We're all gonna die...of liver failure caused by acetaminophen overdose.

Last weekend, This American Life aired a special on acetaminophen, which turned out to be both informative and terrifying. I *highly* recommend listening to the episode.

If you're lazy, let me give you the message that I took home from it: The margin between a safe dosage of acetaminophen and a dosage that can cause liver failure is extremely slim, and it's unpredictable, i.e. different for every person. That means that even if you take just a leeeeetle bit more than recommended, or accidentally take the recommended dose of two products that contain acetaminophen, at the same time (Tylenol PM and NyQuil, let's say, to use an example that may or may not be drawn from personal experience), you could end up with liver failure. And/or death.

The link in the above paragraph is to a ProPublica article, which has a lot of the same information as the TAL podcast, but also additional info as well; ProPublica contributed a lot of the investigative reporting in the TAL piece. The article and its associated features are worth a perusal. But again, if you're lazy, ProPublica has come up with a list of five key takeaways that I'll cut and paste here:

1. About 150 Americans die a year by accidentally taking too much acetaminophen, the active ingredient in Tylenol, federal data from the CDC shows.

2. Acetaminophen has a narrow safety margin: the dose that helps is close to the dose that can cause serious harm, according to the FDA.

3. The FDA has long been aware of studies showing the risks of acetaminophen. So has the maker of Tylenol, McNeil Consumer Healthcare, a division of Johnson & Johnson.

4. Over more than 30 years, the FDA has delayed or failed to adopt measures designed to reduce deaths and injuries from acetaminophen. The agency began a comprehensive review to set safety rules for acetaminophen in the 1970s, but still has not finished.

5. McNeil, the maker of Tylenol, has taken steps to protect consumers. But over more than three decades, the company has repeatedly opposed safety warnings, dosage restrictions and other measures meant to safeguard users of the drug.

A surprisingly large number of people have died from accidental acetaminophen overdose in the past decade (and even more have died of purposeful overdose, but that's a different beast altogether). By contrast, almost nobody has died of naproxen or ibuprofen overdose, though it is true that many naproxen and ibuprofen takers have had stomach bleeding as a result of their usage. Still, if I'm going to pick my poison, I'd rather have a stomach ulcer than a grave.

US deaths by accidental acetaminophen overdoseSource: U.S. Centers for Disease Control and Prevention Multiple Cause of Death database

I don't take much Tylenol as it is, but I'm certainly going to be wary of my acetaminophen dosing from here on out!

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In completely unrelated news, I want to go to there.

Seriously, this stuff is much more compelling than DARE ever was...

First I find out that cocaine can melt your face off, and now I learn that heavy use of marijuana can increase your chances of getting schizophrenia, especially if you use it during adolescence. What! Maybe drugs actually are bad for you!

A recent piece in Neuroscience and Biobehavioral Reviews has reviewed the scientific literature linking cannabis use and adult-onset psychosis/schizophrenia. Distressingly, the piece convincingly argues--using a number of different streams of research (particularly epidemiological (prospective and retrospective) and animal research)--that use of marijuana, at any point in life but particularly during adolescence, is linked (potentially causally?) to "schizophrenia outcomes." Indeed, pretty much all of the reviewed research on the topic that used human subjects, both from Western and non-Western populations, has shown that smoking the giggle weed is associated with a two- to three-fold increase in the risk of developing schizophrenia. The amount/extent of use is a factor as well--in one study of Swedish army conscripts, those who were heavy ganja users at the time of conscription were more than SIX TIMES as likely as non-users to receive a diagnosis of schizophrenia during the 27-year study period.

During adolescence, it is thought that cannabis use interferes with the development of neuronal networks, causing permanent brain changes that raise the likelihood of developing paranoia and schizophrenia. Studies in rats have shown that immature rats are more sensitive to the cognitive effects of cannabis, and that the "detrimental effects of acute cannabinoids on behavior are greater during puberty compared to adulthood." In an imaging study of human adolescents who had "long-term use of cannabis" (side note: how long could that term possibly be?), it was found that cannabis use "was associated with gyrification abnormalities in the cortex, suggesting that early cannabis use affected normal neurodevelopment." That does not sound good.

At this point I should probably pause to point out the obvious fact that smoking the jive stick won't necessarily give you schizophrenia--there are many other factors at play as well. To quote the article I read, "cannabis use is clearly not an essential or sufficient risk factor [for psychotic illness] as not all schizophrenic patients have used cannabis and the majority of cannabis users do not develop schizophrenia." Nevertheless, there is "a developmental link between cannabis and increased vulnerability to behavioral and cognitive impairments."

So here's my advice (kids, listen up): You may not think smoking the Mary J is a big deal now, but you'll be changing your tune when you start hearing God, the Devil and Zeus all talking to you at once, convincing you you can fly and that your coworker is poisoning your lunch. Just saying. You should probably wait to inhale until you're a bit older.*

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In high school, my best friend and I were convinced that Vladimir and Estragon (protagonists in Becket's Waiting for Godot), were super stoned. Why else did they keep waiting/forgetting they were waiting for Godot?

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In other crazy drug-related news, a bunch of people (in Texas and Seattle, according to this article, but California has this issue as well) have recently gotten botulism from black tar heroin. Yes, BOTULISM. The canned food disease. (Evidently this is old news...but it's new news to me, as everything I know about heroin I learned from watching Intervention, and none of the heroin addicts (that I've seen so far) have had to be hospitalized due to botulism.) Most of the heroin-related botulism cases come from wounds associated with injection sites.

(Aside: Remarkably, people have been known to get MULTIPLE CASES of "wound botulism" (as the medical literature calls it) at their heroin injection sites. You'd think once would be enough to learn your lesson, but apparently not!)

Another even more dire potential complication of black tar heroin use is necrotizing fasciitis (aka flesh-eating bacteria), one of the only diseases I can't even read about because it is so utterly terrifying. (Seriously. I didn't even look at the text of that Wikipedia article I just linked to; I don't want nightmares tonight!) There is no way to get rid of botulism from heroin (I have no idea if the flesh-eating bacteria is get-riddable, but let's just assume no), so it's probably best to stay away from the black tootsie roll. Aaaand...that's all I have to say about that.

This has been your PSA for the day. Stay away from the drugs, kiddos.

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*This is by no means an endorsement of smoking weed or any other illegal substances.

Dare to keep kids off drugs?

...Or dare them to do drugs? Let's just tell them about the flesh-eating levamisole that cocaine has allegedly been laced with, then see how bad they want to try it.

According to this article, "69 percent of cocaine shipments seized entering the United States contain levamisole, a veterinary drug linked to serious weakening of the immune system in humans." Says ABC, "the drug, used to deworm cattle, pigs and sheep, can rot the skin off noses, ears and cheeks."  Check out that picture I took from the ABC website. Ew!

This isn't just a sensational news story, either.  Even justice.gov warns of the dangers of laced cocaine--as of 2009, they report, 71% of tested wholesale cocaine samples contained levamisole.  And it's not just cocaine; New York State (from which I am proud to be from!) says that Heroin has also been laced with levamisole.

YUM.  And who said DARE doesn't work!