James Lewis, the sole suspect in the 1982 Tylenol murders, has died
July 10, 2023 8:25 AM Subscribe
posted by kirkaracha at 8:52 AM on July 10, 2023
Interesting to realize that this was the beginning of tamper protection for medications and other products. Seems not that long ago, but I guess it was...
posted by Chuffy at 8:53 AM on July 10, 2023 [12 favorites]
posted by Chuffy at 8:53 AM on July 10, 2023 [12 favorites]
I remember this so clearly. The Walgreens where those tainted Tylenol were distributed is two blocks from where I went to high school.
posted by adamrice at 8:55 AM on July 10, 2023 [8 favorites]
posted by adamrice at 8:55 AM on July 10, 2023 [8 favorites]
Interesting to realize that this was the beginning of tamper protection for medications and other products.
Nobody had ever thought someone would tamper with OTC meds like that - there's a reason it's said regulations are written in blood.
And Johnson & Johnson's response is still taught to this day as an example of proper crisis management - while the short term losses were significant, the decision to pull Tylenol from the market ahead of revised tamper-resistant packaging built long term brand trust that was much more valuable.
posted by NoxAeternum at 8:58 AM on July 10, 2023 [52 favorites]
Nobody had ever thought someone would tamper with OTC meds like that - there's a reason it's said regulations are written in blood.
And Johnson & Johnson's response is still taught to this day as an example of proper crisis management - while the short term losses were significant, the decision to pull Tylenol from the market ahead of revised tamper-resistant packaging built long term brand trust that was much more valuable.
posted by NoxAeternum at 8:58 AM on July 10, 2023 [52 favorites]
It was not a great time to be in Chicago, especially coming a few years after John Wayne Gacy's arrest, and right around the time of the Ripper Crew. There were also a lot of copycat crimes; tamper-proof everything can be a pain in the ass sometimes, but I don't complain.
posted by Halloween Jack at 9:00 AM on July 10, 2023 [8 favorites]
posted by Halloween Jack at 9:00 AM on July 10, 2023 [8 favorites]
Living in St. Louis at the time, there was a full-on Moral Panic caused by this. A perfect encapsulation of that city's paranoid style. Love and hearts to the few not caught up in it.
What was really remarkable, re: TFA, was how quickly every brand, every generic, every store brand, soon had tamper-proof packaging, even a bit of a marketing thing for a short bit over which brand was safer/est.
posted by riverlife at 9:33 AM on July 10, 2023 [5 favorites]
What was really remarkable, re: TFA, was how quickly every brand, every generic, every store brand, soon had tamper-proof packaging, even a bit of a marketing thing for a short bit over which brand was safer/est.
posted by riverlife at 9:33 AM on July 10, 2023 [5 favorites]
The authors of that piece are the creators of a recent podcast, Unsealed: The Tylenol Murders [I never know the best practice for linking to podcasts, I think the Tribune’s own page for it may be paywalled]
posted by staggernation at 9:38 AM on July 10, 2023 [6 favorites]
posted by staggernation at 9:38 AM on July 10, 2023 [6 favorites]
This was at the very beginning of my sophomore year at Northwestern, and so it was a huge deal when somebody in my dorm went around and put two Tylenol capsules in front of everyone's door. I don't recall if anyone ever copped to that prank.
posted by briank at 9:59 AM on July 10, 2023 [5 favorites]
posted by briank at 9:59 AM on July 10, 2023 [5 favorites]
I remember this well; I think of it almost every time I struggle to get a tamper-resistant package open. I remember when they arrested the guy who wrote the extortion letter; I seem to remember that the official word at the time was that he was probably not the killer, but just used the poisonings as an opportunity to make some cash. I wonder what the real story is.
posted by TedW at 10:01 AM on July 10, 2023 [3 favorites]
posted by TedW at 10:01 AM on July 10, 2023 [3 favorites]
Living in St. Louis at the time, there was a full-on Moral Panic caused by this.
I was just pissed that it led the city of E. St. Louis to ban trick-or-treating that year. Although I ended up going with a friend in a nearby town and got such a good haul that I went with her for a couple years after that too.
posted by dlugoczaj at 10:10 AM on July 10, 2023 [5 favorites]
I was just pissed that it led the city of E. St. Louis to ban trick-or-treating that year. Although I ended up going with a friend in a nearby town and got such a good haul that I went with her for a couple years after that too.
posted by dlugoczaj at 10:10 AM on July 10, 2023 [5 favorites]
I've told my kids about the origin of all the little plastic seals we have to pull off of every container we open. They think it's interesting and mildly uncomfortable that you could've just opened the lids of non-vaccum sealed things in the grocery store.
posted by Ickster at 10:15 AM on July 10, 2023 [6 favorites]
posted by Ickster at 10:15 AM on July 10, 2023 [6 favorites]
it was a huge deal when somebody in my dorm went around and put two Tylenol capsules in front of everyone's door
Shit, dude. Now THAT's an offside prank.
posted by Jessica Savitch's Coke Spoon at 10:20 AM on July 10, 2023
Shit, dude. Now THAT's an offside prank.
posted by Jessica Savitch's Coke Spoon at 10:20 AM on July 10, 2023
Living in St. Louis at the time, there was a full-on Moral Panic caused by this.
I was a young'un then (pre-teen) and remember the Tylenol stuff vividly but I don't recall the "moral panic" in St. Louis. I was just outside the St. Louis county radius but we still watched local news out of St. Louis and got the St. Louis Post-Dispatch (a formerly great newspaper).
Maybe it was something you had to be in/around the city proper to feel, or I was just oblivious. But I remember the murders quite vividly. As a kid it was an introduction to a type of evil I had never considered before that.
posted by jzb at 12:16 PM on July 10, 2023 [5 favorites]
I was a young'un then (pre-teen) and remember the Tylenol stuff vividly but I don't recall the "moral panic" in St. Louis. I was just outside the St. Louis county radius but we still watched local news out of St. Louis and got the St. Louis Post-Dispatch (a formerly great newspaper).
Maybe it was something you had to be in/around the city proper to feel, or I was just oblivious. But I remember the murders quite vividly. As a kid it was an introduction to a type of evil I had never considered before that.
posted by jzb at 12:16 PM on July 10, 2023 [5 favorites]
Worth keeping in mind that Lewis was only the “sole suspect” because several others have already died, and that the strongest evidence against him was that he could come up with a way to… put something into capsules.
In all likelihood, this is yet another case where the Chicago police botched their investigation from the beginning, and have clung to a single weak theory for decades in order to deflect from that.
posted by Molten Berle at 12:21 PM on July 10, 2023 [26 favorites]
In all likelihood, this is yet another case where the Chicago police botched their investigation from the beginning, and have clung to a single weak theory for decades in order to deflect from that.
posted by Molten Berle at 12:21 PM on July 10, 2023 [26 favorites]
Somehow in my brain I file this event together with the shoe bomber, in the sense that one very low-probability incident forever changed how things are done by everyone.
(in stark contrast to, say, preventing transmission of airborne disease vectors)
posted by Dashy at 12:34 PM on July 10, 2023 [26 favorites]
(in stark contrast to, say, preventing transmission of airborne disease vectors)
posted by Dashy at 12:34 PM on July 10, 2023 [26 favorites]
when somebody in my dorm went around and put two Tylenol capsules in front of everyone's door
That must have given the administration... quite a headache, wokka wokka wokka.
posted by justsomebodythatyouusedtoknow at 12:46 PM on July 10, 2023 [6 favorites]
That must have given the administration... quite a headache, wokka wokka wokka.
posted by justsomebodythatyouusedtoknow at 12:46 PM on July 10, 2023 [6 favorites]
It was not a great time to be in Chicago, especially coming a few years after John Wayne Gacy's arrest, and right around the time of the Ripper Crew.
Don't forget the worst airline disaster in US history. My main recollection of this period through the lens of grade school was that the world is a deeply weird place, largely reinforced by leaving Chicago just in time to arrive in Atlanta for the Wayne Williams period.
posted by jquinby at 12:54 PM on July 10, 2023 [5 favorites]
Don't forget the worst airline disaster in US history. My main recollection of this period through the lens of grade school was that the world is a deeply weird place, largely reinforced by leaving Chicago just in time to arrive in Atlanta for the Wayne Williams period.
posted by jquinby at 12:54 PM on July 10, 2023 [5 favorites]
Here is Rebecca Watson's video asserting that Tylenol is dangerous and useless. Seems fitting somehow that a highly questionable medication that arguably shouldn’t have been there in the first place became a vehicle for murder, and yet miraculously survived and is thriving four decades later
As far as I know I’ve never taken it and I refused to take aspirin after I was about eight because it tasted so awful.
posted by jamjam at 1:10 PM on July 10, 2023 [2 favorites]
As far as I know I’ve never taken it and I refused to take aspirin after I was about eight because it tasted so awful.
posted by jamjam at 1:10 PM on July 10, 2023 [2 favorites]
A period doesn't seem appropriate here, so . . .
?
posted by Kibbutz at 1:38 PM on July 10, 2023 [2 favorites]
?
posted by Kibbutz at 1:38 PM on July 10, 2023 [2 favorites]
Johnson & Johnson's response to the crisis was exemplary and brilliant — Tylenol in capsules was taken off the shelves everywhere immediately after the murders. Then, 10 weeks later they reintroduced Tylenol in tamper-resistant containers, and ran full-page ads in most daily newspapers, with a coupon for a free bottle. The cost was enormous, of course, but the result was a bottle of Tylenol back in millions of medicine cabinets, pre-empting sales of competing products for weeks or months during which Tylenol re-established trust in its brand. Tylenol regained its market share within a year.
posted by beagle at 1:41 PM on July 10, 2023 [22 favorites]
posted by beagle at 1:41 PM on July 10, 2023 [22 favorites]
As a kid it was an introduction to a type of evil I had never considered before that.
Exactly this: the idea of random poison in something you buy because you are trying to be responsible really stuck with me. Worse, the shopper in the next aisle could have done it. These realizations were anxiety-producing but perhaps not the worst lessons, considering what the next several decades brought.
posted by MonkeyToes at 1:44 PM on July 10, 2023 [6 favorites]
Exactly this: the idea of random poison in something you buy because you are trying to be responsible really stuck with me. Worse, the shopper in the next aisle could have done it. These realizations were anxiety-producing but perhaps not the worst lessons, considering what the next several decades brought.
posted by MonkeyToes at 1:44 PM on July 10, 2023 [6 favorites]
A one-time Cambridge cable show host had been trying since 2007 to tie Lewis to the Tylenol deaths.
posted by adamg at 1:48 PM on July 10, 2023 [4 favorites]
posted by adamg at 1:48 PM on July 10, 2023 [4 favorites]
wonder what the real story is.
It was so left field at the time I figured it was someone covering up a murder in classic mystery manner.
posted by Mitheral at 2:27 PM on July 10, 2023 [4 favorites]
It was so left field at the time I figured it was someone covering up a murder in classic mystery manner.
posted by Mitheral at 2:27 PM on July 10, 2023 [4 favorites]
what's exhausting to me is that one fucking person ruined everything for everyone. WHY do people have to be evil assholes? why did people go around licking ice cream? why did someone put cyanide in capsules? why do people smear shit in toilet stalls? why throw tacks on the road at the tour de france? what do they get out of it?
posted by misanthropicsarah at 2:39 PM on July 10, 2023 [17 favorites]
posted by misanthropicsarah at 2:39 PM on July 10, 2023 [17 favorites]
Wow. This happened five years before I was born, and somehow I never heard of it? But learning about it now is really informative in the way (when I was much younger) learning about various events of the 1980s explained why people were so weird in the 1990s. We're really always fighting the last war, huh?
posted by grandiloquiet at 2:40 PM on July 10, 2023 [3 favorites]
posted by grandiloquiet at 2:40 PM on July 10, 2023 [3 favorites]
Johnson & Johnson's response is still taught to this day as an example of proper crisis management - while the short term losses were significant, the decision to pull Tylenol from the market ahead of revised tamper-resistant packaging built long term brand trust that was much more valuable.
Wow simply impossible to imagine a brand with long term thinking like that now.
posted by latkes at 2:59 PM on July 10, 2023 [13 favorites]
Wow simply impossible to imagine a brand with long term thinking like that now.
posted by latkes at 2:59 PM on July 10, 2023 [13 favorites]
It was so left field at the time I figured it was someone covering up a murder in classic mystery manner.
Like this?
I had the Stella Nickell story mixed up with with the Tylenol murders in my head so I was surprised to see TFA suggesting the Tylenol murders were never solved.
posted by duoshao at 3:50 PM on July 10, 2023 [2 favorites]
Like this?
I had the Stella Nickell story mixed up with with the Tylenol murders in my head so I was surprised to see TFA suggesting the Tylenol murders were never solved.
posted by duoshao at 3:50 PM on July 10, 2023 [2 favorites]
Rebecca Watson's video asserting that Tylenol is dangerous and useless.
Tylenol has always been utterly useless at reducing pain for me, I guess I'm not the only one? Though it does seem effective at amplifying/extending the effects of painkillers that actually work.
posted by tavella at 3:59 PM on July 10, 2023 [3 favorites]
Tylenol has always been utterly useless at reducing pain for me, I guess I'm not the only one? Though it does seem effective at amplifying/extending the effects of painkillers that actually work.
posted by tavella at 3:59 PM on July 10, 2023 [3 favorites]
In recent years, I've often thought how this one (awful) incident led to massive implementation of universal tamper-proof packaging, as compared to no answer to our contemporary daily mass shootings.
posted by NorthernLite at 4:52 PM on July 10, 2023 [15 favorites]
posted by NorthernLite at 4:52 PM on July 10, 2023 [15 favorites]
what do they get out of it?
Sociopaths are different than most.
posted by tiny frying pan at 4:54 PM on July 10, 2023 [3 favorites]
Sociopaths are different than most.
posted by tiny frying pan at 4:54 PM on July 10, 2023 [3 favorites]
wonder what the real story is.
Now I’m normally a sane person, but my money here is on the CIA.
posted by slogger at 4:55 PM on July 10, 2023 [1 favorite]
Now I’m normally a sane person, but my money here is on the CIA.
posted by slogger at 4:55 PM on July 10, 2023 [1 favorite]
"Tylenol has always been utterly useless at reducing pain for me, I guess I'm not the only one? Though it does seem effective at amplifying/extending the effects of painkillers that actually work."
Knocks all my bio-/viro-logical fevers straight out of the park.
Other than that, I could be chewing on dried grass (as far effects-discerned).
I've never been on blood thinners, so YMMV.
posted by splifingate at 5:05 PM on July 10, 2023 [1 favorite]
Knocks all my bio-/viro-logical fevers straight out of the park.
Other than that, I could be chewing on dried grass (as far effects-discerned).
I've never been on blood thinners, so YMMV.
posted by splifingate at 5:05 PM on July 10, 2023 [1 favorite]
Gotta mention:
Experiencing existential dread? Tylenol may do the trick
Tylenol Fights Headaches…and Existential Angst?
posted by tiny frying pan at 5:08 PM on July 10, 2023 [4 favorites]
Experiencing existential dread? Tylenol may do the trick
Tylenol Fights Headaches…and Existential Angst?
posted by tiny frying pan at 5:08 PM on July 10, 2023 [4 favorites]
During a mandatory diversity & inclusion training at my firm, the presenters (a D&I consulting company) brought up a study described in this article, that showed that Tylenol reduced activity in the brain that processes "social pain". The "social pain" in the experiment was people being excluded from a simple ball tossing game.
The consultants: "Exclusion hurts! You can see it on a brain scan. And if you can see it from something as simple as being excluded from a game, imagine how it feels in the workplace!"
All I could think was "please don't let the partners hear about this study" because the message they'd take would not be "build an inclusive workforce" but rather, "just give everyone Tylenol instead, that's so much easier and cheaper."
posted by creepygirl at 5:30 PM on July 10, 2023 [11 favorites]
The consultants: "Exclusion hurts! You can see it on a brain scan. And if you can see it from something as simple as being excluded from a game, imagine how it feels in the workplace!"
All I could think was "please don't let the partners hear about this study" because the message they'd take would not be "build an inclusive workforce" but rather, "just give everyone Tylenol instead, that's so much easier and cheaper."
posted by creepygirl at 5:30 PM on July 10, 2023 [11 favorites]
what's exhausting to me is that one fucking person ruined everything for everyone. WHY do people have to be evil assholes? why did people go around licking ice cream? why did someone put cyanide in capsules? why do people smear shit in toilet stalls? why throw tacks on the road at the tour de france? what do they get out of it?
posted by misanthropicsarah
Some people are just misanthropic.
posted by ActingTheGoat at 6:01 PM on July 10, 2023 [3 favorites]
posted by misanthropicsarah
Some people are just misanthropic.
posted by ActingTheGoat at 6:01 PM on July 10, 2023 [3 favorites]
It was so left field at the time I figured it was someone covering up a murder in classic mystery manner.
Like this?
Or this? “The man who ruined Halloween”, indeed.
posted by TedW at 6:10 PM on July 10, 2023 [3 favorites]
Like this?
Or this? “The man who ruined Halloween”, indeed.
posted by TedW at 6:10 PM on July 10, 2023 [3 favorites]
Wow simply impossible to imagine a brand with long term thinking like that now.
It kind of is. Although a couple come to mind.
Maple Leaf Foods gets credited with a good crisis response (truth may be fuzzier. This Wikipedia article is sure a throwback, crediting the early response system put in afters SARS (1))
This Chapman’s story is different, but it’s my favourite and one of the reasons I buy Chapman’s whenever I can.
posted by warriorqueen at 7:39 PM on July 10, 2023 [2 favorites]
It kind of is. Although a couple come to mind.
Maple Leaf Foods gets credited with a good crisis response (truth may be fuzzier. This Wikipedia article is sure a throwback, crediting the early response system put in afters SARS (1))
This Chapman’s story is different, but it’s my favourite and one of the reasons I buy Chapman’s whenever I can.
posted by warriorqueen at 7:39 PM on July 10, 2023 [2 favorites]
I was living in Chicago and working downtown when this happened. It was a Huge Deal not only because of the shock and feelings of helplessness, but also because the tainted packages were found in several suburban stores as well as stores in the city. The suburbs were not adjacent. The tainted capsules were from different manufacturing lots.
No one knew if the tainting was limited to Tylenol. Any packaged OTC pills could be affected. I’m sure a lot of medicine cabinets were emptied (including mine).
As noted above, J&J’s response was exemplary.
I was working onsite in a mainframe software support position at the time. One of the hardware techs put a bottle of Tylenol on his desk with a note saying they were free to all. This was absolutely in character for them.
posted by Warren Terra at 7:47 PM on July 10, 2023
No one knew if the tainting was limited to Tylenol. Any packaged OTC pills could be affected. I’m sure a lot of medicine cabinets were emptied (including mine).
As noted above, J&J’s response was exemplary.
I was working onsite in a mainframe software support position at the time. One of the hardware techs put a bottle of Tylenol on his desk with a note saying they were free to all. This was absolutely in character for them.
posted by Warren Terra at 7:47 PM on July 10, 2023
Debbie Downer voice: We never did catch whoever sent out that anthrax, either.
posted by The Pluto Gangsta at 7:55 PM on July 10, 2023 [2 favorites]
posted by The Pluto Gangsta at 7:55 PM on July 10, 2023 [2 favorites]
Debbie Downer voice: We never did catch whoever sent out that anthrax, either.
The leading suspect in that investigation committed suicide - by taking an overdose of Tylenol.
posted by atoxyl at 9:12 PM on July 10, 2023 [1 favorite]
The leading suspect in that investigation committed suicide - by taking an overdose of Tylenol.
posted by atoxyl at 9:12 PM on July 10, 2023 [1 favorite]
Rebecca Watson's video asserting that Tylenol is dangerous and useless.
Paracetamol is the only OTC painkiller that does not negatively interact with my other medication so for me it's absolutely not useless, thank you.
posted by Pendragon at 2:35 AM on July 11, 2023 [9 favorites]
Paracetamol is the only OTC painkiller that does not negatively interact with my other medication so for me it's absolutely not useless, thank you.
posted by Pendragon at 2:35 AM on July 11, 2023 [9 favorites]
Some packaging is impossible to open even with the jaws of life.
posted by DJZouke at 4:59 AM on July 11, 2023
posted by DJZouke at 4:59 AM on July 11, 2023
Rebecca Watson's video asserting that Tylenol is dangerous and useless.
Glad the links in the manosphere thread have some competition for “worst take I’ve seen this month.”
Seriously, though, this is nearly identical to any number of “the Covid booster is dangerous” videos with a few find-replace changes. It even opens with the same casual dismissal of, you know, facts.
Yes, paracetamol is often misused. Yes, it has bad side effects if abused. But there’s heaps of evidence that it works literal orders of magnitude better than placebo for most of its prescribed uses. And side effects essentially don’t exist if you actually follow instructions.
This whole video is right on the edge of the ~big pharma doesn’t want you to know about natural medicine~ trash fire.
posted by Molten Berle at 11:03 AM on July 11, 2023 [5 favorites]
Glad the links in the manosphere thread have some competition for “worst take I’ve seen this month.”
Seriously, though, this is nearly identical to any number of “the Covid booster is dangerous” videos with a few find-replace changes. It even opens with the same casual dismissal of, you know, facts.
Yes, paracetamol is often misused. Yes, it has bad side effects if abused. But there’s heaps of evidence that it works literal orders of magnitude better than placebo for most of its prescribed uses. And side effects essentially don’t exist if you actually follow instructions.
This whole video is right on the edge of the ~big pharma doesn’t want you to know about natural medicine~ trash fire.
posted by Molten Berle at 11:03 AM on July 11, 2023 [5 favorites]
Glad the links in the manosphere thread have some competition for “worst take I’ve seen this month.”
Neither the video nor this response seems quite fair. It is in fact a dangerous drug in the sense that it’s one of the most common for people to unintentionally overdose on, and criticism of its widespread use for this reason is pretty mainstream. A lot of this comes down to the fact that it is casually thrown into a ton of products, though, even used as an “abuse deterrent,” rather than its inherent margin of safety being that low. And some people are particularly vulnerable to toxicity, like children, of course, and heavy drinkers (regular alcohol consumption is likely a bigger risk than concurrent alcohol consumption, which is not how many people think of it even if they are aware of some risk).
It also seems to be true that it is less effective than NSAIDs for many indications, while some of its purported advantages over NSAIDs are smaller than commonly assumed.
But I agree that there’s still a niche for it.
posted by atoxyl at 1:05 PM on July 11, 2023 [1 favorite]
Neither the video nor this response seems quite fair. It is in fact a dangerous drug in the sense that it’s one of the most common for people to unintentionally overdose on, and criticism of its widespread use for this reason is pretty mainstream. A lot of this comes down to the fact that it is casually thrown into a ton of products, though, even used as an “abuse deterrent,” rather than its inherent margin of safety being that low. And some people are particularly vulnerable to toxicity, like children, of course, and heavy drinkers (regular alcohol consumption is likely a bigger risk than concurrent alcohol consumption, which is not how many people think of it even if they are aware of some risk).
It also seems to be true that it is less effective than NSAIDs for many indications, while some of its purported advantages over NSAIDs are smaller than commonly assumed.
But I agree that there’s still a niche for it.
posted by atoxyl at 1:05 PM on July 11, 2023 [1 favorite]
Molten Berle: "But there’s heaps of evidence that it works literal orders of magnitude better than placebo for most of its prescribed uses."
Per this article from Oxford, not actually?
"The evidence is that it probably does not work at all for chronic pain. Large, good and independent clinical trials and reviews from the Cochrane Library show paracetamol to be no better than placebo for chronic back pain or arthritis. This is at the maximum daily dose in trials lasting for three months, so it has been pretty thoroughly tested.
Acute pains are sudden in onset and go away after a while (headache or pain after an operation, for instance). For these, reviews from the Cochrane Library show that paracetamol can provide pain relief, but only for a small number of people. For postoperative pain, perhaps one in four people benefit; for headache perhaps one in ten. This evidence comes from systematic reviews, often of large numbers of good clinical trials."
And that acetaminophen is exceptionally easy to overdose lethally on for an OTC medicine is as far as I know, accepted wisdom. The fact some people's LD is extremely low, the fact that it can interact dangerously with even a couple of alcoholic drinks, the fact that it is an additional ingredient in many OTC medicines, etc. It's the single largest cause for liver transplants in the US.
posted by tavella at 1:28 PM on July 11, 2023 [3 favorites]
Per this article from Oxford, not actually?
"The evidence is that it probably does not work at all for chronic pain. Large, good and independent clinical trials and reviews from the Cochrane Library show paracetamol to be no better than placebo for chronic back pain or arthritis. This is at the maximum daily dose in trials lasting for three months, so it has been pretty thoroughly tested.
Acute pains are sudden in onset and go away after a while (headache or pain after an operation, for instance). For these, reviews from the Cochrane Library show that paracetamol can provide pain relief, but only for a small number of people. For postoperative pain, perhaps one in four people benefit; for headache perhaps one in ten. This evidence comes from systematic reviews, often of large numbers of good clinical trials."
And that acetaminophen is exceptionally easy to overdose lethally on for an OTC medicine is as far as I know, accepted wisdom. The fact some people's LD is extremely low, the fact that it can interact dangerously with even a couple of alcoholic drinks, the fact that it is an additional ingredient in many OTC medicines, etc. It's the single largest cause for liver transplants in the US.
posted by tavella at 1:28 PM on July 11, 2023 [3 favorites]
it can interact dangerously with even a couple of alcoholic drinks
Not specifically encouraging you to bet your liver on the following factoid but I find it interesting- as I mentioned in passing in my other comment, this is more complex and a little different than most people think. APAP a.k.a. paracetamol a.k.a. Tylenol has a breakdown product, part of a secondary metabolic pathway, that is toxic to the liver. That’s the big problem with it. If you take an overdose with alcohol, the alcohol is conceivably actually protective, because it will compete for the same enzymes involved in this pathway. However if you drink regularly, it increases the activity of those enzymes (to help break down the alcohol, of course) as well as depleting the antioxidants that are needed to detoxify the toxic metabolite, and thus increases your susceptibility. Fasting/malnutrition also increases susceptibility, as does use of APAP for multiple days in a row. So what you really don’t want to be is an alcoholic who regularly takes Tylenol for hangovers, but in my experience almost nobody thinks about it like that, they just know you’re not supposed to take them at the same time.
posted by atoxyl at 2:26 PM on July 11, 2023 [3 favorites]
Not specifically encouraging you to bet your liver on the following factoid but I find it interesting- as I mentioned in passing in my other comment, this is more complex and a little different than most people think. APAP a.k.a. paracetamol a.k.a. Tylenol has a breakdown product, part of a secondary metabolic pathway, that is toxic to the liver. That’s the big problem with it. If you take an overdose with alcohol, the alcohol is conceivably actually protective, because it will compete for the same enzymes involved in this pathway. However if you drink regularly, it increases the activity of those enzymes (to help break down the alcohol, of course) as well as depleting the antioxidants that are needed to detoxify the toxic metabolite, and thus increases your susceptibility. Fasting/malnutrition also increases susceptibility, as does use of APAP for multiple days in a row. So what you really don’t want to be is an alcoholic who regularly takes Tylenol for hangovers, but in my experience almost nobody thinks about it like that, they just know you’re not supposed to take them at the same time.
posted by atoxyl at 2:26 PM on July 11, 2023 [3 favorites]
This piece does suggest that simultaneous use of alcohol is not good, as well, though it puts 3 drinks as ok. Either way, not the thing to take after a night out, I'd say.
posted by tavella at 6:59 PM on July 11, 2023
posted by tavella at 6:59 PM on July 11, 2023
That says no more than three drinks a day with my explanation about inducing CYP2E1. I meant that literally taking them at the same time may be protective in acute (think intentional) overdose - there are studies supporting this but again it’s more of a “fun” fact, not an experiment to try at home.
posted by atoxyl at 7:15 PM on July 11, 2023
posted by atoxyl at 7:15 PM on July 11, 2023
I don't recall taking Tylenol for pain relief, but it does work on fevers. I took NSAIDs (ibuprofen, mostly) for pain relief, or for injuries to reduce swelling (ice, elevation and Advil). Neither is particularly good for your kidneys and liver.
posted by Chuffy at 11:49 AM on July 13, 2023
posted by Chuffy at 11:49 AM on July 13, 2023
Do you actually want to reduce fever, at least low ones? Isn't that your body trying to deliberately cook away the invader?
posted by tavella at 12:43 PM on July 13, 2023
posted by tavella at 12:43 PM on July 13, 2023
When I had a 100+ fever for 10 days, I was happy for any relief.
posted by Chuffy at 1:26 PM on July 13, 2023
posted by Chuffy at 1:26 PM on July 13, 2023
If Tylenol is that good at knocking down fevers, you have to wonder whether it damps down increases in the metabolic rate in general, such as when a person increases their food intake, for example
And if it does do that, with annual sales of 25 billion doses in the US, nearly a hundred doses a year for every person in the US, you also have to wonder what role it has played and is playing in the obesity epidemic.
posted by jamjam at 9:13 PM on July 15, 2023
And if it does do that, with annual sales of 25 billion doses in the US, nearly a hundred doses a year for every person in the US, you also have to wonder what role it has played and is playing in the obesity epidemic.
posted by jamjam at 9:13 PM on July 15, 2023
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