Acetaminophen and Alcohol
I’ve always heard it mentioned by various armchair physicians that using acetaminophen and alcohol is bad for your liver. Being the skeptic that I am, I wanted some confirmation of this little factoid. Its not that I didn’t believe it. I’ve heard it come up enough times to suggest there is certainly something there. I just wanted a clearer, more accurate understanding of why it is so. So naturally, I researched it for myself.
Acetaminophen is a non-aspirin based analgesic (pain killer) found most often in products like Tylenol. The directions for proper use clearly state that it is not to be consumed with alcohol. It seems that this was widely attributed to the simple facts that both alcohol and acetaminophen can cause liver damage and other health problems if abused.
Is Acetaminophen with Alcohol really Dangerous?
The question of whether or not using acetaminophen and alcohol together represents a significant increased danger to liver, kidneys or other vital organs remain debated, but there is evidence to suggest enough risk that it would certainly be wise to avoid the combination. Especially when you consider that there are other widely available pain medications that are not shown to product significant risks of liver damage.
Acetaminophen products such as Tylenol are among the most popular and most widely used analgesics on the market today. Because of this, it is also heavily scrutinized and studied. These studies have shown us that while the overwhelming majority of people who use the drug moderately and have no ill side effects, there are also many cases where its use or over-use has been directly associated with acute liver failure, kidney problems and even death. If you are a frequent alcohol user, you are already at risk for such problems and it may be wise to avoid mixing acetaminophen into the picture.
Overdosing on acetaminophen has actually been shown to be a leading cause of liver failure. Some studies have reported numbers as high as 20-30% of cases of acute liver failure being directly linked to the over-use of acetaminophen alone. Now add alcohol and acetaminophen together and imagine how it might increase the numbers. Needless to say at this point, debated or not, the combined use of the two may be unwise to say the least.
Keep in mind on the other hand that since acetaminophen is inexpensive, effective and very available, there are going to be high numbers of cases of its abuse. These numbers dramatically outweigh the numbers of cases involving liver failure. One reason for this is that the difference between a normal “safe” dosage and a dosage level that is considered toxic is fairly small. From that we can draw that abusing acetaminophen does not necessarily mean that you will have liver failure or else we would see over 70,000 cases of acetaminophen related liver failures each year.
Acetaminophen and Alcohol do Cause Liver Damage
Both acetaminophen and alcohol do put some measure of strain on the liver. Using them together actually significantly lessens the liver’s ability to remove toxins from the bloodstream and body (its main function). In many cases of alcohol abuse, there is an accompanying case of malnutrition since most alcoholics are not exactly prioritizing dietary health. Starving the body of necessary nutrients also disables the livers function by reducing its output of glutathione which is another detoxicant that helps cleanse the body of harmful material.
This is one of the main reasons why acetaminophen and alcohol are potentially much more dangerous that either one alone. Alcoholics are typically weakening the liver through combined excessive drinking and malnutrition. The addition of acetaminophen abuse is overwhelming to the proper function of the liver.
Evidence of the Danger of Acetaminophen and Alcohol
According to a study conducted by Schiodt et al, New England Journal of Medicine, October 1997, this is illustrated even clearer. There were 71 patients treated for acetaminophen overdose. Of those 71 people, 50 of them were attempted suicides and 20 were accidental. Now here is the telling part. Even thought the 50 that were attempted suicides took much higher doses (twice as much), the 21 accidental overdoses had far more resulting cases of coma and death. The reason is that of the 21 accidental cases, most of the patients were alcoholics. In this case you can see pretty clearly that there is some serious potential danger in combined use of acetaminophen and alcohol.
Keep in mind that most recorded cases are based on prolonged use rather than a one-time overdose or the use of Tylenol after a weekend bender in Vegas. Also, don’t assume that you would be safe by simply changing your abuse of acetaminophen over to abusing a new painkiller such as aspirin or ibuprofen. I think the key element here is the proven potential of abusing drugs to be extremely dangerous and that it might be wiser to just endure the headache if you are intent on being hung-over every week. A hangover sucks pretty badly but comas, liver failures and death don’t wear off in 24 hours.
Also note that both acetaminophen and alcohol take several days to fully metabolize and leave the body and liver. Just because you haven’t had a drink since Friday night, doesn’t mean it is totally safe to throw back a handful of pills to combat that backache. For this reason, if you are a frequent drinker, alcoholic or not, it may be time to remove acetaminophen use from your habits altogether. Even moderate drinkers or “social drinkers” who use acetaminophen are at risk for acute liver failure or hepatotoxicity. Wait at least 5 days after any significant alcohol consumption before using acetaminophen but keep in mind that many other factors including age, weight and general health will also affect this waiting period. If you have to take something for a hangover, take something else.
If you feel the acetaminophen and alcohol may be affecting your health, you are advised to seek the help of a qualified physician.