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Side note: acetaminophen is a much bigger threat than most opioid analgesics themselves. It's directly involved in something like 10% of all overdoses in the US
by dbbolton 12y ago
Side note: acetaminophen is a much bigger threat than most opioid analgesics themselves. It's directly involved in something like 10% of all overdoses in the US. There's no practical reason for opioids like hydrocodone to be mixed with it (as opposed to just being prescribed/administered concurrently) except that you get sick if you try to take enough of the opioid to get high. Personally, I feel that hepatotoxicity is a poor abuse deterrent, both in theory and practice.
- Alex3917 12y agoThere are around 115 U.S. acetaminophen deaths per year, versus around 17k opioid analgesic deaths. That said, as far as I can tell there is no reason to take it acetaminophen ever; for pretty much any use case, there is another drug that's more effective and safer. http://www.propublica.org/article/tylenol-mcneil-fda-behind-the-numbers http://www.propublica.org/article/tylenol-mcneil-fda-behind-... http://www.cdc.gov/media/releases/2013/p0220_drug_overdose_deaths.html http://www.cdc.gov/media/releases/2013/p0220_drug_overdose_d...
- tomerico 12y agoCan you elaborate more on the acetaminophen alternatives? We've been using it in my family, and would love to do better.
- unepipe 12y agotry advil
- DanBC 12y agoDo you mean ibuprofen? Long term that's going to be rough on your stomach.
- protonfish 12y agoThat's way better than rough on your liver.
- DanBC 12y agoLong term use of paracetamol at the therapeutic dose is not rough on your liver.
- jstalin 12y agoI've had a long history of headaches and ibuprofen is something I'm taking a few times a week and have been since I was 11 or 12. I've never had stomach issues.
- sosborn 12y agoIf you take it with a meal you won't have problems.
- DanBC 12y agoWhat? Paracetamol, when taking correctly, is very safe and effective. The toxic dose is close to the therapeutic dose so care needs to be taken to avoid overdose and acute overdose is particularly dangerous.
- pessimizer 12y ago>when taken correctly, is very safe and effective. ...is tautological and could be said about almost anything. The fact that the toxic dose is close to the therapeutic dose means that it is not safe. http://www.medpagetoday.com/Psychiatry/Depression/2233 http://www.medpagetoday.com/Psychiatry/Depression/2233 "Liver toxicity from acetaminophen poisoning is by far the most common cause of acute liver failure in the United States, researchers reported."
- DanBC 12y ago> "Liver toxicity from acetaminophen poisoning is by far the most common cause of acute liver failure in the United States, researchers reported." But that's because paracetamol is deliberately used as a self-poisoning method. Very few of those acute overdoses are accidental. Although they do happen accidental overdose is usually old people storing meds in the wrong place and children getting access. Very few people accidentally overdose on paracetamol by doubling up on paracetamol containing meds - and the solution is better packaging and warnings. There are some things that help reduce overdosing. Restricting the sale of paracetamol to blister packs only, and not bottles, does help. (Neither you nor Alex3917 have suggested a safer off the shelf alternative)
- pessimizer 12y agoThe majority of the cases studied in the linked article (in the cases where it was known) were accidental. "Some people deliberately take toxic doses in suicide attempts, but others may accumulate high levels of acetaminophen unintentionally when they take, for example, Tylenol for a headache and a second acetaminophen-containing product for cold symptoms." Also people overdose when they're hung over. >(Neither you nor Alex3917 have suggested a safer off the shelf alternative) And I don't intend to. Ask a doctor. I have no idea why you use it, or if any suggestion of mine would cover that usage. I never find any reason to use anything stronger than aspirin, and Advil was suggested earlier in the thread.
- deleted 12y ago[deleted]
- pjc50 12y agoThere are some painkillers that contain both; which column do those go in?
- Alex3917 12y agoWhichever one kills you. The Tylenol takes several days to kill you, whereas the opiates would be entirely worn off by then, so it should never be ambiguous.
- dbbolton 12y agoThe article clearly states that there were 16,651 overdose deaths "involving" opioids. It does not say anything about cause of death or exclusion of other drugs.
- dbbolton 12y ago>There are around 115 U.S. acetaminophen deaths per year, versus around 17k opioid analgesic deaths. First, I said "overdoses", not "overdose deaths". There is a difference. The source you cited doesn't make it clear whether the known opioid deaths did or did not involve acetaminophen. Since hydrocodone, oxycodone, codeine, dihydrocodeine, and tramadol are all combined with acetaminophen, I'd guess the intersection of the two sets is significant. The FDA recognized this problem and cut the APAP dose in combination analgesics to a maximum of 325mg (compared with the recommended 500mg dose of APAP alone) in 2009. They did not restrict the opioid dosages because they weren't responsible for the toxicity.
- loomio 12y agoThis American Life did a fantastic piece on acetaminophen, how easy it is to overdose on it, and the story behind why it's still thought of as so safe. Interesting listening on this topic! http://www.thisamericanlife.org/radio-archives/episode/505/use-only-as-directed http://www.thisamericanlife.org/radio-archives/episode/505/u...