Overdoses of the common household drug acetaminophen (the main ingredient in Tylenol) leads to more than 78,000 emergency department visits a year. Consumers take Tylenol to reduce pain or fever, but few of them realize that when misused, acetaminophen can lead to acute liver failure and even death, often due to accidental overdose by an uninformed consumer. However, the According to the Centers for Disease Control (CDC), the majority of them are suicide attempts.

Researcher Daniel Budnitz says, "About 70% (of the emergency room visits) are for self-harm attempts, and 13% to 14% are kids getting into products. The other 16% are the adolescents and adults that generally fall into two groups: the younger adults that are misusing over-the-counter products because they are trying to get better pain control and don’t understand the risks, and the older adults that are making some errors using a combination of products. "If you double or triple the dose of acetaminophen, and you take it for several days, you will cause significant liver problems," Budnitz says.

Rather than a sudden, dramatic reaction, overdose symptoms often occur later. "If untreated, the acetaminophen toxicity can take days, maybe weeks, to manifest itself." Young people ages 15 to 24 are at highest risk for suicide attempts or acts of self-harm involving acetaminophen. Budnitz says, "It is often difficult to determine exactly what motivated the patient to take too much–if they had a premeditated plan to end their life with an overdose or if the overdose was an impulsive act."

Maybe doctors should prescribe more placebos! A recent survey reveals that one in five physicians and psychiatrists in Canada have administered or prescribed a placebo. An even higher proportion of psychiatrists (more than 35%) reported prescribing doses of medication below–sometimes considerably below–the minimal recommended therapeutic level to treat their patients. Prescribing treatments that are active in principle, but that are unlikely to be effective for the condition being treated (such as using vitamins to treat chronic insomnia) is more widespread than the researcher thought, and over 60% of psychiatrists believe that placebos can have therapeutic effects.

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