UT Southwestern Study Finds Common Pain Reliever Can Cause Liver Damage, Especially Mixed With Alcohol

October 14, 1997

DALLAS -- October 16, 1997 -- High doses of acetaminophen, especially when mixed with alcohol, caused liver injury in some patients, reported researchers at UT Southwestern Medical Center at Dallas in today's edition of The New England Journal of Medicine.

Dr. William Lee, professor of internal medicine, and his team of liver-disease researchers reviewed the records of 589 patients who overdosed on drugs and were treated at Dallas County's Parkland Memorial Hospital from 1992 to 1995. From that group he found 71 patients who were hospitalized with liver damage after taking acetaminophen, the most common cause of acute liver failure.

Twenty-one patients in this group accidentally took an overdose of the common pain reliever, and in 13 of these alcohol was a factor in the toxic reaction. The other 50 in the group took an overdose of acetaminophen in attempts to commit suicide; 10, who also had consumed alcohol, experienced significant liver injury.

Surprisingly, accidental overdoses compared to suicidal overdoses of acetaminophen were more often fatal even though the amounts taken were lower. The median dose of an accidental overdose was 11 grams, and it proved fatal for four patients. The median dose of a suicide attempt was 24 grams and proved fatal to one of the patients studied. Acetaminophen was found to be the most common cause of acute liver failure during the study period.

Liver injury resulting from suicidal intent is common in the United Kingdom, but in the United States it is more prevalent among alcoholic or fasting patients, who ingest smaller quantities of acetaminophen for pain relief only, Lee said.

"Our study suggests we should be more diligent in educating the public and physicians about the risks associated with acetaminophen because it's commonplace for people to reach for a bottle of pain reliever without thinking about possible complications," said Lee, who directs the Liver Diseases Clinical Center at UT Southwestern's James W. Aston Ambulatory Care Center.

Lee speculates that acetaminophen causes liver damage in alcoholic or fasting patients because alcohol and fasting deplete the body of glutathione, a detoxification agent normally found in large quantities in the liver.

He cautions that even people who aren't alcoholics but consume alcohol before or after taking acetaminophen can experience liver damage.

"In light of these findings, I think we should use this study not as a condemnation of over-the-counter pain relievers that contain acetaminophen but as a means to educate people that these drugs should be used responsibly," Lee said.

The majority of patients Lee studied purposefully or inadvertently took amounts far greater than the 4 grams (eight tablets) per 24-hour limit listed on the packages of most brands.

Other findings of the study:
This news release is available on our World Wide Web home page at http://www.swmed.edu/home_pagesnews/

UT Southwestern Medical Center

Related Alcohol Articles from Brightsurf:

Alcohol use changed right after COVID-19 lockdown
One in four adults reported a change in alcohol use almost immediately after stay-at-home orders were issued: 14% reported drinking more alcohol and reported higher levels of stress and anxiety than those who did not drink and those whose use stayed the same.

Changes in hospitalizations for alcohol use disorder in US
Changes over nearly two decades in the rate of hospitalizations and in-hospital deaths from alcohol use disorder in the US were examined in this study.

Associations of alcohol consumption, alcohol-induced passing out with risk of dementia
The risk of future dementia associated with overall alcohol consumption and alcohol-induced loss of consciousness in a population of current drinkers was examined in this observational study with more than 131,000 adults.

New alcohol genes uncovered
Do you have what is known as problematic alcohol use?

Does estrogen influence alcohol use disorder?
A new study from researchers at the University of Illinois at Chicago shows that high estrogen levels may make alcohol more rewarding to female mice.

Sobering new data on drinking and driving: 15% of US alcohol-related motor vehicle fatalities involve alcohol under the legal limit
A new study in the American Journal of Preventive Medicine, published by Elsevier, found that motor vehicle crashes involving drivers with blood alcohol concentrations (BACs) below the legal limit of 0.08 percent accounted for 15% of alcohol-involved crash deaths in the United States.

Alcohol-induced deaths in US
National vital statistics data from 2000 to 2016 were used to examine how rates of alcohol-induced deaths (defined as those deaths due to alcohol consumption that could be avoided if alcohol weren't involved) have changed in the US and to compare the results by demographic groups including sex, race/ethnicity, age, socioeconomic status and geographic location.

Cuts in alcohol duty linked to 2000 more alcohol-related deaths in England
Government cuts to alcohol taxes have had dramatic consequences for public health, including nearly 2000 more alcohol-related deaths in England since 2012, according to new research from the University of Sheffield's School of Health and Related Research (ScHARR).

Integrated stepped alcohol treatment for people in HIV care improves both HIV & alcohol outcomes
Increasing the intensity of treatment for alcohol use disorder (AUD) over time improves alcohol-related outcomes among people with HIV, according to new clinical research supported by the National Institutes of Health.

The Lancet:Targets to reduce harmful alcohol use are likely to be missed as global alcohol intake increases
Increasing rates of alcohol use suggest that the world is not on track to achieve targets against harmful alcohol use, according to a study of 189 countries' alcohol intake between 1990-2017 and estimated intake up to 2030, published in The Lancet.

Read More: Alcohol News and Alcohol Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.