When I was young, Tylenol was a wonder-drug. You could take it for anything, if it didn’t work, you took more. I carried a bottle around with me starting from middle school.
Nowadays, it seems like if you swallow it too fast your liver melts. What happened?
Some ignorance was successfully fought.
Your post seems to vastly overstate both the benefits and the dangers of acetominophen, but I take it that is just hyperbole. Like pretty much all drugs, it has real benefits, but also real dangers if used improperly.
From what I can read it was a lag effect, ie it got approved for widespread use in the 70-80’s and really took off then as a replacement from aspirin. After 10-20 years we started seeing large amounts of liver and kidney damage from overusing it coming through. And one reason for that problem seems to be people thinking it was ‘safe as houses’ compared to aspirin rather than actually being quite dangerous if taken in excess of recommended doses.
And then it takes time again to start limitting it and for people to get the message.
Otara
The amount of times a drug is considered safe due to short term tests, but is determined to be bad in the long run is more common than you would think. I actually wonder why so many doctors want to use the new medicines instead of the older, more proven ones.
There is also the fact that the OP has nothing to do with reality. Even in the 70s when I was nursing it was known that large doses cause liver damage and even now you can OD on it. However recommended therapeutic doses do nothing other than raise liver enzymes that revert to normal upon cessation. So unless you are talking about people taking many, many tablets every day for a long, long time it remains pretty much non-liver killing.
Because people weren’t idiots back then. They knew enough not to take the whole bottle. 
Also aspirin had become villified as something that tears your stomach to shreds. Fair enough if you have an actual stomach problem aspirin isn’t the best but most people can handle and aspirin just fine. And aspirin is dirt cheap. I can get 200 aspirins for $1.00 when it goes on sale. Aspirin also took a major hit as a contributor to Reye’s syndrome in youth.
So you have aspirin which is “evil” (not really but it got a bad rap) versus “Tylenol” which is good.
I also think lack of availability to doctors is a factor. Now that it’s more expensive to see a doctor, if you don’t have insurance, people will try self-medicating more than they did in the past. So you may have people popping Tylenol (or something else) for months, instead of seeing the doctor.
“However recommended therapeutic doses do nothing other than raise liver enzymes that revert to normal upon cessation.”
Wiki seems to suggest that there has been some new research since the 70’s even in the medical arena about what levels should be considered ‘safe’.
I realise thats not a solid gold source so hopefully someone else more qualified can confirm that.
Otara
I think another issue is that we now have all these different “cold and flue”, etc, formulations that less observant people fail to realize contain Tylenol. Also, it seems like a good number of people pop a couple Tylenol PM at night even when they don’t have any aches or pains, when a regular OTC sleeping aid contains the same active ingredient minus the acetaminophen.
But what’s wrong with taking those once in a while? I mean, I’m assuming you’re not sitting around taking them all day.
It is perfectly fine in moderation. The problem is when someone gets a cold and takes some Excedrin Extra Strength for their headache, some Nyquil for their cold symptoms, and some Tylenol PM right at bed time to help them sleep and does not realize that they have just taken three times the recommended dose of acetaminophen.
Nothing wrong with “once in a while”, though as mentioned, using a combination cold formulation as a mere sleep aid is superfluous when a generic antihistamine would work just as well. What they’re saying is, this can become a problem when there is a pattern of a lot of OTC products just adding acetaminophen as a matter of course to the formulation, leading some people to having more APAP in their systems more often than they think.
And yes, even as far as the 70s I knew you had to watch your liver around the stuff.
But that’s why the instructions in every OTC medication say to not take more than a certain amount per day, and to go to a real doctor if the symptoms continue for several days. It’s nto supposed to be a maintenance drug.
Tylenol always carried the danger of liver damage; it’s been a warning since the beginning. In normal doses, the chance is slight, so it’s safe enough, but if you’re taking it every day for long term those can add up.
Tylenol was so popular not because of its effectiveness against pain (aspirin was always just as good), but for two unrelated issues. One was the stomach issue: aspirin can upset stomachs, so if that was a problem with you, Tylenol was recommended. The other was the clotting factor: aspirin inhibits clotting (which is why low-dose aspirin is used for heart disease) and Tylenol does not.
The latter gave Tylenol a perfect marketing hook: hospitals used it after surgery to combat pain because aspirin could lead to bleeding. Tylenol made sure of its advantage by selling to hospitals at a price that was as cheap as or cheaper than aspirin. Thus, hospitals, who bought on price and had the bonus of no inhibiting clotting, switched to Tylenol. And Tylenol was able to advertise “More hospitals use Tylenol than any other pain reliever” and charge customers two or three times the price it charged to hospitals.
In general, all OTC pain relievers (aspirin, acetaminophen, ibuprofin, naproxin, etc.) are equivalent in fighting pain. You choose depending on side effects, how your system reacts, and price.
I’ve lived in a couple of different homes that had fireplaces, but I’ve never been tempted to use Tylenol to clean out the flue.
I don’t even know how that would work.
This is so wrong, it’s dangerous. It’s true that most people are at no risk from taking the maximum recommended daily dose of 4 grams. However, this does not mean that you need to take “many tablets every day for a long, long time” – quite the opposite. A single dose of 10 grams can cause enough liver damage to kill you in days, as can the same amount spread throughout a day. 6 grams a day over 48 hours will do the same – two tablets, every two hours, for two days. Worse, 2 grams can damage or kill a person who has been drinking, or one with existing liver problems. And by “has been drinking,” I don’t mean recently – the most dangerous time for drinkers to take Tylenol begins when the liver starts metabolizing the alcohol, and doesn’t end until the liver enzymes subside, days later. The maximum hazard is reached after all alcohol has been metabolized, when liver enzymes are at their peak, but there’s no alcohol left to compete for them – i.e., right around the time you take a couple pills for your hangover.
Interesting in the extreme. I knew a suicide attemmptee who took “a $16 bottle” IIRC of Ty. She was in her 6th month in the psych ward plus I don’t know how long in medical.
Acetaminophen overdoses have been a headache for the medical profession ever since I belonged to it, back in the 70’s, and even before. As has already been noted, a person with a healthy liver shouldn’t take more than 4 grams of it a day, and a person with an impaired liver (such as a chronic drinker or a person with hepatitis) should consume less than 2 grams a day at most.
But then they started adding acetominophen to damn near everything. So we started seeing chronic pain patients who are not just taking the max 4 grams a day of it, but also taking vicodin 5/500 (5 mg hydrocodone plus 500 mg acetaminophen) 2 tabs every 4 hours, for a possible daily total of 10 grams of acetaminophen. Then add the shotgun cold medicines they’re taking, with acetaminophen added to the cough suppressant and decongestant and antihistamine in it, and the total is even higher.
the next thing you know, Mr. Liver is saying “so long, and thanks for all the hepatotoxins”.
Hospitals got Tylenol SO cheap for a long time that many of them didn’t even bother to inventory it. I worked at several during the 80s-90s where large boxes of the individual-dose packets just sat in a cabinet at the nurse’s station - to give to patients (if ordered, and always recorded), for the convenience of the staff, for visitors if they asked, whatever. Some staff members stuffed their pockets with it to take home; no one cared. It was the most uncontrolled drug you can possibly imagine in the hospital.
There is also the problem with Infant’s Tylenol and Children’s Tylenol (both liquids) looking very similar but having very different dosages - Infant’s Tylenol being much more concentrated. Parents accidentally poison their kids by not realizing they’re giving them the wrong product.
Houses are not really all that safe. Somewhere between 17% and 95% of all accidents occur in them. (Cite.)
The real irony is “safe as houses” was a refence to their safety as savings / investment vehicles, not the absence of injury-causing accidents inside them.
Yet another '70s truism shot to Hell.