such an additive is compatible with the altered substance still being usable for the purpose for which it is being made available. Now, presumably something as simple as “dissolve large amounts of capsaicin in it” wouldn’t work (I’m not even sure if capsaicin can be dissolved in alcohol), but, what about something along those lines? Or something that just causes headaches, or vomiting?
- CamperBob2 5y ago
  I think that's what they ended up doing, post-Prohibition. A bottle of rubbing alcohol from the drugstore is either isopropyl alcohol, which is toxic by itself but not intentionally so, or ethanol mixed with a denaturing agent that's more benign than methanol or whatever they were using back in the day.
  - fuzzfactor 5y ago
    Different denaturants for different purposes. Choose your poison: 27 CFR § 21.151 - List of denaturants authorized for denatured spirits. https://www.law.cornell.edu/cfr/text/27/21.151 https://www.law.cornell.edu/cfr/text/27/21.151

rootusrootus 5y ago

I also wonder where the idea that the FDA 'denatures' hydrocodone with acetaminophen comes from. AFAICT, if you overdose on vicodin it's more likely the hydrocodone will kill you before the acetaminophen.

netizen-936824 5y ago
This is entirely false. You can overdose from ~4 grams of APAP which you can ingest by taking 6 7.5/750 hydrocodone/APAP tablets That's not nearly enough hydrocodone to kill you
- rootusrootus 5y ago
  That seems low -- 4 grams is the max daily dose for OTC acetaminophen. According to this [1] the minimum single dose toxicity for APAP is more like 7.5 to 12 grams. Finding a value for a lethal hydrocodone dose is more difficult, but I did see 90 mg mentioned. For the dose of Vicodin you specified, 90mg of hydrocodone would correspond to 9 grams of APAP. So it's a race that it looks like either one could win. [1] https://www.uspharmacist.com/article/acetaminophen-intoxication-a-criticalcare-emergency https://www.uspharmacist.com/article/acetaminophen-intoxicat...
  - TylerE 5y ago
    The difference is you can build a tolerance to opioids, so the LD of hydrocodone in an addict (or even just someone using for an extended period medically) will be FAR higher than in an opiod-naive person. Opioids kill via respiratory depression, not by destroying your organs.
  - netizen-936824 5y ago
    >The United States FDA clearly states “severe liver damage may occur if you take more than 4000 mg of acetaminophen in 24 hours.” >There is no question that the upper threshold on the maximum daily allowed dose of APAP has been the subject of controversy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4913076/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4913076/

salawat 5y ago

Look up DXM. You will never find it without either Gualfenisin or acetaminophen. Does DXM need either of those to do what it does? No. Would it simplify dosing to be sold alone so that laymen didn't have to worry about potentially overdosing on three drugs at once instead of just one? Yes. However, from the war on drugs perspective, that makes it "easier to abuse" to achieve it's hallucinogenic side effect. Bundled with acetaminophen or gualfenisin however, you'd have to be a chemist intimately familiar with how to seperate the other two components to distill DXM in any amount with abuse potential, and the naive non-chemist trying to get high will either end up puking their guts out (Gualfenisin OD) or burning out their liver (Tylenol OD, which is exacerbated by alcohol consumption as well). The Tylenol one is particularly problematic, because acetaminophen is also commonly prescribed with other common multi-drug formulations that people may not realize are additive. When you take the route of adding a substance that does harm to discourage a pattern of behavior, you are poisoning. Poisoning being the act of artificially and with intent increasing the toxicity of an imbibed substance to disincent some pattern of behavior. This is actually based on a natural pattern of behavior by the way. There is a mushroom that is generally completely harmless... Until you drink alcohol. Metabolizing the mushroom depletes the supply of the same enzymes that detoxify alcohol (and Tylenol). https://en.m.wikipedia.org/wiki/Coprinopsis_atramentaria https://en.m.wikipedia.org/wiki/Coprinopsis_atramentaria So to be clear... If you call this mushroom poisonous, and it targets the same enzyme that alcohol does, then adding something like tylenol to something that doesn't need it to do it's job, you are poisoning. It just happens to be handwaved because in the establishment's mind, those damn druggies aren't worth caring about anyway. Not a partaker of DXM, but very concerned with the ethical implications, and the adverse contribution to trust in public health measures that this practice entails.

lr4444lr 5y ago
Dextromethorphan HBr? It's definitely sold on its own in the US.
throwaway48375 5y ago
https://www.amazon.com/dp/B005E74U3W/ https://www.amazon.com/dp/B005E74U3W/ https://www.amazon.com/dp/B09LKLNKZ7/ https://www.amazon.com/dp/B09LKLNKZ7/

deleted 5y ago

[deleted]