Safety of Paracetamol (Tylenol) questioned

What's the most dangerous drug that people routinely take? I think the answer has to be acetaminophen which is marketed as either Paracetamol (Asia and Europe) or Tylenol (United States).

A Wikipedia article on paracetamol states:

Paracetamol hepatotoxicity is, by far, the most common cause of acute liver failure in both the United States and the United Kingdom. Paracetamol overdose results in more calls to poison control centers in the US than overdose of any other pharmacological substance. Signs and symptoms of paracetamol toxicity may initially be absent or vague. (see the article for references)

The article on Tylenol is more comprehensive, and warns:

Acetaminophen causes three times as many cases of liver failure as all other drugs combined, and is the most common cause of acute liver failure in the United States, accounting for 39% of cases. While it occurs through overdosing^, even recommended doses especially combined with even small amounts of alcohol, have caused irreversible liver failure^.

People who have the highest risk for Acetaminophen related kidney failure include: heavy drinkers (three or more drinks per day), elderly men, and persons with pre-existing liver or kidney damage. In infants and small children, studies have indicated that the toxic dose is less than twice the recommended dose.

Why do so many people take acetaminophen?

It's not as if there are no effective alternatives. For adults -- but not children -- acetylsalicylic acid (Aspirin/ASA) seems to have a somewhat better safety profile.

Another point about aspirin is that -- unlike Tylenol or Paracetamol -- aspirin addresses some underlying cause of inflammation, and is widely considered effective in preventing some chronic diseases. Far fewer positive health effects have been observed for acetaminophen.

Both painkillers could harm you -- especially if taken with alcohol, but the safe-dose threshold for aspirin seems to be higher and aspirin seems to actually help prevent certain diseases.

CounterPunch has an informative article on the aspirin Vs tylenol question. It's author, Fred Gardner, writes: "Aspirin (an extract of willow bark) is not as benign as cannabis, but it, too, has been on the receiving end of a corporate disinformation campaign. " Essentially, it's suggested that J&J supported a fear campaign about Rye's Syndrome -- which kills few children assuming the syndrome actually exists -- and proposed Tylenol as the safer alternative to aspirin. Meanwhile, hardly anyone knows about the dangers associated with Tylenol. The safety scare about the packaging of Tylenol back in the 'eighties also -- paradoxically -- made "pure" Tylenol appear safer:

"Johnson & Johnson's handing of the Tylenol crisis is clearly the example other companies should follow if the find themselves on the brink of losing everything," says a typically admiring text used in a Defense Department communications course. Actually, the terrorist's attack in Chicago gave Johnson & Johnson an opportunity to conflate safety with purity (just as the terrorists' attack on 911 enabled the Bush Administration to conflate safety with conquest abroad and repression at home). Johnson & Johnson reintroduced Tylenol with great fanfare "in new triple-safety seal packaging," writes the DoD analyst a glued box, a plastic seal over the neck of the bottle, and a foil seal over the mouth of the bottle." The label carried a warning not to use if the package had been tampered with -and nothing about liver damage. The unspoken message, etched heavily into consumer consciousness, was that the synthetic compound inside the bottle is perfectly safe as long as it's pure.

Oddly, the Tylenol people have also been going after marajuana (which also has a far better safety profile than either Tylenol or Aspirin). Gardner writes: "James Burke, master salesman of Tylenol, has been selling the marijuana prohibition for decades. Bill Clinton gave Burke the Presidential medal of honor in 1996, when he was chairman emeritus Partnership for a Drug-Free America, the private-sector partners of the drug czar's office."

Needless to say, both marajuana and Aspirin compare favorably with Tylenol.
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Note: "Acetaminophen is best known by the brand name Tylenol, but many consumers don’t realize the drug is found in more than 100 over-the-counter products including cold and cough remedies such as Benadryl, Contac, Robitussin and Sinutab, and medications for menstrual cramp such as Midol and Pamprin, as well as Nyquil, DayQuil, Theraflu, Excedrin, Coricidin D, Triaminic, Dristan, and prescription painkillers, including Vicodin and Percocet. The profusion of products containing acetaminophen explains unintended overdosing." (ahrp)

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