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Should DayQuil Be Legal?

theargumentmag.com

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Re: Should DayQuil Be Legal?

#241

Earlier quoted context omitted.

And, all of this, to avoid selling a little bit of the narcotic codeine. Which was technically permitted to be sold "behind the counter" without prescription, but was made Schedule II as part of cough syrup in the US not long ago. (It used to be Schedule III or IV when combined with homoatropine or promethazine).

100% I wonder if the cost benefit analysis would show that this is still the best policy - I.e. are more people dying because of overdose of acetaminophen than would have from “behind the counter” + controlled acquisition of codeine products. I would also imagine that the compliance / nationwide tracking is now much easier than when the legislation was initially conceived.

I think it was a mostly innocent bystander, because they decided to put codeine-combination painkillers (Vicodin, etc.) in schedule 2 but wrote it as just opiate combination medicines.

Re: Should DayQuil Be Legal?

#242
post #240

I had a cold a year or two ago, I had used the last of a bottle of actually working cough medicine, attempting to buy a replacement failing to do so, I found it had been banned. Turns out the active ingredient was morphine, which is apparently quite an effective decongestant in very low doses(and variants have been used as such for thousands of years) That started me on a quest for a good cough medicine. My research…

Adderall (amphetamine) is a very effective decongestant. And it helps you get more work done!

Re: Should DayQuil Be Legal?

#243

Earlier quoted context omitted.

Yes. 4g is generally considered perfectly safe and is fairly commonplace dosing. 7g can kill you. Hence a therapeutic index of This is why you have to be very, very careful. If you're doing 8 500mg Tylenol pills and then you also do 6 doses of DayQuil or Mucinex without realizing it's also acetaminophen, you can end up needing a liver transplant.

I wonder why it is not a more commonplace useage for suicides. Females seem to enjoy overdoes more, and men seem to enjoy violent ways. But female sucicides often "fails", seems like eating a box of Tylenols (here they come in 20 packs) would solve the "being alive" issue quite quick, no? Better not tip people off... :) >end up needing a liver transplant You won't get one nor should you get one if the reason is this.

Calling women females and men men in the same sentence is really something. Same with the smiley face in a comment about suicide.

Intentionally overdosing on Tylenol gives you a day or so afterwards to panic and seek medical attention and probably live instead of dying a horrible death. More violent means do not give you any time to retroactively back out of it.

And, yes, in America at least, some lucky people do get liver transplants after acetaminophen overdoses, occasionally even intentional ones.

Re: Should DayQuil Be Legal?

#244

Earlier quoted context omitted.

Ibuprofen isn’t much better, unfortunately.

The therapeutic index for ibuprofen is considerably better: it's around 10, fairly similar to alcohol. Accidental overdoses of ibuprofen are rare. The main issue with ibuprofen is that it can have fairly annoying (but non-life-threatening) side effects like stomach upset and GI bleeds even with normal dosing.

> The main issue with ibuprofen is that it can have fairly annoying (but non-life-threatening) side effects like stomach upset and GI bleeds even with normal dosing.

Those side effects are more problematic when used chronically. This is when acetaminophen shines, because it has virtually no side effects at all when used as directed.

Re: Should DayQuil Be Legal?

#245

Earlier quoted context omitted.

I think the thing is that there is no official accepted value of LD50 for THC since there has never been a recorded death from THC: > The median lethal dose (LD50) of THC has been determined in various animal species through oral administration and ranges from 800 to 9000 mg/kg. In humans, there have been no recorded instances of fatal overdoses resulting from acute THC use. However, estimates for a potentially letha…

It's not true that there has never been a recorded death from THC. A quick literature search turned up: B. Hartung, S. Kauferstein, S. Ritz-Timme, T. Daldrup, Sudden unexpected death under acute influence of cannabis, Forensic Science International (2014), http://dx.doi.org/10.1016/j.forsciint.2014.02.001 . Case report of two otherwise-healthy 20-something men who died of cardiac arrhythmia's following large marijuan…

Those appear to be reports of cannabis poisoning.

Without even considering the veracity of the reports, cannabis is not the same thing as THC.

In illegal markets product safety is not assured, there are plenty of examples of cannabis being treated with other drugs, not to mention simple unsafe horticultural practices.

Re: Should DayQuil Be Legal?

#246

Earlier quoted context omitted.

It just seems like a quick patch that doesn't acknowledge or address the root cause: that the FDA is supposed to be regulating both safety and effectiveness, but it is largely abdicating the "effectiveness" role over to companies' marketing departments. If corporate marketing can convince the public that the serpensoleum drug works, then that's enough to put it in a shiny box in the drug store.

The problem is that you're butting up against the highly profitable cult of ignorance. For instance if something isn't intended to actually treat a disease, then it's basically exempt from FDA regulation as it's a "supplement". Then the seller is free to imply whatever they want, regardless of efficacy. I'm advocating something that ideally can sit in the middle of the two philosophical/regulatory regimes with more p…

Yea don't even get me started on the "supplements" loophole. There are so many problems to solve. Making even small amount of progress towards fixing anything would be miraculous, given the economic forces wanting to make the problems even worse.

Re: Should DayQuil Be Legal?

#247

Earlier quoted context omitted.

"Caveat Emptor" and "Do your own research" is not a basis for a functional society. Providing reading material is not a sufficient substitute for regulation in a country like the USA where 54% of adults read below a sixth-grade level. And letting marketing decide what counts as "accurate information" is just letting the fox guard the henhouse.

> Providing reading material is not a sufficient substitute for regulation in a country like the USA where 54% of adults read below a sixth-grade level This is obvious, but thank you for putting it so succinctly. One has to wonder how much support for "do your own research" is driven by people who want to remain proudly-in-denial about their own inabilities.

It's no surprise that the political party/forces pushing on policies that result in worse education and literacy outcomes are the same ones who want "Buyer Beware" and "Do your own research" to be fundamental product regulatory principles.

Re: Should DayQuil Be Legal?

#248
> Most studies have found that dextromethorphan performs the same as a placebo

The citation linked does not support this claim. In fact it suggests the opposite:

"Dextromethorphan was tested in three of the included studies (Lee 2000; Parvez 1996; Pavesi 2001). One report on a series of three successive studies on a total of 451 adults favoured dextromethorphan 30 mg given in a single dose to placebo in terms of cough counts (measured through cough acoustic signals using a microphone on the nose) and subjective visual analogue scales (Parvez 1996). Differences in mean changes of cough counts between active treatment and placebo varied from 19% to 36% (P value A study involving 44 participants tested a single 30 mg dose of dextromethorphan versus placebo (Lee 2000). Both treatment groups showed a decline in cough frequency (from 50 to 19 per 10‐minute period in the active treatment arm compared with 42 to 20.5 in the placebo arm, P value = 0.38 at 180 minutes follow‐up). Mean subjective cough scores showed a decline from 2.0 to 1.0 in the active treatment group compared to a decline from 2.0 to 1.5 in the placebo group (mean difference in decline in cough scores 0.5 at 180 minutes, P value = 0.08).

Pavesi and colleagues also tested a single 30 mg dose of dextromethorphan versus placebo (Pavesi 2001). Outcomes were measured through a three‐hour continuous cough recording, measuring cough bouts, cough components, cough effort, cough intensity and cough latency. Average treatment difference was 12% to 17% in favour of dextromethorphan for cough bouts (P value = 0.004), cough components (P value = 0.003) and cough effort (P value = 0.001), with an increase in cough latency (P value = 0.002)."

Two out of the three studies found DXM was effective in adults. The studies did not find the same efficacy in children but that could be due to differences in dosage (adult dosage is 30mg, child doses vary based on body weight) or in measurement techniques (as far as I can tell the child studies measured results via parental survey as opposed to more objective techniques like cough recordings).

Re: Should DayQuil Be Legal?

#249

The article kinda glossed over it, but one fact under-appreciated by the general public is just how dangerous acetaminophen overdoses can be . Scientists often talk about the "therapeutic index" or "safety ratio" of a drug. It's the LD50 (dose at which 50% of recipients die) divided by the effective dose. Common hard drugs like heroin or methamphetamine have a safety ratio of about 6-10 [1]. "Soft" drugs like marijua…

Replacing Aspirin with Acetaminophen/Paracetamol was absurd. Reyes’s syndrome was nowhere as prevalent as acetaminophen overdoses, which are a horrible way to go.

Re: Should DayQuil Be Legal?

#250
post #240

I had a cold a year or two ago, I had used the last of a bottle of actually working cough medicine, attempting to buy a replacement failing to do so, I found it had been banned. Turns out the active ingredient was morphine, which is apparently quite an effective decongestant in very low doses(and variants have been used as such for thousands of years) That started me on a quest for a good cough medicine. My research…

Adderall (amphetamine) is a very effective decongestant. And it helps you get more work done!

Well that's a bad sign. I'm managing the tail end of a cold again at the moment and I'm already taking dexamphetamine.
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