Why would I want people to suffer pain when in the past I’ve criticized doctors for inadequate pain control? I’ve pointed out how some people get insufficient amounts of painkillers. Others are denied medication for fear of addiction even though they have only days or weeks to live.
But suffering a little bit is the right prescription for millions of other people.
Today, many North Americans take acetaminophen, better known as Tylenol, to ease a variety of pains. It’s been known for years that too much Tylenol can cause liver failure and death.
Now, a new study shows that even taking the recommended daily dose may cause liver problems. This should be a wake-up call for millions of people who take this medication.
Dr. Neil Kaplowitz of the University of Southern California cites a study of 145 healthy patients who took four grams of Tylenol a day, the maximum daily dose, for two weeks. Forty percent of these volunteers showed an increase of aminotransferase, a liver enzyme that indicates possible liver damage. In fact, the elevation was three times the usual point for concern.
Today, acetaminophen causes more overdoses and overdose deaths than any other drug in the United States. A study at the University of Washington Medical Center showed that nearly half of all cases of liver failure in 662 patients from 22 livers transplant centers, over a six-year period, were the result of acetaminophen poisoning.
It’s equally worrying that in 1998 only 28 percent of liver poisonings could be traced to this painkiller. Just five years later in 2003, this figure had escalated to 51 percent.
The Federal Drug Administration in the United States estimates that 56,000 emergency visits a year are due to acetaminophen poisoning.
Some of these emergency visits were due to what researchers call “therapeutic misadventures.” These occur for several reasons, and often patients have no idea what’s happening.
For instance, there is a North American tendency to overdo things. The reasoning is that if eight tablets of Tylenol a day help to ease pain symptoms, then 12 tablets a day would be even more helpful. This is a bad error.
Another unexpected Tylenol trap results in double dosing. While suffering from a backache, you awaken one morning with a cold. Now you reach for a cold remedy that also contains acetaminophen.
Today there are over 150 nonprescription, over-the-counter medicines that contain acetaminophen. And who takes the time, when in pain, to read the label to learn whether this painkiller is present?
Parents should remember that children’s versions of acetaminophen come in a variety of formulations. For instance, by substituting infant drops for syrup or elixir, an infant could receive three times the recommended dose.
Tylenol is a safe medication if used properly. The problem is there are too many unsafe people. The reasons why some people reach for Tylenol and other minor painkillers are also shocking. Some patients tell me, “It lifts me up,” or “It helps to relax me,” or “I have a slight headache.” These patients have been brainwashed by TV ads assuring us that no one need ever suffer any pain, slight as it may be.
Painkillers are metabolized by the liver and excreted by the kidneys. Researchers say that safe doses do not injure these organs. Maybe they’re right, but I can’t believe that even low doses are good for these organs, and the fewer drugs we take the better.
During the past few years, reports have shown how many drugs other than Tylenol have caused either severe injury or death. Some patients were taking these medications for bona fide medical problems. And I have no problem with painkillers used to help ease the suffering of those with arthritis and other disabling diseases.
But compared to our ancestors, who hacked their way into the primitive forest, we’ve become a nation of wimps who expect total freedom from the slightest pain. It’s become a dangerous addiction.
Dr. Gifford-Jones is a medical journalist with a private medical practice in Toronto.
His Web site is Mydoctor.ca/gifford-jones
