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.
There 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.
>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.
Whichever 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.
The 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.
I'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.
What? 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.
> "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)
The 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.
This 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!
