newbie22
Bluelighter
Maybe this is getting too technical, but what counts as one shot? For example if you take one dose and then another one 1-2 hours later, does that count as one shot?
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OD Moderators: Keif’ Richards | negrogesic
Misc Acetaminophen Limit For Single Dose?
- Thread starter newbie22
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Artificial Emotion
Bluelighter
I suppose that would depend on stomach contents and the individual speed of one's metabolic rate.
Cane2theLeft
Bluelight Crew
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Artificial Emotion said:
What fucking purpose did this serve adding this on a *harm reduction* message board? The only effect I can see, regardless of its likelihood of happening, is someone seeing that you were ok and doing something reckless.
Ever heard the adage 'absence of evidence is not evidence of absence'. Have you had a thorough liver work-up performed shortly after or since? Are you sure there was no damage or are assuming because thus far you've been asymptomatic? These questions are rhetorical so respond if you'd like but I'm making a point regardless. 16 grams will inevitably damage most people's livers and be fatal for a substantial portion of the population.
When people add comments that could contribute to others' harm, it frustrates me quite a bit.
Artificial Emotion
Bluelighter
Yes I have had plenty of liver enzyme tests. And the fucking purpose was to calm his nerves. Comments like your frustrate the hell out of me too Canetotheleft.
newbie22
Bluelighter
I don't agree with that, personally. Obviously it varies depending on the individual, but according to emedicine (http://emedicine.medscape.com/article/820200-overview)... "Toxicity is associated with a single acute APAP ingestion of 150 mg/kg or approximately 7-10 g in adults." I do feel that it will damage the liver, and it's always a good idea to follow what it says on the bottle, but when speaking about the max in terms of living or death, I (now) follow the ~150mg/kg rule.
Artificial Emotion
Bluelighter
This is my personal fucking experience. Do you want me to lie? At what fucking point did I say it would be okay to take that much? I explicitly said I DIDN'T RECOMMEND IT.
Yes I know it would be fatal to many people. He's not asking how much to take. He's already taken it. The poin was to reassure him as everyone's different so although there's a maximum daily dose of 4g, people can and do survive after having taken massive doses.
Ksa
Ex-Bluelighter
The recommended limit is always far below the toxicity dose. Why do you want it to be 7-10g? Paracetamol has no euphoric effects, I see no reason why you would want to take that much.
Artificial Emotion
Bluelighter
^ because paracetamol is present in combination with hydrocodone etc and they can't be bothered to a proper CWE so they just take it with the paracetamol and hope for the best.
Ksa
Ex-Bluelighter
Oh I see.
newbie22
Bluelighter
LOL ouch. Truth hurts. To be fair though I have done CWE a few times and felt I didn't get near the same effect from the dose as I usually do without CWE. I mean almost to the point where I didn't feel anything. I'm sure I did something wrong, but to do a proper CWE you have to use a pretty good amount and I only get a certain amount prescribed by my doctor. So if it doesn't work I have nothing for my pain and am basically shit out of luck. Not to mention I can't really afford to keep doing CWEs over and over until I learn the right way, I don't have that type of money. I blame the government and doctors, there would be a lot less problems with overdoses if they took out the tylenol. I mean, you can get a tylenol yourself at walgreens. So that's my defense...
Cane2theLeft
Bluelight Crew
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AE, I wasn't saying you were recommending it but on a site like this, given the audience, you must be cognizant of the potential impact.
Someone could come here wanting to take 12g, see that you took 16 and were fine so feel they'll be ok. Its idiotic but it happens... Especially with drug users who can rationalize nearly anything.
My point was that your experience and dose specificity served no harm reduction purpose. You could've been just as reassuring without potentially contributing to someone rationalizing their own APAP OD.
I'm sorry if I came off like a dick, it was more so to dissuade future readers from doing it than to come down on you but I suppose I worded it very poorly and was combative. My apologies, man.
Someone could come here wanting to take 12g, see that you took 16 and were fine so feel they'll be ok. Its idiotic but it happens... Especially with drug users who can rationalize nearly anything.
My point was that your experience and dose specificity served no harm reduction purpose. You could've been just as reassuring without potentially contributing to someone rationalizing their own APAP OD.
I'm sorry if I came off like a dick, it was more so to dissuade future readers from doing it than to come down on you but I suppose I worded it very poorly and was combative. My apologies, man.
Artificial Emotion
Bluelighter
No, I was just thinking of what I said and how I came across and I think I was in the wrong. I should've been more careful as you probably do get the odd idiot (although you'd have to be quite moron to take as much as 16g of paracetamol like I did). I just had a surge of rage for some reason.
Vittoria
Bluelighter
B25Bulas
Greenlighter
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Toxic daily dose of tylenol
Concern over this, because my Vicodin ES was like 10/600 (or 750--so my daily dose of at least 10 of those could be 6000-7500, thats a toxic daily dose). I calculated daily dosage like what was just said. I was told 3000mg/day was the limit, but I exceeded that. I've read that if you don't exceed 4000-5000 and don't use booze, you may not get a daily toxic dose.
What I did was go to my doc and instead of saying that I'm taking 5 times what you recommend, I said I'm "concerned" about any amount of tylenol effect on my precious liver and could we go to 10mg.Hydro (same as before) but go down to 325mg. tylenol (Norco, as it called). Pretty much the same effect but with lower tylenol. Used to be on the internet, and maybe some local pharmacies, they'll actually mix 10mg. hydro with down to 100mg of tylenol, if the Dr. prescribes).
Concern over this, because my Vicodin ES was like 10/600 (or 750--so my daily dose of at least 10 of those could be 6000-7500, thats a toxic daily dose). I calculated daily dosage like what was just said. I was told 3000mg/day was the limit, but I exceeded that. I've read that if you don't exceed 4000-5000 and don't use booze, you may not get a daily toxic dose.
What I did was go to my doc and instead of saying that I'm taking 5 times what you recommend, I said I'm "concerned" about any amount of tylenol effect on my precious liver and could we go to 10mg.Hydro (same as before) but go down to 325mg. tylenol (Norco, as it called). Pretty much the same effect but with lower tylenol. Used to be on the internet, and maybe some local pharmacies, they'll actually mix 10mg. hydro with down to 100mg of tylenol, if the Dr. prescribes).
Japhy Ryder
Bluelighter
Your intentions are irrelevant. There is still in the message the idea of really large doses being safe because you are providing yourself as an example. You then reinforce your position that large doses aren't a big deal by literally saying big doses are fine for some.
Personally, I think your intentions are not what you are now defensively trying to shield yourself with. I hear bragging. I'm hearing a smug desire to slur medical guidelines and doctors by waving around your self-anecdote as proof they are wrong. I'm hearing you recommend that if you take a large overdose of a deadly toxin,that you don't have to worry and needn't seek medical help. I read your "obviously" caveats as disingenuous, a lip service to harm reduction and perhaps even a contemptuous sarcastic nod towards the rules. You don't sound like you are coming from a place of care, and your position is reckless, kind of the opposite of care.
You have zero knowledge about what is happening inside that guy, or inside all future readers who come the thread with their own concerns. You don't know the medical history of that guy and all future readers of your comment; you don't know their using history, their metabolism, their chemistry, their genetic disposition. The impacts of one single acute dose, and the impacts of an accumulation of doses over a short period will vary from person to person for many reasons and those reasons don't even remain consistent. What is safe and sensible is to err on the most cautious side, not to set the bar at the alleged data point from an anecdote found on a forum. It's certainly not sensible or safe to set the bar at a dose level where survival is is questionable, but hey since we have an alleged anomalous story, let's set the safety bar there. Something else that varies that you also have no information on which to offer any opinion are lifetime accumulated damage to the liver to date from all sources. Even the anecdotal evidence in an example is misleading to offer as meaningful, because a smaller dose could kill that same person on another occasion because their variables were different on that occasion. People die all the time, overdosing on dosages that hadn't harmed them before. Acetaminophen is the leading cause of liver failure.
What you have done is told someone not to be cautious, not to practice self-care. You've also normalized and made seem safe the taking of large doses. You've endorsed doubting or ignoring all together, any medical and other official information sources. You've provided a suggestive deterrent to asking the people best able to help--his doctor who is more informed about his patient's history, and biological make-up than you are, or just any doctor or hospitals who could do tests and offer any treatments for what the test results provide.
Something that is true is a person can ingest a lethal dose of acetaminophen and have it take days to complete the damage to the liver that kills. During those days, there is sometimes a window of time for lifesaving treatment. That window often closes before there are any symptoms to alarm the person who ingested the drug to seek help. So a person can be dying an avoidable death completely unaware. I have watched many people die because nothing felt wrong to them and by the time it did, it was too late for doctors to help.
Acetaminophen can be a very dangerous drug we don't respect how powerful and toxic it is. It's in so many otc and script products, we think it is harmless because it pads out so many products. It isn't hard to end up taking too much of one product, especially if we are seeking opiates, but we can also end up in the toxic zone by mixing and maxing blindly. It is both the ubiquity and the laissez faire attitudes that lead many people to think of it as harmless. Maybe the worst threat is it is a silent danger destroying without warning. Slowly accumulating damage over time usually won't produce pain or symptoms. Worse, taking a dose of acute lethal toxicity also often won't produce pain or symptoms until the liver shuts down and it is too late for help. At that point you will die, and you will die knowing if you'd seen a doctor the day before, you probably would have lived.
I think it is dangerous for strangers on the internet to debate on how much of something can someone "really" take, and influence impressionable minds--or minds desperate for opiates willing to buy any story that means more will still be safe.
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JessFR
Bluelight Crew
Before I say this, I wanna emphasize that I don't directly moderate this part of the site. I'm assigned to provide assistance to the mods here, but I just wanna be clear that this post is intended just as my opinion.
OK so, I would argue that it is not automatically wrong to say that you've survived something that is dangerous. Provided you're clear that it is in fact dangerous.
More than anything else, as I see it the point is to give people an honest perception of the risks. We aren't here to make people's choices for them, or to just tell them not to take risks. We are here to do our best at giving people an accurate idea of the risks related to drugs.
And saying what experiences you have survived is a part of that provided its not encouraging someone to repeat it. And I don't feel simply saying it in itself encourages it.
There's many stupid things I have done and have talked about here on bluelight. If some misguided individual somehow takes that as encouragement to do such things themselves, that's on them. Likewise I have no right blaming anyone else for the stupid risks I took.
That does not mean that you should egg people on, it doesn't mean you should minimize the risks. But just saying that you've survived those risks in itself isn't an encouragement. And I can't say I see the post that was made here as much of an encouragement.
I would emphasize though, that so long as we are holding people accountable for the actions of others. One could make the argument that bumping this post that has laid idle for the past 10 years back to the top can only have done more harm than having done absolutely nothing at all.
It's not wrong to hold concerns about other people's wellbeing here. But simply telling people not to do dangerous things has been a profound failure as a policy. I'd argue it's been shown to be much better to actually discuss the dangers honestly. And the honest truth is there are a lot of stupid risks you can take a hundred times with no ill effect. Or 1 time and face devastating health consequences. Simply saying "it's too dangerous don't do it ever" is not effective harm reduction. It just makes every risk look equally dangerous, or equally not dangerous once people may assume once they realize what they were told wasn't honest.
OK so, I would argue that it is not automatically wrong to say that you've survived something that is dangerous. Provided you're clear that it is in fact dangerous.
More than anything else, as I see it the point is to give people an honest perception of the risks. We aren't here to make people's choices for them, or to just tell them not to take risks. We are here to do our best at giving people an accurate idea of the risks related to drugs.
And saying what experiences you have survived is a part of that provided its not encouraging someone to repeat it. And I don't feel simply saying it in itself encourages it.
There's many stupid things I have done and have talked about here on bluelight. If some misguided individual somehow takes that as encouragement to do such things themselves, that's on them. Likewise I have no right blaming anyone else for the stupid risks I took.
That does not mean that you should egg people on, it doesn't mean you should minimize the risks. But just saying that you've survived those risks in itself isn't an encouragement. And I can't say I see the post that was made here as much of an encouragement.
I would emphasize though, that so long as we are holding people accountable for the actions of others. One could make the argument that bumping this post that has laid idle for the past 10 years back to the top can only have done more harm than having done absolutely nothing at all.
It's not wrong to hold concerns about other people's wellbeing here. But simply telling people not to do dangerous things has been a profound failure as a policy. I'd argue it's been shown to be much better to actually discuss the dangers honestly. And the honest truth is there are a lot of stupid risks you can take a hundred times with no ill effect. Or 1 time and face devastating health consequences. Simply saying "it's too dangerous don't do it ever" is not effective harm reduction. It just makes every risk look equally dangerous, or equally not dangerous once people may assume once they realize what they were told wasn't honest.
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Pickledlemons
Bluelighter
I personally don't like go above 1g of acetaminophen a day, otherwise I feel yucky. Though credit where credit is due, I actually find acetaminophen kills headaches better than any opioid painkiller. but thats just my experience.
JessFR
Bluelight Crew
I've actually had similar experiences. I'm not one of those people who got hooked through legit usage so I dunno, it might well be that I've just been opioid tolerant a long time and never really got a chance to see how effective opioids are for physical pain.
But yeah, for physical pain, I generally find acetaminophen or ibuprofen (or both) are quite a bit more effective than opioids.
Fortunately it's quite rare I have cause to use painkillers for physical pain.
As for the max safe dose of acetaminophen, in most of the world it's 1 gram every 4-6 hours up to 4 times a day for a 4 gram a day total.
Japhy Ryder
Bluelighter
I just found there were remarks that went well beyond simply stating they had survived something. I read it as having an attitude of scoffing risks and then being dismissive of guidelines. Acetominophen is unpredictable about what level of damage it will do.
I'm not talking about being the harbinger of doom voice that just says "don't do it, stay away", I see those often enough and find them irritating and unhelpful. What I am doing is responding to posts that minimize risk and treat caution or respect for a drug as contemptible--the "what do they know" sort of comment. These seem to fly in the face of harm reduction and fall just short of goading on; and in reference to a drug many people don't realise can have potent impact on the liver, let alone that people die of it. It isn't the same as guys goofing around having a pissing contest about their meth or heroin stories, drugs everyone has a sense that they're serious and can be trouble. A lot of people have no idea about tylenol. You end up with kids quaffing bottles of cough syrup for a buzz that end up sick because of the tylenol in it that doesn't even register on people's minds as anything.
Lots of us research and disseminate info about drugs of abuse and often psych meds, but there's a whole class of drugs that are practically invisible as they're considered harmless. I got a shock last year, a friend nearly died--and by that, I mean he spent six weeks on tubes in ICU and was resuscitated three times. He had some kind of hemorrhaging going on that was difficult to contain. The cause it turned out was that he had been using too many advils for too long a time over a bad back. I had no idea you could kill yourself off of what you figured was still within a therapeutic dose of advil. My doc has said go ahead and take it daily, docs here prescribe it at 600mg a pill. I've taken them by the handful--and done worse when they have pseudoephedrine in them and never once thought twice about it.
So, it may be useful when information or questions come up about drugs where there is less awareness, and that have benign reputations, that isn't the time or place for minimizing or bragging about doses you walked away from or casting shade on the idea of caution. I think that is reasonable and not rigid or hyperbolic. Hell, I did a bit of research on baking soda the other day and my findings quite startled me into a more careful and respectful attitude about it. Some substances come with a sign already around their neck saying use at your own risk. Lots of things don't.
Japhy Ryder
Bluelighter
I agree totally on removing the tylenol from opiates. Ironically part of the reason it is there is it is intended as a deterrent from taking too many. That's just willfully ignorant on so many levels. Setting aside how desperate people can be about getting opiates, lots of people are unaware of how toxic too much tylenol is, which makes it a non-starter of a deterrent. I recognise part of the reason is for synergy, same way caffeine is in some light opiate formulas.