
Acetaminophen reduces empathy for pain (2016) - lukas
https://www.washingtonpost.com/news/to-your-health/wp/2016/05/12/this-popular-painkiller-also-kills-kindness/?utm_term=.2158e825bd70
======
jawns
The article doesn't make clear whether the study participants were given
acetaminophen to relieve pain (e.g. a headache), or whether they were simply
given the drug regardless of whether they were currently experiencing pain. So
I looked up the pharmacological procedures in the study itself, which confirms
that it's the latter case. The drug was administered regardless of whether the
subjects were experiencing any pain for which acetaminophen would be an
appropriate treatment.

I would think it's at least conceivable that the body reacts differently to
acetaminophen when it's used to treat pain, versus when it's administered even
if the subject is not in pain. And especially since most people take
acetaminophen for some pain-relieving purpose, rather than for no purpose at
all, I would think it's important to try to emulate those real-world
conditions when designing studies like this (although clearly it's difficult
to control for something as subjective as pain).

Side note: I absolute hate when articles about scientific studies don't even
name the study so you can look it up. In this case, the study appears to be
titled "From painkiller to empathy killer: acetaminophen (paracetamol) reduces
empathy for pain" and the full text is available here:

[https://academic.oup.com/scan/article/11/9/1345/2224135/From...](https://academic.oup.com/scan/article/11/9/1345/2224135/From-
painkiller-to-empathy-killer-acetaminophen)

~~~
fossuser
I also remember reading that there was some evidence that acetaminophen (and
possibly other NSAIDs) helped with anxiety [1] - the idea being that social
pain and physical pain are similar.

It seems like reducing empathy might be the same thing - a more general
dulling of emotions. On a personal note I've found Aleve works really well
(better than Tylenol) when I'm feeling anxious, but maybe that's just placebo.
I originally read about the Tylenol affect after feeling surprisingly less
anxious when I took Aleve and searching around.

[1] [https://blogs.scientificamerican.com/mind-guest-
blog/tomorro...](https://blogs.scientificamerican.com/mind-guest-
blog/tomorrows-anti-anxiety-drug-is-tylenol/)

~~~
pcl
FWIW, acetaminophen is not an NSAID.

Also, the common characteristic of NSAIDs is their anti-inflammatory nature
(the _AI_ in NSAID), which addresses injury-related pain by locally reducing
swelling. This pathway for the class of drugs is unlikely to provide anxiety
benefits.

~~~
slv77
Prostaglandin E2 inhibits the release of endorphins so suppressing
prostaglandins may have an impact on anxiety.

------
vilhelm_s
There was also this paper from 2013, about acetaminophen relieving
"existential dread". The experiemental setup induced subconscious anxiety by
making the subjects watch David Lynch's short film "Rabbits", then measured
it's effect on strictness when recommending fines for hockey rioters.

The researchers concluded, "Despite the many questions that these findings
raise, they do demonstrate that acetaminophen has more far-reaching
psychological consequences than previously realized, and that a single pill
can serve as an effective manipulation in the lab."

[https://www.sciencedaily.com/releases/2013/04/130416085431.h...](https://www.sciencedaily.com/releases/2013/04/130416085431.htm)

[http://journals.sagepub.com/doi/10.1177/0956797612464786](http://journals.sagepub.com/doi/10.1177/0956797612464786)

------
mtgx
So if it numbs not just pain but your empathy feelings as well, could it also
numb feelings like depression or anxiety?

EDIT: After a quick search, the answer seems to be yes?

[https://www.ncbi.nlm.nih.gov/pubmed/26357585](https://www.ncbi.nlm.nih.gov/pubmed/26357585)

[http://time.com/3825042/tylenol-emotion-
acetaminophen/](http://time.com/3825042/tylenol-emotion-acetaminophen/)

[https://www.sciencedaily.com/releases/2009/12/091222154742.h...](https://www.sciencedaily.com/releases/2009/12/091222154742.htm)

[https://www.psychologytoday.com/blog/the-superhuman-
mind/201...](https://www.psychologytoday.com/blog/the-superhuman-
mind/201304/do-you-suffer-emotional-pain-or-anxiety-pop-tylenol)

~~~
55555
Related: Opioids reduce feelings of loneliness.

~~~
ficklepickle
I can attest to that. Please don't use them for this though. It can lead to a
downward spiral, I went through that some years ago. Seek help, and keep
seeking help. Mental health is neglected in our society, IMO.

~~~
copperx
I don't think it's that neglected, but it's incredibly expensive even with a
good insurance policy.

------
propman
Anecdotal but I believe this happened to me...I took maximum daily dosage for
2 years and most likely other factors resulted in this, but I wouldn't be
surprised if this did too. I used to feel awful about people's problems,
depressing stories used to make me want to do anything to help, seeing
homeless on the street near a fast food place made me often buy them a meal,
and I used to care so much about friends' problems but I 90% stopped caring.
Honestly can't say it's a bad thing either, I finally am focusing more on
myself but it is a huge change in my life.

~~~
brohoolio
Did the dosage cause a permanent shift in your behavior?

~~~
propman
Not outwards behavior but things that used to seem like such a big deal became
trivial. Again anecdotal so don't put any stock in what I'm saying, I just
found this to be interesting

~~~
ficklepickle
Get a liver enzyme test. It's very hard on the liver, especially if you
consume alcohol at the same time. Acetaminophen/paracetamol is not as harmless
as most people think. It has wrecked many-a-liver.

~~~
arcticbull
It's the #1 cause of liver failure in the United States. [1]

[1]
[https://www.medpagetoday.com/psychiatry/depression/2233](https://www.medpagetoday.com/psychiatry/depression/2233)

~~~
DanBC
But your link is talking about short term use - deliberate or accidental
overdose. It's not talking about normal long term use.

Paracetamol is commonly used in overdosing because people don't understand how
dangerous an overdose is; they don't understand how painful a death from liver
failure is; paracetamol is available off the shelf in large quantities; and
many people have stocks of it in their homes.

Indeed, your link suggests that long term use is not harmful:

> But in an accompanying editorial, John G. O'Grady, M.D., of the Institute of
> Liver Studies at King's College Hospital in London cautioned that there's no
> need for panic, because acetaminophen-associated liver toxicity is uncommon,
> and the drug itself is not toxic.

> "Measures to minimize acetaminophen hepatotoxicity are important but need to
> be considered in the context that the apparent scale of the problem is a
> reflection of the huge number of patients taking acetaminophen with good
> effects and in the absence of any adverse event," Dr. O'Grady wrote.

> "Educational initiatives to highlight the range of preparations containing
> acetaminophen, together with reiteration of advice on maximum daily dosing,
> have potential benefits, especially with respect to unintentional
> overdosing," he added.

And it says this:

> The data suggest that consistent use of as little as 7.5 g/day of
> acetaminophen could lead to severe hepatic injury, Dr. Larson and colleagues
> wrote.

That's a lot! The recommended dose on the box is 4 g per day - 4 doses of 1 g
each, with 4 hours in between them.

------
alkonaut
I had never heard the name "Acetainophen", apparently it's the same as
Paracetamol.

~~~
Lanthanide
From wiki:

"Both acetaminophen and paracetamol come from a chemical name for the
compound: para- _acet_ yl _aminophe_ nol and _par_ a- _acet_ yl _am_ inophen
_ol_."

The former is the name used by the United States Adopted Name (USAN) while the
latter is the (International Nonproprietary Name (INN) one.

~~~
ac29
Same for Tylenol (most common branded version of the drug, at least in the
US): para-ace _tyl_ aminoph _enol_

------
eeZah7Ux
"If your job ... depends on feeling empathy for others, you might want to
reconsider reaching for the Tylenol"

I'm afraid many "competitive" jobs depend on the opposite.

~~~
atemerev
Like those thousands Facebooks and Reddit mods, whose job is to deal with
unspeakable horrors every day.

Though I suspect that acetaminophen might not be enough in this case, and they
use a stronger drug with proven effect of easing emotional pain: ethanol.

------
pmiller2
I wonder if other pain relievers do the same. Has there been any work with
aspirin, ibuprofen, or prescription pain relievers along these lines?

~~~
debatem1
This is exactly my question. We know that many painkillers work on the pain
caused by heartbreak, for example. Does this effect have a similar root cause?
If so, it would be reasonable to conclude that many painkillers would cause
this as well. The advice in the article would therefore be at best useless.

------
Havoc
> About a quarter of all Americans take acetaminophen every week.

Wow. That seems rather high.

~~~
vilhelm_s
The reference they give is
[http://jamanetwork.com/journals/jama/fullarticle/194572](http://jamanetwork.com/journals/jama/fullarticle/194572)
. Apparently it's the most commonly taken drug, number 2 and 3 were ibuprofen
and aspirin.

To be precise, in a given week, 23% of Americans had taken Acetaminophen. (I
guess the sentence is a bit ambiguous.)

~~~
Havoc
>in a given week, 23% of Americans had taken Acetaminophen

That's still wildly high though, no? So nearly a QUARTER of Americans are on
that painkiller at any given time (give or take duration). Never mind A
painkiller...that particular one???

The whole concept of ~25% painkiller usage just blows my mind. And that's from
someone that used to take heavy grade stuff for a year straight. (Now I just
take the occasional ibu for some DOMS).

~~~
DanBC
5% of Americans aged 15 to 64 took an opioid pain killer last year.

[http://www.unodc.org/documents/data-and-
analysis/WDR2011/Sta...](http://www.unodc.org/documents/data-and-
analysis/WDR2011/StatAnnex-consumption.pdf)

------
dlwdlw
Could this be broadened to say that those who have coping mechanisms for pain
have less empathy for the pain of others? As an explanation why the well off
seem to have less empathy for the less well off.

------
atemerev
I suspect that this result extends to most painkillers. It was demonstrated
before that emotional pain and physical pain are partially regulated by the
same mechanisms, so painkillers work for emotional pain too (though less
effective than specialized drugs) -- which will prevent sharing emotional pain
from some situations, which can be reinterpreted as diminished empathy.

------
exabrial
Wow, pretty crazy find. Seems like a decent sample size too. I hope someone
tries to reproduce the results!

------
cbanek
I wonder if opiates (or other painkillers) have the same effect. Most of the
opiate drugs, such as hydrocodone, are mixed up with acetaminophen anyway in
pill form. For example, a norco 5/325 is 5 mg of hydrocodone and 325 mg of
acetaminophen.

~~~
vilhelm_s
I googled and found this article, which suggests they would.
[http://www.sciencemag.org/news/2015/09/dulling-pain-may-
also...](http://www.sciencemag.org/news/2015/09/dulling-pain-may-also-reduce-
empathy)

Apparently, in this experiment they did not use actual opioid drugs but
instead used a placebo protocol (to avoid side effects), but they did produce
the empathy reduction effect. And this effect was cancelled out by giving the
test subjects naltrexone, so it does seem to be dependent on the opioid
receptors.

------
dlbucci
In regards to the second experiment, isn't that kind of an obvious result? You
take a painkiller, so the white noise causes you less pain, so you think that
other people in the study are in less pain, which makes you seem less
empathetic?

------
tbabb
No mention of effect size. N=200 is pretty small. Smells a bit like BS. Anyone
have the original paper?

~~~
itcrowd
You're down voted but I agree. 200 participants split into A/B for yes/no
drugs, 8 scenarios and 3 different tests makes the sample incredibly small..
would like to hear statistical arguments opposing my PoV

~~~
hammock
Pretty standard for this type of research

~~~
tbabb
"Everybody does it" is not really a statement about its validity.

------
taway_1212
I imagine military should be very interested in this.

~~~
gaius
The Infantry are already Tylenol's biggest fans...

------
mulligan
Might explain baby boomer behavior

~~~
burntrelish1273
There is unlikely to be a cultural or generational explanation other than
having the benefits of working when there was decent income combined with
mostly less violence plus higher civilized behavior standards.

[https://www.ted.com/talks/paul_piff_does_money_make_you_mean](https://www.ted.com/talks/paul_piff_does_money_make_you_mean)

[https://en.wikipedia.org/wiki/The_Better_Angels_of_Our_Natur...](https://en.wikipedia.org/wiki/The_Better_Angels_of_Our_Nature)

------
triangleman
Nice istock photo there.

------
aiyodev
May 12, 2016

------
watertorock
Acetaminophen

Hate the click bait headlines, totally degrading to a paper like Washington
post that presumably wants to maintain respectability. But you won't believe
what happens next!

~~~
murukesh_s
Nowadays I never visit the actual article, just going through HN comments will
often summarize the topic better.

~~~
wjh_
Probably not the best idea. While they do tend to summarise well, comments
tend to be filled with opinion - generally a better idea to ensure you form
your own, rather than rely on a potentially biased third party.

~~~
wnoise
The original article is also generally biased and filled with opinion. At
least the comments might have a diversity of bias.

~~~
ErikBjare
This is what I've been telling myself. Usually skim the article and then read
the comments.

~~~
copperx
Just accept you're being lazy. Nothing wrong with that, though.

------
gaius
The same story without an ad-blocker-blocker
[http://www.independent.co.uk/news/science/popular-
painkiller...](http://www.independent.co.uk/news/science/popular-painkiller-
ingredient-acetaminophen-can-reduce-empathy-study-finds-a7026061.html)

~~~
OscarTheGrinch
Thanks! Time to build an ad-blocker-blocker-blocker.

~~~
brobinson
uBlock Origin already has this. I don't see any ads on the article.

------
egwynn
I’d be in favor of two changes to the HN title:

1\. s/This popular painkiller/Acetaminophen/

2\. (2016)

~~~
Ericson2314
s/This popular painkiller/Acetaminophen, the active ingredient in Tylenol,/

I, for one, never studied chemistry.

~~~
robert_tweed
Everywhere other than the US, it's far more commonly known as paracetamol.

In much the same way that nobody calls aspirin "acetylsalicylic acid",
paracetamol is the generic name, except in the US for some reason.

~~~
dom0
Follow-up question: why does it seem like some drugs are packaged kinda like
candy for the American market?
([https://www.google.de/search?q=tylenol&tbm=isch](https://www.google.de/search?q=tylenol&tbm=isch)
vs. [http://www.verschnupft.com/wp-content/uploads/Paracetamol-
Ra...](http://www.verschnupft.com/wp-content/uploads/Paracetamol-
Ratiopharm_500mg.jpg))

~~~
true_religion
I think it's the difference between brand names and non-brand names. Tylenol
is a brand-name thus tries to distinguish itself from the generics on the
shelf next to it.

This happens in the UK/IE as well.

As a comparison.

Panadol (UK/IE) brand name for acetaminophen:
[https://www.google.de/search?q=panadol&tbm=isch](https://www.google.de/search?q=panadol&tbm=isch)

Walzyr. US "generic" anti-histamine:
[https://pics.drugstore.com/prodimg/419979/450.jpg](https://pics.drugstore.com/prodimg/419979/450.jpg)

Claratin. US Brandname anti-histamine: [https://images-na.ssl-images-
amazon.com/images/I/91rArvDAp9L...](https://images-na.ssl-images-
amazon.com/images/I/91rArvDAp9L._SY355_.jpg)

The US also tends not to have true generic drugs, but 'store brand' generics.
So a store will carry Tylenol + a single store brand generic, instead of
Tylenol + 5 different companies generic brands.

------
floatingatoll
Mods, this is a repost from (2016).

