Acetaminophen, widely recognized by brand names such as Tylenol, is a common over-the-counter medication used for relieving pain and reducing fever. It is commonly used for various ailments. Many wonder if this common drug can produce a “high” or euphoric sensation. This article explores the science behind acetaminophen to answer that question.
Does Acetaminophen Cause a High?
Acetaminophen does not produce a “high,” euphoria, or psychoactive effects. It does not interact with the brain’s reward pathways like substances of abuse, such as opioids. Unlike opioid medications, which bind to specific receptors in the brain to produce feelings of pleasure and pain relief, acetaminophen does not share this mechanism. Any perceived “high” from acetaminophen is likely a misunderstanding or an outcome of significant pain relief rather than intoxication. For instance, individuals experiencing chronic pain might interpret the profound relief from discomfort as a euphoric state.
Acetaminophen is not classified as an opioid. Opioids, like hydrocodone or oxycodone, are often combined with acetaminophen in prescription medications to enhance pain relief, but it is the opioid component that contributes to any euphoric properties. Acetaminophen itself lacks the pharmacological properties for a recreational “high.”
How Acetaminophen Works
Acetaminophen functions as an analgesic (pain reliever) and an antipyretic (fever reducer). Its exact mechanism is not fully understood, but it primarily works within the central nervous system. One key theory suggests it inhibits cyclooxygenase (COX) enzymes, particularly COX-2, which are involved in producing prostaglandins. These compounds contribute to inflammation, pain, and fever.
By reducing prostaglandin synthesis in the brain, acetaminophen helps to lower body temperature and decrease the sensation of pain. Some research also suggests that acetaminophen may influence the endocannabinoid system and serotonergic pathways in the brain, which are involved in pain regulation. However, these mechanisms are distinct from those that produce euphoria or addiction. Unlike NSAIDs such as ibuprofen, acetaminophen has minimal anti-inflammatory effects in peripheral tissues.
Risks of Misuse and Overdose
While acetaminophen does not cause a “high,” taking it in excessive amounts can be extremely dangerous. The primary risk associated with acetaminophen overdose is liver damage, also known as hepatotoxicity. This damage can be irreversible and may result in acute liver failure or even death. Acetaminophen overdose is a leading cause of acute liver failure in the United States.
Symptoms of an overdose may not appear immediately, often taking 24-48 hours to appear. Initial signs can be subtle, such as nausea, vomiting, and malaise, progressing to more severe symptoms like right upper quadrant abdominal pain and jaundice as liver damage worsens. A single ingestion of over 150 mg per kilogram of body weight, or around 7.5 to 10 grams in adults, is considered a toxic dose with a high risk of liver damage. Always adhere strictly to recommended dosage instructions and be aware of acetaminophen as an ingredient in combination medications to avoid accidental overdose.