Accidental overdose of narcotics and acetaminophen: Beware the ingredients

by James Hubbard, M.D., M.P.H.

The FDA has become concerned about an increase in deaths from “accidental” narcotics overdoses.  Apparently, the powers that be have come to recognize what we docs have known all along: Not all who ask for prescription narcotics use them in the manner prescribed, and some will do anything for their “fix.”

Of course the ones who are actually in pain are worst of all (see my previous post).

Here’s a link to the FDA’s “A Guide to Safe Use Pain Medication.” There’s nothing new but it has a lot of good reminders.

The bottom line is simple.  Don’t mix pain meds, and follow directions strictly.  They may cause drowsiness.  Don’t use with alcohol.  Let your prescribing doctor know any and all medications you are taking.

I would just like to emphasize the danger of taking too much acetaminophen (Tylenol).  It can severely and permanently damage your liver.  At regular doses, it’s great, but taking more than recommended not only will not better help the pain or fever; it’s dangerous.  Many prescription pain medicines have a combination of a narcotic and acetaminophen.  Check the ingredients.  If it does, don’t take any additional acetaminophen.  Take one or the other, not both.  The same goes with many over-the-counter cold or pain combinations.

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11 Responses to “Accidental overdose of narcotics and acetaminophen: Beware the ingredients”

  1. Mark Salinas Says:

    “The bottom line is simple. Don’t mix pain meds, and follow directions strictly. They may cause drowsiness. Don’t use with alcohol. Let your prescribing doctor know any and all medications you are taking.” Makes good sense! Thank you.

  2. Dan Says:

    The Dangerously Euphoric Violet Delight

    Often, medications for pain are made from what are called opoid plants. These purple-flowered plants produce poppies that are used in the production to make the analgesic, opium.
    Poppy plants exist and are grown in areas of Asia. The country of Afghanistan is the number one producer of poppy plants. The United States is the number one country that consumes what is derived from these plants.
    Opium is what we in the U.S. call narcotics, and they essentially dull and numb those in pain who ingest these opium-based medications. The narcotics are the drugs of choice for pain management.
    Some narcotics are from natural opium, such as cocaine. In addition, the opiates from the poppy seeds can be used to create semi-synthetic narcotics, such as Heroin. Heroin was marketed by Bayer Pharmaceuticals for 12 years, and during that time this company told potential users of Heroin that it is a non-addicting form of morphine (pure opiate drug).
    This was believed to be a welcome relief for those many soldiers who became addicted to morphine after the U.S Civil War. During that same period of time, Bayer marketed heroin for other medical conditions, such as young children with coughs.
    Of course, we now know that Heroin is very addictive in fact. Ironically, Morphine has been given to Heroin addicts who are recovering.
    Opium-derived medicines once could be bought freely in the U.S. by anyone less than 100 years ago. Yet now, they are classified by the Drug Enforcement Agency as narcotics, and are scheduled accordingly to monitor and limit the use of such drugs by others, as there is a very real element of danger with narcotic usage by others.
    Internationally, the opium trade has been actively placed throughout the world. Historically, brutal force has been implemented by various nations to control what opium plants provide that others desire, as there is a pleasant euphoria experienced by the consumers of narcotics in addition to relieving pain.
    While prescribed to patients for such issues aside from pain on occasion, such as chronic coughing and diarrhea, the intended use of opium drugs is for pain management. Vicodin, which is comparatively a mild narcotic, is the most frequently prescribed and abused drug in the United States presently out of the narcotics available by prescription. Overall, there are about 10 opium-based medications available, and each has a length of effectiveness after administration for a period of about 4 hours
    If patients take opium-derived drugs for long periods of time, tolerance may develop with such patients. When this occurs, this patient needs and desires more of the opiate medication to acquire a level of relief. As a result, such patients may develop a dependence on these types of drugs, which is what often leads to addiction and possible abuse of the narcotic drug. This is why overdose of these types of drugs have occurred. The reasons for taking these drugs initially become replaced with a desperate need for relief due to addiction in some who take narcotics for a long period of time.
    Dan Abshear

  3. James Hubbard, M.D., M.P.H. Says:

    You’re right on track Mark.

  4. Dr. J Says:

    Excellent, even if scary, post Dr. Hubbard!

    Narcotic addiction is brutal! Smoking is easier to quit. Being in the health care field, I’ve seen a few close colleagues almost destroy their lives. It’s painful to relive the memories, but we stood with them and somehow, together we pulled them through it. Without the resources we could make available for them, I doubt they would have made it.

    Dr. Js last blog post..“The Biggest Loser: Couples” episode 8.2: How the game is played

  5. James Hubbard, M.D., M.P.H. Says:

    How true Dr. J

  6. Sagan Says:

    Egads. Think I’ll stay away from the drugs :)

    Sagans last blog post..Happy Birthday, Living Healthy in the Real World!

  7. Migraine Headache Treatment Information | Medical Information Says:

    [...] James Hubbard’s My Family Doctor Blog » Blog Archive » Accidental … [...]

  8. James Hubbard, M.D., M.P.H. Says:

    Good idea Sagan. If you have acute pain they can be great, however. I am thankful I did not live when they weren’t available (and numbing medicine for dental work)

  9. hedley kerr Says:

    Why did we put tylenol in our pain medication in the first place. I’ve heard many rumors that our goverment was responsable for that so people would not abuse the medication and would get sick first is there any truth to this.

  10. Jim Jennings Says:

    I remember a teacher telling us that Acetaminopen was used as a painkiller in our Civil War (1860-65). He told us that it was considered a wonder-drug and was, thus, used in huge quantities, relieving the pain of the wounded but then killing them as their livers failed. Is this true and is there any resource that will corroborate the story? Thank you! Jim Jennings

  11. lotte Says:

    Hi, Jim. I couldn’t find information on that, but it looks like acetaminophen may not have been in use until after the civil war. You might ask Tylenol. Here’s their contact page:

    Good luck.

    Leigh Ann Otte
    Managing Editor
    lotte recently posted..March 2011 Newsletter- How to Save Dried-Out Contacts

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