(Update 3x)Wicked Drug Laws Killed My Dear Friend
By Mona
[Please see all Updates, and read this post by Thomas Knapp. The effing Drug Warriors lace many painkillers with acetaminophen purposely. To "deter" recreational use. Assh*les.]
This past Wednesday, one of my dearest friends in the world died. His death was completely unnecessary. He was an alcoholic whose liver had become severely compromised, so several years ago he switched to weed. That cost him a great job about five months ago when the company that had just hired him received the results of my beloved pal’s pee test.
So, still hunting for jobs, he would sometimes abuse cough medicine. A few weeks ago he got the flu, and his doctor gave him codeine pills which come laced with acetaminophen; with an Rx he could eat them like candy and be job-safe, and eat them like candy he did.
Acetaminophen, however, is dangerous to the liver, and large quantities of it are intolerable for an already seriously compromised liver. So, my friend turned blazing yellow, lost circulation in both legs, and died within hours of being admitted to a trauma unit.
Pot does not kill anyone, and he would have been content to make that his substitute for the mood-altering he seemed to have to have. But he was compelled to give it up, and now he is dead.
This fine man was 49 years old and leaves behind a young widow, mother and hundreds of grieving friends. He was loved by many for his gentleness and many charitable endeavors.
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Tried to leave a comment and it would not post. So here goes:
Glaivester: As far as I know, when docs prescribe pain killers, many if not most come with Tylenol. From wiki:
A class of stronger pain relievers contains codeine: Tylenol 1 (available in Canada without a prescription) contains 325 mg acetaminophen, 15 mg caffeine and 8 mg codeine; Tylenol 2 contains 300 mg acetaminophen and 15 mg codeine, Tylenol 3 (300 mg/30 mg), and Tylenol 4 (300 mg/60 mg). Acetaminophen is also found in other narcotic-based analgesics such as Percocet which contains oxycodone.
Tylenol PM
Tylenol PM is the trademark for a mixture of paracetamol (acetaminophen) and diphenhydramine, distributed by Johnson & Johnson. It is marketed as a combined analgesic and sedative. It is listed as non-habit forming.
This is anecdotal and I do not recall where I read it, but somewhere along the line I encountered the claim that the FDA, DEA etc REQUIRE these pain meds to carry Tylenol, so as to scare people away from abusing them. Don’t know whether there is any truth to that.
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Commenter Thomas, who sounds authoritative, provides discussion as to why at least for the FDA, what I recall reading is false.
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But as for the DEA, it appears I was correct, per these two commenters.
F*cking drug warriors.
Comment by David K —
November 14, 2009 @ 3:00 am
I’m sorry to hear about your friend. As an alcoholic myself I have done my share of self-medicating, never to the depths that your friend did but more than my fair share.
While I’m not an advocate for legalizing all drugs, it’s inane that marijuana remains illegal. When you indulge in something like that it’s illegal, “immoral” or “wrong”, yet if someone becomes addicted to or dies from a prescription, it’s “unfortunate”. Prescription meds have done wonders for many people but they’re not without their shortcomings, side effects or dangers.
May your friend rest in peace and his family, friends and yourself find some peace, strength and understanding.
Comment by Thoreau —
November 14, 2009 @ 3:15 am
My condolences, Mona. It’s a bad week for all of us. I didn’t lose a friend but I do have a friend in a very nasty spot right now.
Comment by temujin —
November 14, 2009 @ 4:49 am
There are no words
Comment by radagastslady —
November 14, 2009 @ 10:56 am
I just lost a beloved nephew to acetamephen poisoning. 25 years old with a wonderful future. I don’t believe he really understood how dangerous Tylenol and other products with acet/ can be. Our culture of popping otc pills is so dangerous.
Comment by Glaivester —
November 14, 2009 @ 11:18 am
Could he have gotten codeine without acetaminophen? (I’m not blaming him, just thinking that if there is a possibility of getting the codeine wihtout the acetaminophen that it should be pointed out to the people in this condition in the future to try to prevent these incidents).
There is something perverse about the fact that he needed a prescription for codeine, but that he was poisoned by the part of the drug that did not require a prescription.
Comment by Glaivester —
November 14, 2009 @ 11:20 am
(In other words, we really need to educate people about the danger of acetaminophen. I would not be surprised if 90% of people think “hey, it’s Tylenol, it’s over-the-counter. It MUST be safe”).
Comment by Jennifer —
November 14, 2009 @ 6:16 pm
Very sorry to hear it. The drug
waswar causes more pain than drugs themselves ever could.[Mona changed a typo for Jennifer.]
Comment by All Your Summer Songs —
November 14, 2009 @ 8:17 pm
[comment redacted]
Comment by Thomas —
November 14, 2009 @ 11:17 pm
FDA, DEA etc REQUIRE these pain meds to carry Tylenol, so as to scare people away from abusing them.
Don’t know about DEA, but FDA doesn’t. Oxycontin is the clearest counterexample.
An FDA advisory committee recommended back in June that these combination acetaminophen/opioid products should be removed from the market, for exactly this reason (the meeting transcript isn’t up yet, but it was widely reported in the media). Tragically for your friend, it hasn’t happened yet.
Combination pain treatment is a good idea: the opioids and the OTC painkillers work by different mechanisms and have different toxicities, so giving both at once results in better pain control. For most people this is pretty safe – the opioid has side-effects that most people find unpleasant, at well below the dosage where Tylenol will kill you. Of course, the opposite is true for people who want the opioid side-effects, so you really have to be able to decouple the dosages of the two drugs.
Comment by Thomas —
November 14, 2009 @ 11:29 pm
I just noticed that my editing of the quote in the previous comment made its tone look quite different from the original version with disclaimers. That wasn’t intended. Sorry.
Comment by Mona —
November 14, 2009 @ 11:31 pm
No problem Thomas; I posted a link to your initial comment as a second update. Truth matters!
Comment by Fraud Guy —
November 15, 2009 @ 2:08 am
A friend also ran into that problem, and was taking multiple Tylenol a day due to lower back pain, at their doctor’s recommendation. Eventually, the side effects brought them back to the doctor, who then told them they weren’t supposed to take it every day, and now she may have permanent liver damage.
But, hey, at least it’s not a NSAID, right?
Comment by Thomas L. Knapp —
November 15, 2009 @ 7:27 am
The DEA doesn’t, strictly speaking, PROHIBIT the prescription of opiate painkillers without acetaminophen.
What they do instead is “schedule” them differently, such that a doctor who prescribes unalloyed opiates instead of the acetaminophen-laced kind is more likely to come under scrutiny and risk having his license to prescribe yanked.
It’s a bullshit idea that kills people. Sorry to hear that your friend was one of them.
Comment by Glaivester —
November 15, 2009 @ 11:39 am
Although it doesn’t say that anyone requires the practice, the wikipedia article on hydrocodone (I’m not providing a link, because my comments seem not to be appearing) mentions the use of acetaminophen to prevent drug abuse.
It doesn’t seem to make much sense, though. There is no reason to believe that the side effects of acetaminophen are going to turn someone off the drug before they cause serious damage, so the effect doesn’t seem so much to be to turn the user off of using the drug as much as to scare him off through making overdose easier. This seems to me to be a recipe for making more drug-related deaths, not to reduce addiction.
(This of course ignores the issue of the use of acetaminophen as a complementary analgesic).
Comment by Karen —
November 15, 2009 @ 12:35 pm
My most serious condolences Mona. If it means anything, I had a good friend who died from very similar causes. We have decided that we should be vindictive toward people who use certain kinds of drugs we don’t like and ignore the effects of addictions of which we approve, like working 90-hour weeks. This is insane.
Comment by Jennifer —
November 15, 2009 @ 2:10 pm
If the government treated cars the way the DEA treated drugs, all automobiles would be required to have outside-mounted gas tanks guaranteed to explode in even the most minor of accidents. See, the thing is, if cars are not made inherently dangerous that might encourage people to drive recklessly, and God forbid people get the idea they can be lousy drivers without suffering severe consequences.
Comment by John Emerson —
November 15, 2009 @ 3:45 pm
The case is very similar to that of “denatured alcohol”. Alcohol for drinking is very heavily taxed; at cost it would cost les than a dollar fifth. Rubbing alcohol for non-drinking purposes is cheap, but it’s deliberately poisoned so people won’t drink it. But some people do, and some of them die or have other serious effects.
Comment by John Emerson —
November 15, 2009 @ 3:47 pm
Per the updates, the fact that the DEA trumps the FDA is characteristic of American practice generally. The DEA has succeeded in terribly distorting American pain management practices, even for patients who are terminally ill and not at risk of addiction.
Comment by David Bilek —
November 15, 2009 @ 5:11 pm
I suspect that if acetaminophen came up for FDA approval today it would never pass. I don’t touch the stuff.
That said, it’s a fairly trivial process to remove acetaminophen from codeine in pills which are a mixture of the two. Completely hypothetically I would almost certainly do such an extraction were I to require such pain meds. Hypothetically.
Comment by Jennifer —
November 15, 2009 @ 8:28 pm
Hypothetically, how?
Comment by Mona —
November 15, 2009 @ 8:37 pm
Jennifer: If you read Thomas Knapp’s post all the way through, the search terms will be obvious. However, doing so is likely to bring you unwanted attention.
Comment by Tom Jackson —
November 15, 2009 @ 10:23 pm
My condolences to Mona.
This blog has done a great job of repeatedly raising the issue of our country’s cruel and unjust drug laws.
If I might add something, the government’s policy of encouraging wide open alcohol use and banning pot raises public safety concerns. I just finished writing a story for my newspaper about a drunk guy who allegedly assaulted two people and locked his wife and young stepdaughter out of the house. When I read police reporters, the reports of violence are routinely associated with alcohol. I seldom read a police report about someone smoking a joint and turning violent.
Comment by Mona —
November 15, 2009 @ 10:44 pm
Tom Jackson sez:
Pot alone induces violence extremely infrequently — as in, almost never. Except, of course, against canisters of Pringles and Hostess Cupcakes.
Comment by matthew h —
November 15, 2009 @ 11:20 pm
“Pot alone induces violence extremely infrequently. . . ”
Except by governments to their citizens.
Comment by J sub D —
November 17, 2009 @ 12:33 pm
I too extend my sympathies.
Sadly, your friend is but one the thousands of Americans killed by the War on Sanity annually.
For example …
Comment by DPO —
November 21, 2009 @ 8:20 pm
I’m sorry to hear about your friend. This is why I request hydrocodone/ibuprofen when offered pain medications, as opposed to hydrocodone/acetaminophen. With only 200mg of ibuprofen per pill, and no significant hepatotoxicity, your margin of safety is much, much higher.
It’s also possible to take advantage of the differential solubility of hydrocodone and acetaminophen through a hot/cold-water extraction and separate the two.
Comment by Robert Hutchinson —
November 23, 2009 @ 10:26 pm
I know someone who specifically had to ask his doctor for medicine that wasn’t laced with acetaminophen. Said person had to find out himself that what he’d been prescribed had a crazy amount of acet. in it, as it was never mentioned by the doctor or pharmacist.
I’m so sorry about your loss, Mona.