ACSH friend Dr. Aric Hausknecht takes issue with the July 4th advice tweeted by Surgeon General Jerome Adams, which recommended the use of IV Tylenol for post-operative pain. The New York neurologist and pain management physician gave us exclusive permission to print his response to Dr. Adams.
Bad headlines are ... bad. Sometimes they're bad enough that they screw up the story to the point where the headline says one thing and the paper, study or story says another. The folks at the Hospital For Special Surgery in New York did just that, by issuing a press release which suggested that Tylenol is useful for pain following hip replacement. But the study says no such thing. In fact, another study says it's useless.
Johnson & Johnson, the makers of Tylenol, have some 'splaining to do. It would seem as if the company is using some unsavory marketing tactics to boost sales of its product. How so? For starters, the company has informed us that Tylenol is not an opioid. Who knew? What's the reason behind this odd claim? Better keep reading.
The pain relief counter in your pharmacy can be a confusing place ... enough so to give you a headache. But actually, it can all be very simple. There are four over-the-counter painkillers, some of which can be taken together and some of which can't. Here's the scoop, presented in a way that's easy to swallow. 
Tylenol (acetaminophen) is very widely used for various types of pain, and to reduce fevers. The drug is also largely perceived as safe and effective. We've already written that it's not all that safe. But does it work well? The answer is: Not even close. Multiple Cochrane reviews make this clear.
Over-the-counter drugs – especially for coughs, colds and insomnia – are routinely combined with pain medications. This is usually unnecessary and possibly dangerous. So why are these drugs in there? It's due to unethical marketing by drug companies. Not cool, guys. 
It's relatively easy to accidentally overdose on acetaminophen. The compound is found in headache and cold medicine. When people get sick, they often take a combination of over-the-counter drugs to relieve symptoms. But there may be an option.
Acetaminophen has become the go-to analgesic for many painful conditions. And when used appropriately, it can be effective for headaches and fever reduction. But it's not useful for inflammatory conditions like arthritis, and it can have a significant downside if used in excess.
It is no secret that the U.S. has an enormous narcotic addiction problem, and that much of this can be traced to overprescription beginning in the 1990s. In a recent NY Times op-ed, Dr. Richard Friedman blames most of this on physicians. But it's just not that simple.
We tend to think of over the counter (OTC) drugs for pain relief as interchangeable but this can be a dangerous misconception.
All too often, parents give only an approximate amount of medicine to their ill children, trying to follow label directions for teaspoons or other kitchen measurements. Doctors have been guilty of this and it has led to catastrophic overdoses. The AAP says: stop! Measure accurately.
Josh Bloom in Medical Progress Today, August 6, 2013 As if the FDA doesn't have enough to do. Yes, they sure do, but this didn't stop them from issuing a warning last week that is so ridiculous that it gave me a headache.