Acetaminophen (APAP) overdose means taking more APAP than it is safe to take. It may also be called APAP poisoning. APAP is called paracetamol in countries outside the United States. When used correctly, APAP is a safe drug that decreases or takes away pain and lowers fevers. Many medicines contain APAP, including some that you can buy without a prescription.
As noted by Time Magazine, prescriptions for opioid painkillers have risen by an incredible 300 percent over the past 10 years, but the excessive use of over-the-counter (OTC) painkillers like acetaminophen is equally troublesome:
“Acetaminophen, which includes Tylenol and other generic brands, causes more than 80,000 emergency room visits each year because people often aren't aware they're taking too much.”
Part of the problem is that acetaminophen can be found in more than 600 different drugs, from cold and allergy medications, to fever reducers and sleeping pills, and many people fail to add all these sources together when taking several different remedies and/or prescription drugs.
Other Dangers associated with narcotics are also related to acetaminophen being mixed with other drugs.
New Guidelines for High-Dose Prescription Acetaminophen Have Been Issued
On January 14, this year, the FDA finally issued a statement, urging doctors and other health professionals to discontinue prescribing and dispensing prescription combination drug products that contain more than 325 milligrams (mg) of acetaminophen per tablet, capsule, or other dosage unit. According to the FDA, there's no evidence suggesting that taking more than 325 mg of acetaminophen provides any benefit that might outweigh the increased risk of severe liver damage.
The FDA also notes that while more than half of manufacturers have voluntarily complied by reducing the amount of acetaminophen per dose, prescription products that contain more than the recommended maximum of 325 mg of acetaminophen still remain on the market. So please, always check the label before you take any medication containing acetaminophen, to make sure you're not getting too much.
“In the near future FDA intends to institute proceedings to withdraw approval of prescription combination drug products containing more than 325 mg of acetaminophen per dosage unit that remain on the market,” the FDA noted.
Factors That Increase Risks Associated with Acetaminophen
Please beware that your risk of severe liver injury and/or death increases if you:
- Take more than one regular strength (325 mg) acetaminophen when combined with a narcotic analgesic like codeine or hydrocodone
- Take more than the prescribed dose of an acetaminophen-containing product in a 24-hour period
- Take more than one acetaminophen-containing product at the same time. Make sure to read the list of ingredients on any other over-the-counter (OTC) or prescription drug you take in combination.
- Drink alcohol while taking an acetaminophen product. Research suggests that acetaminophen also significantly increases your risk of kidney dysfunction if taken with alcohol—even if the amount of alcohol is small.
Non-Drug Options for Pain Relief
With all the health risks associated with acetaminophen and opioid painkillers, I strongly recommend exhausting other options before you resort to these drugs. Below I list some non-drug alternatives for the treatment of pain. These options can often provide excellent pain relief for mild pain, without any of the health hazards that prescription (and even over-the-counter) painkillers carry. This list is in no way meant to represent the only approaches one can use. These are just some of the best strategies that I know of. If you are in pain, please try these first, before even thinking about prescription painkillers of any kind.
- Medical cannabis has a long history as a natural analgesic and is frequently not used by many who read this site and seek to justify their use of opioids. At present, 20 US states have legalized cannabis for medical purposes. Its medicinal qualities are due to high amounts (about 10-20 percent) of cannabidiol (CBD), medicinal terpenes, and flavonoids. As discussed in this previous post, varieties of cannabis exist that are very low in tetrahydrocannabinol (THC)—the psychoactive component of marijuana that makes you feel “stoned”—and high in medicinal CBD.
The Journal of Pain, a publication by the American Pain Society, has a long list of studies on the pain-relieving effects of cannabis and would certainly seem worth the effort for anyone with chronic pain to utilize. One needs to seek a knowledgeable cannabis physician as many have no idea of the proper dosing. If you are seriously considering medical cannabis for pain, it is imperative that you view my interview with Dr. Alan Frankel, who is one of the leading medical cannabis physicians in the US. He can do consultations on the phone if one needs specific questions answered.
- Eliminate or radically reduce most grains and sugars from your diet. Avoiding grains and sugars will lower your insulin and leptin levels and decrease insulin and leptin resistance, which is one of the most important reasons why inflammatory prostaglandins are produced. That is why stopping sugar and sweets is so important to controlling your pain and other types of chronic illnesses.
- Take a high-quality, animal-based omega-3 fat. My personal favorite is krill oil. Omega-3 fats are precursors to mediators of inflammation called prostaglandins. (In fact, that is how anti-inflammatory painkillers work, they manipulate prostaglandins.)
- Emotional Freedom Techniques (EFT) is a drug-free approach for pain management of all kinds. EFT borrows from the principles of acupuncture, in that it helps you balance out your subtle energy system. It helps resolve underlying, often subconscious, negative emotions that may be exacerbating your physical pain. By stimulating (tapping) well-established acupuncture points with your fingertips, you rebalance your energy system, which tends to dissipate pain.
- K-Laser Class 4 Laser Therapy. If you suffer pain from an injury, arthritis, or other inflammation-based pain, I'd strongly encourage you to try out K-Laser therapy. It can be an excellent choice for many painful conditions, including acute injuries. By addressing the underlying cause of the pain, you will no longer need to rely on painkillers. K-Laser is a class 4 infrared laser therapy treatment that helps reduce pain, reduce inflammation, and enhance tissue healing—both in hard and soft tissues, including muscles, ligaments, or even bones.
The infrared wavelengths used in the K-Laser allow for targeting specific areas of your body, and can penetrate deeply into the body to reach areas such as your spine and hip. For more information about this groundbreaking technology, and how it can help heal chronic pain, please listen to my previous interview with Dr. Harrington.
- Chiropractic. Many studies have confirmed that chiropractic management is much safer and less expensive than allopathic medical treatments, especially when used for pain, such as low-back pain. Qualified chiropractic, osteopathic, and naturopathic physicians are reliable, as they have received extensive training in the management of musculoskeletal disorders during their course of graduate healthcare training, which lasts between four to six years. These health experts have comprehensive training in musculoskeletal management.
- Acupuncture can also effectively treat many kinds of pain. Research has discovered a “clear and robust” effect of acupuncture in the treatment of back, neck, and shoulder pain, osteoarthritis, and headaches.
- Physical and massage therapy has been shown to be as good as surgery for painful conditions such as torn cartilage and arthritis.
- Ginger: This herb has potent anti-inflammatory activity and offers pain relief and stomach-settling properties. Fresh ginger works well steeped in boiling water as a tea or grated into vegetable juice.
- Curcumin: In a study of osteoarthritis patients, those who added 200 mg of curcumin a day to their treatment plan had reduced pain and increased mobility. A past study also found that a turmeric extract composed of curcuminoids blocked inflammatory pathways, effectively preventing the overproduction of a protein that triggers swelling and pain.
- Boswellia: Also known as boswellin or “Indian frankincense,” this herb contains specific active anti-inflammatory ingredients. This is one of my personal favorites as I have seen it work well with many rheumatoid arthritis patients.
- Cetyl myristoleate (CMO): This oil, found in fish and dairy butter, acts as a “joint lubricant” and an anti-inflammatory. I have used this for myself to relieve ganglion cysts and a mild annoying carpal tunnel syndrome that pops up when I type too much on non-ergonomic keyboards. I used a topical preparation for this.
- Evening primrose, black currant, and borage oils: These contain the essential fatty acid gamma linolenic acid (GLA), which is useful for treating arthritic pain.
- Cayenne cream: Also called capsaicin cream, this spice comes from dried hot peppers. It alleviates pain by depleting the body's supply of substance P, a chemical component of nerve cells that transmits pain signals to your brain.
- Methods such as yoga, Foundation Training, massage, meditation, hot and cold packs, and other mind-body techniques can also result in astonishing pain relief without any drugs.
It's important to remember that just because a drug is sold without prescription does not mean it is completely harmless. This is particularly important to remember if you're using OTC drugs for your children. There have been tragic cases of acetaminophen overdosing when an infant is given children's brand Tylenol, at an older child's recommended dosage. Always make sure to check the dosage recommendations for the age of your child!
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