A sign in my local Kroger store. Julia Hubbel

The bad news/good news world of research into what we put into our bodies

Some years ago I interviewed then-Washington State Attorney General Christine Gregoire for a cover story for Spokane Woman magazine. Gregoire had been a leader of a team of AGs who’d taken on, and won, the battle against Big Tobacco to take down its advertising. I asked her if anyone would ever have the guts to do the same with alcohol. She said no, unequivocally. Not only had our experience with Prohibition shown that this was impossible, there’s just too much money in moonshine. The worldwide value of the booze business is expected top 1.75 trillion by 2024.

There is no way those who have a vested interest in that kind of coin are going to cooperate simply because it’s a health risk. Not on your life, even if there is plenty of evidence that alcohol use, even moderate, can cost you your life and those of people you love.

For those who have argued strenuously that their grape juice has to be alcoholic, there’s this:

No alcohol safe to drink, global study confirms
Bad news for those who enjoy what they think is a healthy glass of wine a day. A large new global study published in…

From the article:

A large new global study published in the Lancet has confirmed previous research which has shown that there is no safe level of alcohol consumption.

…Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.

This is one hell of a lot easier pill to take if you, like me, are a teetotaler. I’ve been that way for life, having had a single drink one time only. I was ten; I drank six big glugs out of a bottle that I thought held water. It turned out to be vodka. While it was funny later, it wasn’t at the time. That my father and brother were both alcoholics, and those addictions cost them their health and their lives, also influenced my decision.

Perhaps more so, I left home very young and have lived alone most of my life. I am at risk in the world quite enough as it is without further making myself vulnerable by not being in complete control of my faculties at all times.

Photo by Omar Lopez on Unsplash

I have always hated the sick-sweet smell of alcohol, alcohol breath, and the simply awful behaviors of those under the influence. Mean drunk, nice drunk, makes no diff to me. Drunk is drunk, and drunk is dangerous. Especially if you are female, single, and in a world designed by men for men. Drinking, especially heavy drinking, in remote places, in such a world is Just. Plain. STUPID.

But that’s just me, and my opinion is meaningless. Still, there was something kinda righteous about reading the study. It confirmed what I intuited: there is no “good” level of alcohol. There is only calculated risk, which varies considerably by individual.

In the same way, you and I play a bit of Russian roulette when we take any kind of drug as well. No matter how “safe” we are told a drug may be, nothing you put down your craw is innocent, including water. There is a payment for all substances, again, depending on our own unique systems and bodies. To that, there was this a significant study done on the one drug that I understood to be the least offensive of all the pain meds you and I might ingest: acetaminophen. Being a bleeder, I can’t take aspirin. Acetylsalicylic acid is potentially deadly for me, and any derivatives like Ibuprophen work the same way. So as with all pills we might pop or bark we might bite into, it’s a substance, and every substance carries some kind of risk.

This Elemental article caught my attention, given that I have to use this alternative to aspirin and other painkillers:

New Study Says Common Painkillers Could Make People Riskier
Surprising effects on the brain found in widely used over-the-counter drugs

From Britt’s article:

Acetaminophen, the pain-killing ingredient in Tylenol, alters a person’s perception of risk, potentially leading to behaviors they would otherwise not consider, preliminary new research suggests. The drug can also lower physical pain caused by emotional distress such as hurt feelings and even lessen our empathy for other people, other research finds. (author bolded)

In that way that too many of us listen to those slick drug ads, you might well have read the first part of what I bolded and skipped over the cost. So let me tease it out: YOU might be able to reduce physical pain caused by emotional distress, which is good for you. AND you might well lessen your empathy for others in the process, which is lousy not only for you but for everyone else.

There is distressing research which shows that as a society we already are caring a lot less about others:

Speaking of Psychology: The decline of empathy and the rise of narcissism
There's scientific research to back up the notion that Americans are caring less for others and more about themselves…


Shocker: Empathy Dropped 40% in College Students Since 2000
You wind up with a society that teaches kids that "you're on your own" and that helping others is for suckers. A…

We see this lack of regard and respect for others in society in general, with the rise of social media. I wonder how much of this is also due to the increasingly widespread use and abuse of Tylenol, which may well suppress the very feelings that make us human?

I can’t know. But it’s worth asking. Because if one of the side effects of numbing our pain is also numbing us to the pain of others, that might explain why we tolerate abuse, blame the victim, tolerate racism and a great many other rather striking — and growing- aspects of our society. I don’t see the same kinds of shifts in other parts of the world. It seems to be uniquely American, where we pop an awful lot of painkillers. This article speaks to that, and while it addresses opioids, please note that acetaminophen is often a key component in those drugs:

Analysis | Americans use far more opioids than anyone else in the world
The number of opioid prescriptions has decreased in the past few years, after more than a decade of explosive growth…

In all fairness to all of us who have to use something, I am in no way saying take nothing. I couldn’t function without a migraine med once a month. My point is more so the same kind of risk assessment that a competent, caring healthcare provider makes when giving you a recommendation: you weigh risks vs. benefits. If what you get is greater than the price you have to pay (in side effects) then you buck up and bolt it down.

We might want to be a lot more aware and mindful of what we do bolt down. That’s asking a lot in a society which increasingly wants a pill to “make it all go away.” The problem also comes, as with my male family members, that using drugs or alcohol or both to make anger go a way actually fuels that very anger.

What we consume in terms of the toxic drug of outrage and ugliness online is as much medicine as anything else, but that’s another article. We might find that by drastically reducing the outrage drug we might also drastically reduce the need for pain medication and alcohol, but that’s just me.

For Tylenol, which is in damned near everything from cough meds to codeine meds to cold meds, there are new indications that there are more dangers than people had previously thought. It isn’t just that people overdose on acetaminophen and end up with liver failure. It’s apparently a lot more serious than that. Here is the study from Britt’s piece:

Effects of acetaminophen on risk taking
Acetaminophen, the active ingredient in Tylenol ® and nearly 600 other medicines, is taken each week by an estimated…

From the study:

With nearly 25% of the population consuming acetaminophen each week (Kaufman et al., 2002), reduced risk perceptions and increased risk taking could have important societal effects. Many areas of daily life require making decisions that involve the processes examined here. For example, many patients in the hospital have acetaminophen in their systems when presented with risk information and asked to make potentially life-changing risk assessments such as whether or not to do an invasive surgery. Similarly, when driving, one is regularly presented with decisions that involve risk perception and assessment. Thus, it is imperative that we understand acetaminophen’s effects on choices made and risks taken. Risk perception and risk taking are judgments and decisions that can affect many aspects of our lives, and this common, over-the-counter drug may influence this process, unbeknownst to the millions taking the drug.

Put very, very simply: people taking Tylenol have impaired judgement about risky behaviors, and when asked, deny it, because they aren’t cognizant of those changed behaviors.

In other words, they’re drunk. That’s how I read it. They behave with reduced awareness of risk, they are more likely to deny that they do it. Sounds drunk to me.

But there’s more. From Britt’s article:

Ibuprofen appears to alter emotions, too. One study found it makes women feel less social pain, but it makes men feel it more. And in unpublished research still in progress, Way and colleagues are “seeing effects of ibuprofen on blunting perceptions of emotion as well,” he says.

Interestingly, there may be ways which either or both of these drugs and similar compounds may help ameliorate depression or social distress. The question remains, at what cost? For if we take drugs to reduce our awareness of our pain and in the process we fail to see others’ pain, that potentially reduces empathy even more.

Photo by Aarón Blanco Tejedor on Unsplash

As someone who has to depend on Tylenol for pain medication, this gets my attention. I already use it for various aches and pains, albeit sparingly, unless I’ve hurt myself, which is often enough. Acetaminophen gets dangerous or potentially deadly when we layer all kinds of pain meds with cough meds and other meds which incorporate this supposedly “safe” drug as part of the suite of chemicals used to manage all manner of ailments. It’s up to us to read the labels, know how much we’re taking and not insult our livers and bodies with overdoses. That’s easy to say but a lot harder to do, if for no other reason than the list of ingredients in most of the products is in such small type face that it’s nearly impossible to read.

On top of that, as with alcohol or any drug, how much is too much depends. It depends on everything from age, body weight, gender, our unique body chemistry, what we ate or didn’t eat that day, you get it. That’s why general recommendations are just that: general guidelines.

As I read the research for this article, it strikes me- and I am hardly the first person to pose this question- if by blunting our perceptions of our own pain we blunt our ability to love, to feel, and to care for others. For my part, I see that in how we treat people of color, the aged, each other based on differences of opinion ranging from our choice of sports teams to elected officials. I saw how alcohol and chronic drug abuse turned the two men in my family into selfish, self-centered human beings, defensive about any kind of feedback and protective, above all, of their access to their drugs of choice.

Photo by Laurynas Mereckas on Unsplash

From where I sit this morning, about to head into surgery this Wednesday, the challenge of pain management is front and center. I will be managing that pain for the short term. Long term, I have little interest in having a stash available just in case life gets hard. It IS hard. Running from it doesn’t teach me how to manage it better. Anesthetizing myself to life’s hard knocks reduces my resilience, while at the same time potentially causing me to have less patience and little care for those around me who also have pain.

Pain has a purpose. Physical pain is the body’s signal that it’s in trouble.

Psychic or emotional pain is the mind’s signal, the heart’s signal, that there is deep work to be done.

I’ve had my share of both. Because of that, and my willingness to address that pain, I have great empathy for others’ pain.

In a conversation with Rosenna Bakari this morning (yesterday was her birthday) we shared how our bodies pain us in response to triggers caused by early childhood sexual abuse. As tempting as it is to bury that pain under a weighted blanket of drugs, I won’t. Like Dr. Bakari, I’d much rather walk through those dark and difficult forests clear-eyed and ready for whatever I may encounter. That is what friends are for. Dr. Bakari is there, as are the best of caregivers, to help us shoulder our pain, not to avoid it.

If we’re anesthetized, we are also anesthetized to others. That’s both inhuman and inhumane, which, if I may, is where we are headed as a society if the last four years are any marker.

No drug is a safe drug, no drink is a safe drink. Regularly consuming outrage as our national social media drug of choice doesn’t seem to be a particularly helpful diet either.

Pain is a teacher, a guide and a signpost. If I’m blinded to where my pain is pointing me, I will never find my way out of the woods. Rather, given the choice, I’d rather have the love and compassion from those who have walked their own paths.

Too bad you can’t bottle empathy. That’s a drug we could all use in greater supply.

Photo by Annie Spratt on Unsplash