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Comment by _delirium | Hacker News Reader

> I found it bafflingly expensive in the US.

Brand-name Tylenol is relatively expensive, but generic acetaminophen/paracetamol is dirt cheap in the US. Here are 200 tablets of 500 mg each for $4.00, i.e. $0.02 per tablet: http://www.walmart.com/ip/Equate-Extra-Strength-Value-Pack-A...

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Here's 1000 for less than $11.

http://www.costco.com/Kirkland-Signature%E2%84%A2-Extra-Stre...

Is this a late April fool's joke?

In Switzerland, I _can't_ buy more than ~2 [1] packages with 16 pills (500mg acetaminophen/paracetamol) at a time without a prescription from my doctor. And the biggest package size is 100, but that always needs a prescription. Also, you can only buy it at a pharmacy anyway.

[1]: it depends a bit on the pharmacy/pharmacist, sometimes you can get away with 3, but they start asking questions and propose you just come back again when you used up the 2 packages they are willing to sell to you.

The Netherlands might be the closest country to Switzerland where you can buy lots of painkillers for cheap. Germany is also expensive.

It's not a joke! In Canada, go to the pharmacy section of any large supermarket and you can easily find large bottles with 500 tablets of 500mg acetaminophen/paracetamol. Even small pharmacies carry bottles with 100-200 tablets of Tylenol (branded product) or a generic version.

you can buy paracetamol in packs of 200? jeez. isn't this one of the main killers, though overdoses (many accidental)? i'm pretty sure size for otc sale is regulated in other countries.

paracetamol is nasty stuff - dying from it is not pleasant, and it's surprisingly easy to do.

I believe there isn't currently any mechanism for the U.S. FDA to restrict number of pills sold of OTC medication, only the contents of each individual pill and the dosage instructions. The assumption is that OTC means purchase itself is unregulated, so you can order a truck-load if you really want to stock up.

The only cases I'm aware of where purchase numbers are limited for OTC drugs is when separate laws targeting drug precursors impact them, which is why you can't buy large numbers of pseudoephedrine tablets at once (they can be used to manufacture meth).

The FDA does seem to be reducing the maximum dosage of each tablet, though: from 2014 the maximum will be 325mg, so the 500mg tablets linked above will be phased out. But that change seems aimed at reducing accidental liver damage from excessive "normal" use, rather than aimed at reducing suicides from deliberate overdoses.

I believe there isn't currently any mechanism for the U.S. FDA to restrict number of pills sold of OTC medication

There are exceptions (but I'm not sure if they're from the Law Enforcement side, or the FDA). For example, you can't buy Sudafed (whose active ingredient, pseudoephederine(?), is used to make meth) without severe restrictions: not more than a pack a day, need a valid ID, etc.

Potassium is another (more bizarre) example.

http://answers.yahoo.com/question/index?qid=20101219083208AA...

While the limit is indeed bizarrely chosen, I think that one falls into the fairly common case of the FDA setting a per-pill maximum, not a limit on overall quantities. There's a limit of 100mg potassium per pill, but afaict there aren't any controls on buying the supplements in bulk, so you could order thousands of the pills if you wanted. The total-quantity limits seem to only be on things where the DEA has gained some authority over the substance.

Not that easy, can take a couple of days while your liver shuts down. If a family member gets the person to a hospital, they can survive easily enough, but it does some damage to the liver. Horrible way to go :/

> you can buy paracetamol in packs of 200? jeez. isn't this one of the main killers, though overdoses (many accidental)?

Do you (or anyone else) have some concrete data for incidence rate of fatal overdoses in the U.S.? I'm curious if it's really all that common.

One study [1] gives these annual numbers: 56,000 emergency room visits, 26,000 hospitalizations, and 458 fatalities. They further estimate about 75% of the fatalities are intentional overdoses, and 25% unintentional. Though I recall reading elsewhere that the majority of the non-fatal cases are accidental overdoses, e.g. from unwittingly taking multiple products that have acetaminophen as a component.

[1] http://www.ncbi.nlm.nih.gov/pubmed/16294364

So, the incidence rate for accidental overdose is something like .048 per hundred thousand persons, compared to murder which is 4.7 per hundred thousand persons. You are 100 times more likely to be murdered than accidentally overdose on Tylenol. I'm not sure why there is so much concern over this?

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