The most common pain reliever in the world is associated with risky behavior

Recent evidence suggests that one of the most commonly consumed medications in the U.S. – and the most commonly used analgesic worldwide – can do much more than simply eliminate headaches.

Acetaminophen, also known as paracetamol and which is widely sold under the Tylenol and Panadol brands, also increases risk-taking, according to a September 2020 study that measured changes in people’s behavior under the influence of common over-the-counter medications.

“Acetaminophen seems to make people feel less negative emotions when they consider risky activities – they just don’t feel so scared,” said neuroscientist Baldwin Way of Ohio State University in September 2020.

“Given that nearly 25 percent of the U.S. population takes acetaminophen each week, reduced risk perception and increased risk-taking could have important effects on society.”

The findings add to recent research that suggests that the effects of acetaminophen on pain reduction extend to a variety of psychological processes, reducing people’s susceptibility to hurt feelings, experiencing reduced empathy, and even numbing cognitive functions.

Similarly, recent research shows that people’s affective ability to perceive and assess risks may be reduced when they take acetaminophen. Although the effects might be negligible, they are certainly worth noting, given that acetaminophen is the most common ingredient in the drug, and is found in over 600 different types of over-the-counter and prescription drugs.

In a series of experiments involving over 500 students, Way and his team measured how a single dose of 1000 mg acetaminophen (the recommended maximum single dose for adults) randomly assigned to participants affected their risk behavior compared to those randomly given to the placebo control group. .

In each of the experiments, participants had to inflate an uninflated balloon on a computer screen, and each individual pump earned imaginary money. Their instructions were to make as much imaginary money as possible by inflating the balloon as much as possible, but to be careful not to throw the balloon, in which case they would lose money.

The results showed that students taking acetaminophen were at significantly higher risk during exercise, compared with the more cautious and conservative placebo group. On the whole, those on acetaminophen pumped (and burst) their balloons more than controls.

“If you don’t want to take a risk, you can pump a few times and then decide to cash in because you don’t want the balloon to burst and lose money,” Way said.

“But for those on acetaminophen, as the balloon grows, we believe they have less anxiety and less negative emotions because of the size of the balloon and the possibility of it bursting.”

In addition to simulating balloons, participants completed surveys during two experiments, assessing the level of risk they perceived in various hypothetical scenarios, such as betting daily income at a sporting event, jumping bungee from a high bridge, or driving a car without a seat belt.

In one study, acetaminophen consumption appeared to reduce the perceived risk compared to the control group, although in another similar study the same effect was not observed.

Overall, however, based on the average of the results of different tests, the team concludes that there is a significant relationship between taking acetaminophen and choosing a higher risk, even if the observed effect may be negligible.

In this regard, they acknowledge that the obvious effects of drugs on at-risk behaviors could be interpreted in other types of psychological processes, such as reduced anxiety.

“It could be that as the balloon grows in size, those on the placebo feel more and more anxious about the potential outbreak,” the researchers explain.

“When anxiety becomes too much, they end up testing. Acetaminophen can reduce that anxiety, leading to greater risk-taking.”

Research into such psychological alternative explanations for this phenomenon – as well as research into the biological mechanisms responsible for the effects of acetaminophen on human choices in such situations – should be addressed in future research, the team said.

While in this, scientists will undoubtedly also have future opportunities to further explore the role and effectiveness of acetaminophen in pain relief, after studies in recent years found that in many medical scenarios the drug may be ineffective in pain relief and sometimes no better than placebo , with reference to other types of health problems.

Despite the seriousness of these findings, acetaminophen still remains one of the most commonly used drugs in the world, considered a key drug by the World Health Organization, and recommended by the CDC as a primary drug you should probably take to relieve symptoms if you think you may have coronavirus.

In light of what we learn about acetaminophen, we might want to reconsider some of those tips, Way said.

“Maybe someone with mild COVID-19 symptoms might not think it’s risky to leave their home and meet people if they take acetaminophen,” Way said.

“We really need more research on the effects of acetaminophen and other over-the-counter drugs on the choices and risks we take.”

The findings are reported in Social cognitive and affective neuroscience.

A version of this article was first published in September 2020.

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