Comment by cowlby
9 hours ago
I keep reading about this lately but what doesn't make sense then is how few deaths/injuries there are relative to how much acetaminophen is consumed. If tens of millions take it every day, that's billions of doses a year of acetaminophen. Why don't we see MORE injuries/deaths?
"Acetaminophen toxicity is the second most common reason for liver transplantation worldwide and the most common cause of acute liver failure in the United States. Responsible for 56,000 emergency department visits and 2600 hospitalizations, acetaminophen poisoning causes 500 deaths annually in the United States."
56,000 emergency room visits is the key here, because "the mortality associated with acetaminophen overdose is low if recognized and treated within the first 8 hours after an acute ingestion."
So I guess it depends on if you think 56,000 is low or not.
Source: "Acetaminophen Toxicity", David H. Schaffer; Brian P. Murray; Babak Khazaeni. 2026/02/19. https://www.ncbi.nlm.nih.gov/books/NBK441917/
About 50% of overdoses are intentional (especially suicidal teenagers), with the other 50% accidental.
So when pondering the issue of numbers, it matters what path people took to overdose.
For all accidental acute poisonings leading to hospitalizations from OTC drugs amongst adults and adolescents, the top culprits are:
1. Acetaminophen: Dangers noted in article, and stats given in my parent comment
2. NSAIDs: "NSAIDs are ingested commonly in overdose, however severe toxicity is rare"
3. Salicylates "Severe salicylate poisoning follows ingestion of greater than 500 mg/kg". For an adult weighing 150lbs that is 68kg, which means severe poisoning requires 34g of aspirin, which at 325mg per pill is 104 pills total. Hardly easy to do this accidentally.
[1] "Acute poisoning: understanding 90% of cases in a nutshell", S L Greene, P I Dargan, A L Jones, Postgrad Med J 2005;81:204–216