Acetaminophen is a great little drug, a pain killer that we have probably all used at varying times for those minor aches or what have you. Approximately 458 people in the US will die because of it this year, either by intentional overdose or, far worse, accidental and prolonged overdose. So naturally, we should all jump to other pain relievers, right?
Well, like most stuff, it really isn’t that simple. As Scott Gavura points out this morning in a Science-Based Medicine article entitled Acetaminophen: Still the pain reliever you should trust?, there are serious pros and serious cons to both Acetaminophen and NSAIDs like aspirin, ibuprofen, and naproxen, and what is really required is an understanding of how to properly take pain killers (and medications in general).
I went through a phase when I was at the tail end of high school through the next few years of my life wherein I took a lot of pain killers. I get sinus migraines that are utterly debilitating if not caught quickly, and they come on seemingly from certain weather shifts, which is a common malady for people from My Home Town. Just a couple of days ago, I snuck home from work early, sacrificing perfectly good working hours (and therefore, perfectly good money) on the alter of pain. But I digress.
I was, way back when, in possession of some Parafon-Forte C8 that I had been given for earlier muscle spasms, and decided I would take those to manage my headaches. Yeah, good plan is good. Take a powerful codeine-laden painkiller on a whim, probably after it had expired. What can I say, I wasn’t always the paragon of intelligent decision making I am today. This drug is has 300 mg of acetaminophen, 250 mg of chlorzoxazone, and 8 mg of Codeine. As the headaches progressed, I go to the point where I would eat 4 at a time, sometimes three times a day. That means I was taking 300 * 4 * 3 mgs of acetaminophen, or 3,600 mgs a day. I didn’t realize it, but I was skipping dangerously close to the 4,000 mg daily limit. If I had encountered any other acetaminophen in the day, I could have easily wound up causing myself some serious liver damage.
As it turns out, the pills worked for a while and then I found myself developing a tolerance (thus the increase to 12 pills a day). As I recognized that I was nomming more and more of the pills, I became concerned that it might be a bad idea. So I quit. Eventually, I would discover that the cure for me was actually decongestants, and at the expected dose, so it ended up fine.
What bugs me is that I think most people do the same thing. Knowing what I know now, this is more than disconcerting. And so I ask that everyone read that article to properly understand that Tylenol isn’t as nice as you might think, though it’s also not the devil incarnate.