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500 people die annually due to acetaminophen poisoning, mostly from attempting to take too many painkillers which include both opiates and acetaminophen. The a

500 people die annually due to acetaminophen poisoning, mostly from attempting to take too many painkillers which include both opiates and acetaminophen. The acetaminophen is included for the express purpose of "dissuading abuse."

Firehed 14y ago
Well, you can't deny that it does stop the abuse. Really poor implementation though.
- Tarential 14y ago
  I have to weigh in here. It does not stop the abuse. Separating opiates from acetaminophen is extremely simple (look up cold water extraction). All it does is kill people who aren't aware of the danger or the alternatives. There are many good reasons not to abuse oxycodone. The government doesn't need to add to the damage of people who are only hurting themselves.
  - arkonaut 14y ago
    Or kills people that aren't aware that it can be extracted.
  - malandrew 14y ago
    Actually I think that poster was being slightly facetious and meant that it does stop that abuse for those 500 people a year because a dead person can't abuse drugs.
- jlgreco 14y ago
  Abuse of prescription painkillers is massive. Acetaminophen does not prevent abuse, it only injures.
  - icelancer 14y ago
    That was his point.
    - jlgreco 14y ago
      > "Well, you can't deny that it does stop the abuse." Unless he is pointing out that liver failure induced death puts an end to any addiction, I am absolutely denying that it puts a stop to abuse.
      - Firehed 14y ago
        That's exactly what I was pointing out, actually. Hence the poor implementation ;)
Steko 14y ago
"mostly from attempting to take too many painkillers which include both opiates and acetaminophen" Brief Google returns 31%. Still a large percentage but nothing like the number of people who die from prescription opiate abuse (the better part of 15K). Powerful drugs sometimes result in the death of user, news at 11. [1] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1874350/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1874350/
- jlgreco 14y ago
  The danger posed by abusing narcotic painkillers is disputed by nobody. The issue being discussed here is the practice of making the abuse more dangerous to 'discourage' abuse. I know it is hard for a lot of people to identify with drug users/addicts/fiends, so imagine we tried to apply the same sort of 'solution' to, say, speeding. Make all cars disable driver-side airbags once you go, say, 15% over the national speed limit. Speeding sometimes results in the death of the driver, news at 11. How does that sit with you?
  - Steko 14y ago
    They don't put acetaminophen in opiates to poison people, they put it in because it's an effective painkiller and the natural check for abuse makes the powerful opiate more easily available than it otherwise would be. "Make all cars disable driver-side airbags once you go, say, 15% over the national speed limit." I'll suggest a better analogy. People have to wear seatbelts/motorcycle helmets. Unfortunately this does kill some people but on the whole it does far more good than harm.
    - jlgreco 14y ago
      > They don't put acetaminophen in opiates to poison people, they put it in because it's an effective painkiller and the natural check for abuse makes the powerful opiate more easily available than it otherwise would be. > They don't put acetaminophen in opiates to poison people > natural check for abuse The "natural check for abuse" is a threat of poisoning. If acetaminophen did not poison, it would provide no "check for abuse". Seatbelts are not a deterrent to anything. Your analogy is terrible.
dhughes 14y ago
So many people I know in their 20s only use Tylenol and especially after drinking binges nobody I know uses Aspirin, zero. Tylenol the worst thing to take with alcohol after binge drinking it's terribly hard on your liver. It's worse for women who can't process ethanol ("alcohol") as well as men due to women's bodies producing less dehydrogenase which breaks down the ethanol. From what I understand alcohol and acetaminophen (Tylenol) are processed by the liver in the same way so ingesting both overloads the liver, more so in women. I think liver failure is going to be common in a few years in the 30-something crowd. I'm not a doctor and not involved in any way in the medical field just a concerned citizen. https://www.ncbi.nlm.nih.gov/pubmed/2248624 https://www.ncbi.nlm.nih.gov/pubmed/2248624 http://www.health.harvard.edu/fhg/updates/overdoing-acetaminophen.shtml http://www.health.harvard.edu/fhg/updates/overdoing-acetamin...
- sliverstorm 14y ago
  I can't speak for everyone, but I used Tylenol essentially out of habit as a young adult, because my parents gave me Tylenol as a child. This makes sense (I think), I am told aspirin should not be given to children. So, it's probably just an education thing. Tylenol seems fine at what it does, and it isn't like people are misled. I bet you the label warns against mixing alcohol with Tylenol, and people really should know not to mix alcohol with other drugs.
  - pimeys 14y ago
    Are they selling Ibuprofein products in the USA? They're only harmful for your stomach if used a lot and much safer than Paracetamol.
  - dhughes 14y ago
    Not misled but unaware or ignorant and also the binge drinking is a big part of it. I can't recall where I read it but I remember reading how a person should not use Tylenol even three days after drinking since the liver is still dealing with it. I'm not sure if that's true for any drink or just binge drinking. College students who bing, take Tylenol, next weekend bing and so on are probably the ones who will suffer the most liver damage. The liver is an amazing organ it's the only organ that can repair itself and regrow due to physical damage but not systemic damage.
fulafel 14y ago
It's actually included because the combination has a synergistic pain killing effect.
- nazgulnarsil 14y ago
  Yeah, that must be it, it's not like a doctor could possibly just say: "take aspirin with this."
  - zurn 14y ago
    There are a lot of drugs that contain >1 ingredients that work together. What makes you think it must be a poisoning conspiracy? The paracetamol+opiates combined effect is widely documented in medical literature, and many of the most common painkillers are combinations of paractamol along with a mild optiate like codeine.
- neurotech1 14y ago
  Correct. There are times when you do want the anti-inflammatory properties of acetaminophen. Using only opioids for inflammatory pain, or muscle aches requires a higher dosage than if it was mixed with acetaminophen. I usually take muscle relaxants (Soma) with Naproxen for back pain, and avoid the opioid pain meds or acetaminophen.
  - cmccabe 14y ago
    Acetaminophen is not an anti-inflammatory. Just a painkiller.
    - neurotech1 14y ago
      My point is that acetaminophen adds to the effect of pain-killers like Vicodin, compared to a 5mg hydrocodone or oxycodone dosage.
      - cmccabe 14y ago
        It's kind of crazy that acetaminophen gets added to so many drug cocktails prescribed by doctors. When your liver is already handling a bunch of other stuff, do you really want to throw one of those most liver-toxic medications out there on top? Even if your doctor knows all the drug interactions, he doesn't know the other stuff you're consuming like alcohol, grapefruit juice, over-the-counter painkillers, and so forth. See http://www.dailymail.co.uk/health/article-1158671/How-healthy-fruit-juice-liver-failure-worse.html http://www.dailymail.co.uk/health/article-1158671/How-health... Apparently I'm not the only one who feels this way. According to wikipedia: On June 30, 2009, a U.S. Food and Drug Administration (FDA) advisory panel voted by a narrow margin to advise the FDA to remove Vicodin and another painkiller, Percocet, from the market because of "a high likelihood of overdose from prescription narcotics and acetaminophen products". The panel cited concerns of liver damage from their acetaminophen component, which is also the main ingredient in commonly-used nonprescription drugs such as Tylenol.[8] Each year, acetaminophen overdose is linked to about 400 deaths and 42,000 hospitalizations.

Firehed 14y ago

Well, you can't deny that it does stop the abuse. Really poor implementation though.

Tarential 14y ago
I have to weigh in here. It does not stop the abuse. Separating opiates from acetaminophen is extremely simple (look up cold water extraction). All it does is kill people who aren't aware of the danger or the alternatives. There are many good reasons not to abuse oxycodone. The government doesn't need to add to the damage of people who are only hurting themselves.
- arkonaut 14y ago
  Or kills people that aren't aware that it can be extracted.
- malandrew 14y ago
  Actually I think that poster was being slightly facetious and meant that it does stop that abuse for those 500 people a year because a dead person can't abuse drugs.
jlgreco 14y ago
Abuse of prescription painkillers is massive. Acetaminophen does not prevent abuse, it only injures.
- icelancer 14y ago
  That was his point.
  - jlgreco 14y ago
    > "Well, you can't deny that it does stop the abuse." Unless he is pointing out that liver failure induced death puts an end to any addiction, I am absolutely denying that it puts a stop to abuse.
    - Firehed 14y ago
      That's exactly what I was pointing out, actually. Hence the poor implementation ;)

Steko 14y ago

"mostly from attempting to take too many painkillers which include both opiates and acetaminophen" Brief Google returns 31%. Still a large percentage but nothing like the number of people who die from prescription opiate abuse (the better part of 15K). Powerful drugs sometimes result in the death of user, news at 11. [1] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1874350/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1874350/

jlgreco 14y ago
The danger posed by abusing narcotic painkillers is disputed by nobody. The issue being discussed here is the practice of making the abuse more dangerous to 'discourage' abuse. I know it is hard for a lot of people to identify with drug users/addicts/fiends, so imagine we tried to apply the same sort of 'solution' to, say, speeding. Make all cars disable driver-side airbags once you go, say, 15% over the national speed limit. Speeding sometimes results in the death of the driver, news at 11. How does that sit with you?
- Steko 14y ago
  They don't put acetaminophen in opiates to poison people, they put it in because it's an effective painkiller and the natural check for abuse makes the powerful opiate more easily available than it otherwise would be. "Make all cars disable driver-side airbags once you go, say, 15% over the national speed limit." I'll suggest a better analogy. People have to wear seatbelts/motorcycle helmets. Unfortunately this does kill some people but on the whole it does far more good than harm.
  - jlgreco 14y ago
    > They don't put acetaminophen in opiates to poison people, they put it in because it's an effective painkiller and the natural check for abuse makes the powerful opiate more easily available than it otherwise would be. > They don't put acetaminophen in opiates to poison people > natural check for abuse The "natural check for abuse" is a threat of poisoning. If acetaminophen did not poison, it would provide no "check for abuse". Seatbelts are not a deterrent to anything. Your analogy is terrible.

dhughes 14y ago

So many people I know in their 20s only use Tylenol and especially after drinking binges nobody I know uses Aspirin, zero. Tylenol the worst thing to take with alcohol after binge drinking it's terribly hard on your liver. It's worse for women who can't process ethanol ("alcohol") as well as men due to women's bodies producing less dehydrogenase which breaks down the ethanol. From what I understand alcohol and acetaminophen (Tylenol) are processed by the liver in the same way so ingesting both overloads the liver, more so in women. I think liver failure is going to be common in a few years in the 30-something crowd. I'm not a doctor and not involved in any way in the medical field just a concerned citizen. https://www.ncbi.nlm.nih.gov/pubmed/2248624 https://www.ncbi.nlm.nih.gov/pubmed/2248624 http://www.health.harvard.edu/fhg/updates/overdoing-acetaminophen.shtml http://www.health.harvard.edu/fhg/updates/overdoing-acetamin...

sliverstorm 14y ago
I can't speak for everyone, but I used Tylenol essentially out of habit as a young adult, because my parents gave me Tylenol as a child. This makes sense (I think), I am told aspirin should not be given to children. So, it's probably just an education thing. Tylenol seems fine at what it does, and it isn't like people are misled. I bet you the label warns against mixing alcohol with Tylenol, and people really should know not to mix alcohol with other drugs.
- pimeys 14y ago
  Are they selling Ibuprofein products in the USA? They're only harmful for your stomach if used a lot and much safer than Paracetamol.
- dhughes 14y ago
  Not misled but unaware or ignorant and also the binge drinking is a big part of it. I can't recall where I read it but I remember reading how a person should not use Tylenol even three days after drinking since the liver is still dealing with it. I'm not sure if that's true for any drink or just binge drinking. College students who bing, take Tylenol, next weekend bing and so on are probably the ones who will suffer the most liver damage. The liver is an amazing organ it's the only organ that can repair itself and regrow due to physical damage but not systemic damage.

fulafel 14y ago

It's actually included because the combination has a synergistic pain killing effect.

nazgulnarsil 14y ago
Yeah, that must be it, it's not like a doctor could possibly just say: "take aspirin with this."
- zurn 14y ago
  There are a lot of drugs that contain >1 ingredients that work together. What makes you think it must be a poisoning conspiracy? The paracetamol+opiates combined effect is widely documented in medical literature, and many of the most common painkillers are combinations of paractamol along with a mild optiate like codeine.
neurotech1 14y ago
Correct. There are times when you do want the anti-inflammatory properties of acetaminophen. Using only opioids for inflammatory pain, or muscle aches requires a higher dosage than if it was mixed with acetaminophen. I usually take muscle relaxants (Soma) with Naproxen for back pain, and avoid the opioid pain meds or acetaminophen.
- cmccabe 14y ago
  Acetaminophen is not an anti-inflammatory. Just a painkiller.
  - neurotech1 14y ago
    My point is that acetaminophen adds to the effect of pain-killers like Vicodin, compared to a 5mg hydrocodone or oxycodone dosage.
    - cmccabe 14y ago
      It's kind of crazy that acetaminophen gets added to so many drug cocktails prescribed by doctors. When your liver is already handling a bunch of other stuff, do you really want to throw one of those most liver-toxic medications out there on top? Even if your doctor knows all the drug interactions, he doesn't know the other stuff you're consuming like alcohol, grapefruit juice, over-the-counter painkillers, and so forth. See http://www.dailymail.co.uk/health/article-1158671/How-healthy-fruit-juice-liver-failure-worse.html http://www.dailymail.co.uk/health/article-1158671/How-health... Apparently I'm not the only one who feels this way. According to wikipedia: On June 30, 2009, a U.S. Food and Drug Administration (FDA) advisory panel voted by a narrow margin to advise the FDA to remove Vicodin and another painkiller, Percocet, from the market because of "a high likelihood of overdose from prescription narcotics and acetaminophen products". The panel cited concerns of liver damage from their acetaminophen component, which is also the main ingredient in commonly-used nonprescription drugs such as Tylenol.[8] Each year, acetaminophen overdose is linked to about 400 deaths and 42,000 hospitalizations.