Neighbors,

http://www.philly.com/inquirer/home_top_stories/20090701_FDA_panel_backs_cut_in_maximum_Tylenol_dosage.html


This warning is a good thing.  However, this article did not provide an 
additional warning about liver toxicity to those who drink alcohol, even at 
moderate levels.  That information is important too.

As stated in the article, acetaminophen is ubiquitous in over the counter 
medications.  Chronic pain patients, who take it regularly, are at increased 
risk when adding these additional drugs.  But what is not commonly known, in my 
opinion, is the increased risk of overdose for those who drink alcohol.

The liver enzymes which break down acetaminophen also break down alcohol.  
While a half a bottle of wine may be recommended with dinner in a healthy 
lifestyle, a chronic pain patient using acetaminophen daily may get a toxic 
build up in the liver.   Years ago, I read such cases, yet the health care 
industry often does not probe for such common potential drug interactions for 
their patients.

Example:  When I had wisdom teeth removed some years ago, the assistant came 
with the prescription while I was still goofy.  It was prescription strength 
acetaminophen with codeine.  I explained that short term narcotic use was fine 
and that I had no history of narcotic abuse.  I explained that I use alcohol 
and avoid acetaminophen, especially such high doses.  First, she was confused 
and then returned to say that there was no alternative narcotic she would give. 
 Knowing what they plan to prescribe, they should screen patients for common 
drug interactions before the surgery and they should explain such a common and 
expected interaction.

Pharmaceutical companies wish to mask symptoms and that is why they put 
acetaminophen in so many over the counter drugs.  Consumers feel relief from a 
multitude of symptoms and buy more of their crap.  Medical providers are 
terrified of appropriate narcotic use for pain because of diversion by narcotic 
addicts.  (Opiates have risk of overdose and dependence but are not 
particularly toxic).  Many people do not have their pain treated appropriately 
in our society because of this fear by medical providers.  

It's best to take a journal listing any and all drugs you take when going to 
any medical provider.  And be very careful about mixing all these "safe" over 
the counter drugs.  Even western medicine has reluctantly admitted that 
acupuncture can be very effective in treatment of pain for those with some 
chronic condition.

Glenn



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