Opioids Acetaminophen stupidity...please help

[nineteen42]

I'd like to acknowledge that what I have been doing is very stupid and I will do anything to reverse any effects i've caused...

The last four days I've been taking more acetaminophen then apparently I'm supposed to (approx 5-5.5g each day, no more I'm pretty positive) each day these doses were spread out taking no more than 975-1300mg per three hours. I was always under the impression that taking a massive dose at one time is more harmful than spreading it out but I read somewhere that over time is worse...

I've been drinking TONS of water for the past four days (pissing about five times a day, that's not usual for me it's only because of all the water). I've also taken cold showers because I heard that really helps raises the enzyme that detoxifies apap (or something like that.)

I just want to know how serious damage I have caused and if I am in danger of death...or is this worthy of a hospital visit...and I know consulting the internet about this stuff isn't the best course of action but if my mother found out about this she would literally be devestated....so this is what I'm deciding to do first.

It should be noted that I drink very, VERY rarely (hardly even once a month).
Also, 10/325 percocets are what I've been ingesting.
I'll tell my mom and go to the hospital if i must...I just want to see what you have to say.

 

[Oxide]

You shouldn't rush out to the hospital just yet. I had the same worries for awhile, ingesting high amounts of APAP isn't a joke. But because I wasn't doubled over with liver pain I figured I'd just get a blood test to make sure everything was ship-shape. It was, and now I keep APAP ingestion down to 2-3 grams a day instead of 5-6 grams. This still isn't by any means safe or healthy, but harm reduction is the name of the game.

Please stop ingesting high amounts of APAP, get a doctors appointment and have some tests done if you're pretty worried.

 

[NomNomNom]

^ What Oxide said, also:

It's worth the time to look into doing a cold water extraction (CWE) on your pills. It's a lot less complicated than it sounds, will all but eliminate the APAP from your perks, and possibly most importantly, will give you peace of mind.

Use the search function to find out about it. Basically you crush up your pills to a powder, add water, freeze, then strain through a coffee filter. The acetaminophen stays in the coffee filter the perky goodness is contained in the water. You slug that down and you'll be feeling right as dodger's for this after lunch.

^
Don't take my word for it, i may not have the process exactly right, but i didn't want you to be discouraged by a scientific sounding process like "cold water extraction" do a search for CWE or cold water extraction to get the proper directions. Good luck!

 

[nineteen42]

Alright...i'll be making an appointment ASAP. I still am seriously worried though...also I have tried CWE a few times and it just doesnt do it for me, i must be doing something wrong...i'll try again.

Another thing that's really worrying me is I keep feeling these sharp but not very painful little pangs in what may be my liver. I really don't know if it's actually my liver (it takes place in my lower sides all the way up to my high chest sometimes) but i honestly thing it might be my mind making symptoms. It does that sometimes when i'm worried abou something, like when I'm smoking weed sometimes I make myself feel like my lungs are crumbling or my heart is bleeding or some weird shit like that, when there is pretty much nothing going on.

apparenlty you're not supposed to feel any symptoms until it's too late but maybe i am? can anyone describe liver pain?

 

[Tommyboy]

Look at where your liver is located on an anatomy diagram or something. It is just pain in that area.

Milk thistle may help

http://en.wikipedia.org/wiki/Milk_thistle#Toxin-induced_liver_damage

 

[nineteen42]

oh, apparently the liver is in the chest. I had always thought it was down by your hip and that's where all the pangs have been. i guess it's something else, or my hypochondria at work...maybe it's all the water i've been drinking. well i guess its relieving that i don't have liver pain, but then again, the symptoms arent supposed to be there until it's too late...

i haven't been to the doctor since i started taking opiates. I should tell him my addiction when I go in right? i feel like i should be straight forward with the doctor to get the best results. surely he cant do anything right? doctor patient confidentiality?

 

[Tommyboy]

^ You won't get in any legal trouble for telling your doctor that you abuse pain killers.

Also, your liver isn't in your chest. It is above your kidneys on your right side by your lower ribs.

 

[cj]

I doubt you have done any major damage your definatly not gonna die I have personally taken more apap then that and I am still around. Im not saying that because I did it its ok to do or anything but honestly 5 grams isnt an astronomical dose. The liver is an amazing organ it can actually heal itself pretty cool stuff. Dont do it again now if you start vommiting uncontrollably or your eyes turn yellow or something then seek immediate medical aid but I think ur fine.

 

[comatoserct]

I've heard of chronic users taking doses like that daily for months or even longer. The body is strong and a few blows to it probably isn't going to knock it down. I would definitely never do this again, but I feel you should be ok.

 

[amapola]

Hey OP,

Fortunately I highly doubt you'll notice any negative effects from this. Those levels are just barely above the recommended daily maximums and there is a solid safety margin factored in with a 7g dose being considered a beginning to be toxic level in adults. Although it can be lower for more susceptible people, you're also young, barely drink, and are therefore definitely on the low risk end of the scale. It is your life though and you have to be the one to make the decision to seek medical treatment or not. Don't let some stranger over the internet convince you not to if you think you should.

The treatment for APAP poisoning if you are interested is N-acetylcysteine and is available over the counter in most countries. It works by helping inhibit enzymes that start converting APAP into its toxic metabolite when the primary mechanism of APAP breakdown is saturated I believe. Actually I'm not sure maybe it binds with the toxic chemical I don't know. Either way if you've been taking a steady dose each day and damage would be occurring daily as well and I don't know if it would help now or not.

Here is the Cold Water Extraction Mega Thread & FAQ v2.0 so this doesn't occur again.

 

[benzoheadplus44]

This thread actually sort of answered my question that I just had asked five minutes ago in another APAP worry thread. I figured that the FDA or whoever would not set the maximum dose at 4grams a day and "if you go over that you're fucked" kind of thought, otherwise people would be dying left and right (which they already really are, but I mean even moreso).

I could not picture it being 4001 mg and you're dead... even 5 grams a couple of times ( which I don't do, I only take up to the max limit, unless I have a couple hundred of the pills then I would only CWE. But with 30 or so of them I find it not too unnecesarry (spelling? haha) to take up to the max limit. Even though thats not the best idea, I figure it cannot be automatic death, depending on the individual and other factors, like alcohol which I really do not drink all that much. You also won't catch me taking the max with shit like Kava Kava... which is also not good for the liver I understand.

 

[SangerRainsford]

The treatment for APAP poisoning if you are interested is N-acetylcysteine and is available over the counter in most countries. It works by helping inhibit enzymes that start converting APAP into its toxic metabolite when the primary mechanism of APAP breakdown is saturated I believe. Actually I'm not sure maybe it binds with the toxic chemical I don't know. Either way if you've been taking a steady dose each day and damage would be occurring daily as well and I don't know if it would help now or not.

NAC is given in hospitals for apap od's, the pills aren't something i'm sure of though (but i have tried! they are HORRIBLE, i had to eat them over a 20min period ). oh and i think nac (and charcoal) would need to be used pretty quickly after the ingestion (5-10hrs maybe?)

CWE's rule - you do not want to overdose on apap, from what i hear it's a pretty slow, painful death :/

 

[animalpee]

I have heard that it is easier on your liver to take say 4000mg at once, than 500mg 8 times throughout the day. Still not very good for your liver though.

 

[SangerRainsford]

it's the other way around. the liver can handle lower-dosed apap quite well. but, there's a level the liver can't process at once, and whatever's past that becomes pretty toxic.
(someone can correct me, but i believe that's the reason cats would, theoretically, OD on a tiny piece of apap, as that 'level' in them is practically nothing)

 

[dokomo]

The treatment for APAP poisoning if you are interested is N-acetylcysteine and is available over the counter in most countries. It works by helping inhibit enzymes that start converting APAP into its toxic metabolite when the primary mechanism of APAP breakdown is saturated I believe. Actually I'm not sure maybe it binds with the toxic chemical I don't know. Either way if you've been taking a steady dose each day and damage would be occurring daily as well and I don't know if it would help now or not.

N-acetylcystine is available over the counter, however oral dosing of the supplement is very complex (large amounts of the supplement must be taken at strictly times intervals to be effective.) Its seen to be fairly ineffective when administered orally, because it almost always causes nausea and vomiting

A much better over the counter supplement is s-adenosylmethionine (also sold as SAMe or just 'methionine') Its available at almost any health food store or pharmacy. Oral dosing of 2500mg of methionine every four hours for a total of 10,000mg was as effective as IV/inhaled n-acetylcysteine in clinical trials.

Either of these supplements are only effective if taken shortly after the APAP overdose, the sooner the better. If administered within 2 hours of the overdose, the prognosis is good, however it can be effective if administered as long as 8 hours after the overdose.

 

[dropthatpickle]

Nineteen42: You're not alone. 4 yrs ago, I OD'd on APAP by taking +/- 20 AC/C a day(6.5g?) for well over a year. I knew that much was bad, but thougt I was fine bc i never had symptoms. Anyway, the poisoning was discovered in my labs during an ER visit after a wimpy accident. I had to stay in the hospital two weeks. No IVs, treatment was with daily vitamins and Celexa. Also, they tested my blood twice a day.

APAP detox by itself is dangerous. Instead of steadily declining, the amount in your system goes down at first, rises about 36 hrs later and peaks 75% of initial value, then falls again. The hill and valley pattern is repeated (each peak a bit lower than the one previous) until the APAP is flushed from the system. Throughout detox, liver failure remains a risk.

I know my liver has to be fucked up. I obviously can't take anything with APAP or drink alcohol for the rest of my life, but I got off lucky - I've never felt sick and my liver functions all check out normal.

 

[amapola]

Thanks doko I knew there was something like that

Good to hear you got to it before anything too bad happened dropthatpickle! Feel free to give us an update if you get the chance as well OP.