New York tried to ban sodas larger than 16 ounces. Will the federal government try to ban medication bottles that hold more than 25 pills?
"We need to make it harder to buy pills in bottles of 50 or 100 that can be easily dumped out and swallowed. We should not be selling big bottles of Tylenol and other drugs that are typically implicated in overdoses, like prescription painkillers and Valium-type drugs, called benzodiazepines. Pills should be packaged in blister packs of 16 or 25. Anyone who wanted 50 would have to buy numerous blister packages and sit down and push out the pills one by one. Turns out you really, really have to want to commit suicide to push out 50 pills. And most people are not that committed."
http://www.theblaze.com/blog/2013/06/03 … f-tylenol/
I hope you can see the irony of calling them a "death panel" in this context.
Personally, having to buy two bottles instead of one seems like very much not a big deal. Especially if it does help prevent suicide.
I take blood pressure meds twice a day. I buy them in a three month supply - 180 pills - because it's half the cost of a monthly prescription - 60 pills.
Hate to think what 180 BP pills would do to someone taking them all at once, but would hate even more hitting the drug store weekly and paying 4 times the price.
Bet they are in blister packs though!
We are restricted to buying no more than 16 paracetamol at one go, it's no big deal, unless of course it saves a life, and then it's a really big deal.
Nope - counted out by the pharmacist and dumped into a bottle.
There are some drugs that it makes sense to limit, mostly those that are not expected to be taken long term. Antibiotics, for instance, are very rarely taken for more that a couple of weeks - fine, blister pack individual pills if you want. My wife had a tooth extraction yesterday and got a prescription for a handful of pain pills - again, blister pack individual pills if you want.
Drugs that you will be taking for months on end, though - leave those alone and let the customer buy a 90 day supply or even more. Drug costs are a major cost to many people; lets not make their life any harder than it already is by doubling or tripling the cost of needed meds and making weekly drugstore trips necessary because someone else might use them for suicide.
But not available over the counter though?
Who has ever tried to kill themselves with antibiotics?
Nobody should be taking none prescription painkillers for more than a day or two.
Who CAN kill themselves with antibiotics?!
LET'S SEE HOW YOU LIKE ALL OF THIS PENICILLIN, BODY!! I BET YOU WANNA SHUT DOWN NOW, DON'T YOU?!
I don't know, but I would never have thought of using Tylenol, either.
Pain killers; In my small group of close friends and family, at least 6 have been on painkillers for years for chronic pain management. Whether I disagree with their "treatment" plan or not, millions of people are doing it.
For those who prefer to read the source document rather than the sensationlized
spin offered in The Blaze, here is Dr.Emanuel's actual OpEd from the NYT.
Simple Way to Reduce Suicides
By EZEKIEL J. EMANUEL
Ezekiel J. Emanuel on health policy and other topics.
Tags: Containers and Packaging, Deaths (Fatalities), Poisoning and Poisons, Suicides and Suicide Attempts, Tylenol (Drug)
EVERY year about a million Americans attempt suicide. More than 38,000 succeed. In addition, each year there are around 33,000 unintentional deaths by poisonings. Taken together, that’s more than twice the number of people who die annually in car accidents.
The tragedy is that while motor vehicle deaths have been dropping, suicides and poisonings from medications have been steadily rising since 1999. About half of suicides are committed with firearms, and nearly 20 percent by poisoning. A good way to kill yourself is by overdosing on Tylenol or other pills. About 90 percent of the deaths from unintentional poisonings occur because of drugs, and not because of things like household cleaners or bleach.
There is a simple way to make medication less accessible for those who would deliberately or accidentally overdose — and that is packaging.
We need to make it harder to buy pills in bottles of 50 or 100 that can be easily dumped out and swallowed. We should not be selling big bottles of Tylenol and other drugs that are typically implicated in overdoses, like prescription painkillers and Valium-type drugs, called benzodiazepines. Pills should be packaged in blister packs of 16 or 25. Anyone who wanted 50 would have to buy numerous blister packages and sit down and push out the pills one by one. Turns out you really, really have to want to commit suicide to push out 50 pills. And most people are not that committed.
Sound ridiculous? Consider some data.
In September 1998, Britain changed the packaging for paracetamol, the active ingredient in Tylenol, to require blister packs for packages of 16 pills when sold over the counter in places like convenience stores, and for packages of 32 pills in pharmacies. The result: a study by Oxford University researchers showed that over the subsequent 11 or so years, suicide deaths from Tylenol overdoses declined by 43 percent, and a similar decline was found in accidental deaths from medication poisonings. In addition, there was a 61 percent reduction in liver transplants attributed to Tylenol toxicities. (Although it was a long and detailed study, some studies got a different result. One in Ireland, for example, found no reduction in overdoses.)
Not only can blister packs reduce suicide attempts by adults, but also poisonings of children. After the Food and Drug Administration required blister packaging for iron pills, which cause poisoning death in young children, the number of iron-ingestion calls to poison control centers in the country dropped by about 33 percent and the number of deaths went almost to zero.
Why haven’t we seen more blister packages? One reason is money. Manufacturers would have to redesign packaging, and the blister packaging would cost more compared with loose pills in a bottle. The other main reason is that some consumers — notably people with arthritis — might find it challenging to open the packages.
But considering the tens of thousands of deaths and emergency room visits, these reasons seem a bit feeble. The packaging should be changed.
From http://www.ncbi.nlm.nih.gov/pubmed/15239078 there are about 458 deaths each year from acute liver poisoning due to acetaminophen. The question in the short article is "By enabling self-diagnosis and treatment of minor aches and pains, its benefits are said by the Food and Drug Administration to outweigh its risks. It still must be asked: Is this amount of injury and death really acceptable for an over-the-counter pain reliever?
The answer is yes.
Other recent threads have discussed the legalization of currently illegal drugs; people have the right to take what drugs they like, regardless of potential damage to them or others. Many apply the same reasoning to even hard drugs, drugs that will harm the user.
Here, we see the flip side; we need Big Daddy Washington to protect us from ourselves. Anyone else seeing the irony?
Good points, wilderness.
458 deaths compared to 80,000.
I think 80,000 is a scary number.
I guess by the blisterpack logic, we should get rid of any bottles larger than the airplane size.
Have to agree. If someone wants to kill themselves it's not our right to stop them anyhow (I believe) I would argue there should be such a ban for purchasers under the age of 18 but that is it,
But is it our duty to make it easier for somebody to kill themselves?
No reduction overall in the UK though, maybe we should try blisterpacking bridges!
It isn't good enough to just believe that you are right, you need to back it up. Here's a bit of help
My point was John that although you can only buy 16 paracetamol at a time in the UK suicide rates went up 2010-2011 suggesting those who find themselves unable to go on will find other ways to commit suicide.
For those who suffer the pain of losing a loved one to suicide it matters not how they do it and suicide is never easy whether someone is taking tablets or jumping from a bridge (like my brother in law) it's not easy.
The poiont being that taking pills is easy and can be done on the spur of the moment. Jumping off a bridge requires much more commitment.
The fact that somebody who is determined to end their life can always find a way is no reason not to make accidental deaths or cries for help that go wrong more difficult.
Nor is it a reason to demand that big government play nanny to it's citizens. To help someone in trouble, certainly, but not at the cost of playing nanny to all citizens as if everyone out there is either insane (why else commit suicide) or simply incompetent to care for themselves.
Is the government playing nanny when it prescribes the measure of a gallon or the ounces in a pound?
And levelling a charge of insanity at somebody desperate enough to end their own life is rather lacking in sympathy don't you think?
You're equating setting standard measurement values to telling someone how to live "properly"? What to eat, what to wear, and anything else govt. thinks is unsafe for you?
Lacking in sympathy? I guess I could have used other words, made it PC and all, but it seems to me that anyone wanting to suicide is either in a terminal situation anyway, in tremendous pain all the time (which will drive one insane) or in some not think clearly (definition of insane).
Hardly! They aren't saying you can only buy . . . just you can only buy in small quantities, nothing to stop somebody calling at half a dozen shops and buying a small quantity in each.
If that prevents accidental overdoses and spur of the moment suicides then who am I to begrudge anybody that chance of life?
It's not a matter of PC, it's understanding of the human condition. I could as easily argue that anybody who chooses to carry on living is insane but I suspect that would not be popular..
They are saying you can only buy small, expensive quantities, and in only such a way it poses extra work to get the product out of the packaging. Because, mind you, you are not competent to use the product properly; packaging must be used that will make it more difficult for you to do bad things to yourself. Nanny.
Who are you? You are the person deciding that you have the right to impose extra effort and cost on other people because you think it might help someone. You are the one deciding that you know better than someone else how they should live their life. You are the nanny.
Tylenol, or paracetamol as it is called in the UK, is only available off prescription in quantities of max 16, which is plenty for any of the ailments it is used for. In the UK that quantity is available for about 30p or about 0.46 US dollars.
That will hardly break the bank will it?
Oh the effort of having to go to more than one shop to acquire enough pills to kill yourself and, lawks a mercy, pop them out of their blisters!
I have to agree with John, you don;t have to be insane to want to kill yourself. (All the more reason not to ban it I guess.)
There are certain circumstances I can imagine wanting to, for example discovering I had degenerative dementia.
Sure but now as a sane person, I would rather die than go through it, lose my mind, dignity etc.
I agree - I am a big proponent of assisted suicide. The question becomes, then, do we prevent the sane from suiciding or only the insane.
The sane has every right to buy 10,000 pills; the insane needs a nanny to help him not to.
Sane or insane, nothing to stop anybody from buying 10,000 pills.
I agree, if someone wants to kill themselves they have the right to do so, maybe they have good reason, in a scenario where I was in such a situation I would like to go out on my own terms and I thinks it's unfair to deny that right to others.
It doesn't deny that right to anybody but it does make it a little harder for, say, an emotional teenager who has just split up from their first love and can see no reason for living to actually deprive themselves of the opportunity of proving themselves wrong.
As I noted previously it should be illegal for people under 18/21.
And it makes it a LOT harder for 90 year old grandma, who now has to walk to the drug store weekly and pay 3 times the amount (from a limited, fixed budget) for the meds she needs.
Grandma takes priority, in my mind.
90 year old grandma takes priority over ten year old child.
Perhaps the solution is to pay 90 year old grandmas a big enough pension to be able to afford to pay for the paracetamol that she doesn't need in huge quantities.
Who will pay that pension? The 10 year old child being "saved"?
As usual, John, you and I have much in agreement, right up to the point where lines are being drawn. We both want to help people, keep the suicides alive for treatment. The difference always seems to be that you will go to any lengths in taking care of people, always at someone else's cost, whether they want it or not and whether the one paying wants to or not.
I choose to believe that people have a responsibility for themselves and that it is not ethical to "spread the wealth" by robbing from the rich to give to the poor. Both are necessary to a functioning society, but both need a line drawn somewhere - you do not appear to recognize any line at all until a complete nanny state is formed. One where everyone is catered to and taken care of from birth to grave.
Or if you do have a line somewhere, it is far, far above anything I would consider ethical or moral.
Er, selling paracetamol (Tylenol) in small quantities is all about personal responsibility!!
If you are reducing it to cost, the cost of liver transplants has to be borne by somebody, and they cost far more than blister packs and small quantities of Tylenol,
No, it's not about personal responsibility. It's about John Holden declaring that he feels a personal responsibility for preventing suicides, coupled with a declaration that he has the innate right to demand that everyone else cover the cost of his feeling.
But it's also about the John Holdens of the world that will resort to such tactics as insinuating that the increased societal monetary costs of increased liver transplants caused by selling large containers of paracetamol will be greater than the costs of producing and selling blister packs. A complete falsehood, as I'm sure you would agree if you weren't using it in that manner.
Plus a complete disregard of all other costs, monetary or otherwise. Such as increased use of trees to make the blister pack, increased used of oil for additional travel as well as the pollution that comes with it, increased time required to make multiple trips and loss of buying power to purchase other items. The increased difficulty for some people in getting the pills out of the blister pack and all the increased costs of less dense packaging such as increased freight, larger bulk packages, etc. The list is quite extensive, and while insignificant for one blister pack will add up with millions of such packs - it should not be ignored.
Lets's just stick to the money angle shall we, rather than getting personal.
Trees are grown as a cash crop, the more trees used, the more profitable forestry is.
The oil used for making blister packs is a by product of the oil refined for your car, it would otherwise go to waste if not used for plastics.
Your argument about increased quantities falls flat when you consider that selling smaller packs would result in less quantities being sold.
The few people who have difficulty removing pills from a blister pack would have many other difficulties as well - to the extent where they would have home help who would be perfectly capable of extracting pills from blister packs. Anyway, the blister pack idea is just a distraction, they can, and do, sell paracetamol in containers holding 16 tablets but not blister packed.
All your arguments for costs are insignificant against the cost of a liver transplant, one of which would easily surpass the cost of reduced package size.
Paper may come from a tree farm near you, but everything by me is cut from recreational forests. It's why the gorgeous old growth forests are all gone.
You're seriously comparing two grams of plastic in a blister pack to a gallon of gasoline? Times one million?
You misunderstood the size thing; blister packs of 16 take up a lot more room in a truck than bottles of 150. More volume means more truck loads and more large boxes to hold the bottles or blister packs. It's what happens when large packages are used for small products.
You're minimizing the difficulty people with arthritis have with blister packs. They're hard to open, and it hurts to do so, but if you don't do that you've made it easier to buy and use enough pills to kill yourself with.
Considering all the costs - extra packaging, freight, travel to purchase, etc. and the volume of these cheap analgesics vs the one or possible two extra liver transplants per year (out of 350,000,000 population) I think you'll find that cash wise it will be cheaper to do the liver transplants.
But the biggest objection is that the person needing a liver transplant because of excess use of Tylenol did it to themselves, and did so intentionally. They did not take the pills by accident. The people you want to pay for that stupidity did nothing, yet you want to hold them responsible, both financially and otherwise.
No, no, no, the margin between a therapeutic dose and a toxic dose is very small, small enough for a forgetful person to step over the line.
And one or two extra transplants a year! The population of the UK is much smaller than the US and yet it has saved over 40 transplants a year.
Sorry, but reducing packaging size and using blister packs isn't going to stop anyone from taking 3 pills instead of the 2 they should. Even if they forget they have already taken 2 and don't need the third one. What it WILL do is be of some small help to the person wishing to take 50 as a suicide tool.
40 liver transplants per year, all due to excess tylenol usage? What does the UK do - 50,000 liver transplants each year if you count all those from disease and alcohol usage? I think you've either been smoking something really great or intentionally trying to confuse the reader into accepting that [all liver transplants] = [liver transplants caused by acetaminophen].
60% drop in liver transplants - you work it out, I can't be bothered - too sunny.
You all take far too much acetaminophen anyway.
Not this person. Drugs of all kinds, and particularly pain control drugs, scare me. I don't take Tylenol at all, and probably only 4-6 aspirins per year for pain control.
Me neither, except I take aspirin every day in very small doses to thin my blood.
Unfortunately some people pop none prescription pain killers like sweets, I can't remember the actual US consumption of Tylenol but the figure is frightening.
I do the same - one aspirin per day as a blood thinner - which is why I specified for pain control.
Yes, Americans have become a nation of druggies. The easy and quick way out, but it also leads to laziness and addiction. Which is why I'm afraid of drugs in general.
In terms of nanny things I object to, this would be very, very low in the list because the inconvenience to me is very small, and the potential benefits to others is very high.
Indeed. Quite why a private citizen would need a bottle of 100 loose Tylenol I don't know. The right to do so is maintained here anyway, you just need to buy more units. Big whoop.
Doctors etc will still be able to buy it in bulk. Private buyers will be out the cost of a few grams of plastic. I just can't get too outraged about this. I doubt my pharmacist sells bottles of 100 anyway. I don't recall every seeing bottles that big.
If the market demands 100ct bottles then the manufacturers should be allowed to offer that size bottle. If there is a demand for blister packs by the purchasing public, then manufacturers will produce those. There is no legal Constitutional reason for the federal government (speaking for the U.S.A.) to be involved in this argument at all as per the 10th Amendment and the enumerated powers of the Constitution. If I choose to purchase a 44oz. soda to wash down a few Tylenol, then that is my choice. While I don't think suicide is ever a good answer, I do believe that if someone want to kill themselves they will.
First article stats from CDC on number of suicides and how.
Firearms should come in blister packs, perhaps?
More concerning is alarming rise in suicides among Baby Boomers.
Maybe Tylenol bottle of whatever size should have printed in big, big numbers
the suicide prevention line.
The overuse, dependence on and addiction to prescribed painkillers needs
cooperation of doctors and pharmacists.
http://www.nytimes.com/2013/05/03/healt … in-us.html
Who cares about the small and sometimes frail elderly that have a hard time popping the blister packs, if they die from...well whatever their pills would of helped with then it's a small price to pay for stopping a person from killing themselves, when they don't want to live.
If a person wants to kill themselves, it might not feel right to others, but it is their choice.
Hmmm. You're not very PC are you? The very thought - that people have a choice in how to live (or not) - is totally abhorrent to any good liberal.
Perhaps you should go back to school? Any California college will quickly disabuse you of such quaint notions.
And what about the frail elderly who forgets just how many Tylenol they have taken and destroys their liver, purely by accident.
And they'd remember the blister tab any better if they are that forgetful?
Your right though Wilderness never got exposed to enough college to have them PC'ify me enough....and I"m a male nurse. I've seen patients beg for death, and family members with power of attorney making sure their loved ones live long (often miserable) lives. I just hope that the detached family members get their just reward in the end, when their kids put them in LT care.
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