Tylenol Abuse | Effects & Risks Of Acetaminophen Misuse

Acetaminophen, also called paracetamol, is the active ingredient in the common over-the-counter medication Tylenol, as well as a component of other prescription and OTC medications.

Acetaminophen is not euphoric and does not generate physical dependence or addiction in the same way as stronger painkillers. However, it can nevertheless be misused and abused with serious or even life-threatening consequences.

Why Tylenol Abuse Occurs

Although its exact mechanism of action is unclear, acetaminophen use appears to interrupt the production of molecules that contribute to pain and inflammatory responses in the body.

Accordingly, acetaminophen is prized and trusted as a mild:

• analgesic (pain reliever)
• antipyretic (fever reducer)

Unfortunately, individuals struggling with frequent headaches, backaches, toothaches, arthritis, or other forms of chronic pain may take more Tylenol than recommended in an attempt to self-medicate their symptoms.

Or individuals may misuse other drugs that contain acetaminophen, especially prescription opioid/opiate pain medications that use acetaminophen with hydrocodone, oxycodone, or codeine, which includes the brand name Tylenol 3. 

Effects Of Acetaminophen Abuse On The Liver

Despite being an over-the-counter medication, acetaminophen overdose (also known as acetaminophen toxicity) is currently the leading cause of acute liver failure in the United States.

While the liver is able to tolerate and process acetaminophen at lower doses, high doses of the drug or use of acetaminophen with other substances (especially alcohol and cocaine) can cause sudden liver damage or even life-threatening acute liver failure.

The effects of acetaminophen overdose may take twelve to twenty-four hours to appear, and can include:

• jaundice, a yellowing of the skin and the whites of one’s eyes
• pain or swelling in the upper abdomen
• nausea or vomiting
• loss of appetite
• fatigue
• heavy sweating
• pale skin
• unusual bruising or bleeding
• dark or tea-colored urine
• dark tarry stool
• diarrhea

Children, older adults, those in poor health, and those with a history of alcohol, tobacco, or drug addiction may also be at an increased risk of experiencing acetaminophen linked liver-damage.

Treating Acetaminophen Overdose

In the same way that naloxone (Narcan) can rapidly reverse the effects of opioid overdose, a drug called N-acetylcysteine can reverse the effects of acetaminophen overdose.

Healthcare providers will administer this drug while monitoring a patient’s vitals, performing tests, and providing supportive care, potentially including life-support care.

In the event that the liver is simply too damaged and cannot function, an emergency liver transplant will be required.

Other Effects & Risks Of Acetaminophen Misuse

When used correctly, acetaminophen is generally well-tolerated and rarely causes side-effects. It is also generally considered to be safe to use during pregnancy, though some recent research has called this into question.

Rare but documented risks and side effects associated with acetaminophen may include:

• allergic reactions, including severe skin rash, hives, and itching
• other skin reactions, including red spots or pustules forming on skin
• sores, ulcers, or white spots on the lips or in the mouth
• constipation

When taken chronically, individuals may also experience certain negative effects including an increased risk of kidney disease and bleeding in the digestive tract. And acetaminophen should not be taken by those consuming three or more alcoholic beverages in a day.

The drug may also cause a dependence/withdrawal symptom-like effect triggering several days of severe headaches or migraines when the meds are discontinued.

Acetaminophen Combination Product Abuse

While acetaminophen abuse does occur, the drug is considered to have a negligible potential for addiction or dependence.

However, certain products and prescription drugs that contain acetaminophen are commonly abused for various reasons:

• combination opioid products can be abused by those seeking to get high, as oxycodone, hydrocodone, and codeine can be euphoric and pleasurable when taken either in therapeutic or high doses
• pseudoephedrine-containing products, used as cold and sinus medications like Sudafed, can be abused as-is or modified to create the powerful illicit stimulant drug methamphetamine

In the wake of the American opioid and methamphetamine epidemics, these products have been subject to increased scrutiny and security in recent years. 

All opioid-containing products are now classified as controlled substances and pseudoephedrine-containing products have moved behind the pharmacy counter with strict purchase limits and ID requirements.

FAQ

Can Tylenol Be Abused?

Any use of acetaminophen (Tylenol), or any product that contains acetaminophen, that disregards the instructions provided with the medication can be considered drug abuse.

Despite being an OTC drug, acetaminophen can be dangerous in cases of overdose, and the drug is the leading cause of acute liver failure in the United States.

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