Acetaminophen, known by brand names like Tylenol or paracetamol, is a common over-the-counter medication. It relieves mild to moderate pain and reduces fever. Used globally for ailments like headaches, muscle aches, and cold symptoms, its accessibility makes it a household staple.
Normal Use of Acetaminophen
Acetaminophen is designed for oral consumption, available as tablets, capsules, or liquid. When taken by mouth, it absorbs primarily through the small intestine into the bloodstream, exerting therapeutic effects. Absorption rate can be influenced by factors like gastric emptying time. This method ensures controlled and predictable absorption, its intended use.
Immediate Physical Impact of Snorting
Snorting acetaminophen, or any powdered substance, harms the delicate tissues of the nasal passages and respiratory system. Insufflating crushed pills introduces fine particles and chemical irritants into the nose. This causes irritation, burning, pain, and inflammation within the nostrils and sinuses. The foreign powder damages the fragile mucous membranes lining the nasal cavity, which are not designed to process solid particles.
Such trauma can result in nosebleeds, chronic runny nose, or nasal congestion. Repeated snorting can lead to severe damage, including erosion and perforation of the nasal septum, the cartilage dividing the nostrils. This destruction can extend to the throat and respiratory tract. Irritation also increases the risk of localized sinus infections due to disrupted natural protective barriers.
Internal Body Effects and Overdose
While snorting acetaminophen causes direct nasal damage, the drug can still absorb into the bloodstream through the nasal mucosa. This absorption is often unpredictable, leading to rapid, uncontrolled entry into the system, bypassing normal digestive processes that regulate absorption.
The primary concern with acetaminophen overdose, regardless of administration route, is severe liver toxicity. In the liver, acetaminophen metabolizes, forming a toxic byproduct called N-acetyl-p-benzoquinone imine (NAPQI).
At normal doses, the liver’s natural antioxidant, glutathione, neutralizes NAPQI. With an overdose, glutathione supply becomes overwhelmed and depleted. This allows NAPQI to accumulate and bind to liver cells, causing widespread cellular damage and necrosis. This can lead to acute liver failure.
Symptoms of acetaminophen overdose can be delayed, often not appearing for 24 to 48 hours. Initial symptoms may be non-specific, resembling flu-like illness, including nausea, vomiting, loss of appetite, and general malaise. As liver damage progresses, severe symptoms develop, such as abdominal pain, jaundice, dark urine, and confusion. Beyond the liver, overdose can also lead to kidney damage, such as acute kidney injury.
Seeking Emergency Help
Immediate medical attention is important if someone has snorted acetaminophen or is suspected of an overdose. Do not wait for symptoms to appear, as significant internal damage can occur before any outward signs are visible. Early intervention can significantly improve outcomes and prevent severe complications.
Contacting poison control (1-800-222-1222 in the United States) or emergency services (911 or your local equivalent) is the recommended course of action.
Medical professionals will assess the situation, determine the amount of acetaminophen involved, and initiate appropriate treatment, which may include administering an antidote like N-acetylcysteine (NAC). This professional medical assessment is essential, even if symptoms are not yet apparent, due to the delayed and serious nature of acetaminophen toxicity.