Something that may be quite internalized in society is that taking too much of a medication Anyone can have a very harmful effect on the body, and logically we avoid taking a lot of ibuprofen or paracetamol at once. But social networks have taken this as a new challenge which consists of taking paracetamol pills in a group to see who can achieve spend more time admitted in the hospital due to the liver failure it generates.
Crazy. What has been dubbed the “paracetamol challenge” on social media is becoming a real nightmare for emergency and toxicology services. And it is no wonder, since behind the false sense of security that an over-the-counter medication such as paracetamol gives, hides a mechanism of implacable toxicity capable of destroying the liver of a teenager in a matter of hours.
At an international level. The phenomenon is not new, but it has raised alarm bells internationally due to its recent outbreaks. In the United Kingdom, newspapers such as The Independent have been echoed of police warnings after registering cases of teenagers intentionally intoxicated in Soutampaton due to this challenge. And, although the first thing you might think is that it is a suicide attempt, since paracetamol is one of the ways used to do it, the reality is that they do it because of a challenge seen on TikTok.
This too has reached countries like Belgiumwhere health authorities have had to launch a strong alert about videos that encourage people to overdose on this medication.
In Spain. Has not been left behind our country, which has also reported cases of adolescents who have followed this challenge. But to such an extent that in Malaga There have been two hospital admissions due to liver failure due to a drug overdose.
The paracetamol trap. Although it is a medication that can be found over the counter, in the case of Spain, generally the dose is 500 mg, the truth is that it has a great danger behind it, since paracetamol overdose is one of the most frequent and potentially lethal pharmacological poisonings.
But the great deception of this challenge is that symptoms of poisoning do not occur in the first hoursbut a teenager can ingest several grams of acetaminophen and feel at most mild nausea or vomiting. In this way, while the young man thinks that “nothing has happened” and that he has won the challenge to his friends, the liver is silently collapsing.
In days. International clinical guidelines place special emphasis on this: late liver deterioration, since the symptoms of severe liver failure appear only three days after taking the paracetamol overdose. And here on many occasions it is too late to act from medicine, which causes the death of the patient.
The mechanism. Playing the “paracetamol challenge” is, in medical terms, playing Russian roulette, since massive intake of this drug saturates the metabolic pathways of the liver, generating a highly toxic metabolite called NAPQI that destroys liver cells when in large doses. With a normal and scheduled intake, this metabolite is produced, but the liver can control it by transforming it into another product that it quickly discards. But when the amount is very high, the liver literally has no capacity to process it into something less harmful.
The treatment. Right now, the only thing that has shown a reversal of liver damage from acetaminophen overdose is N-acetylcysteine. However, the effect decreases as time passes, and it is ideal to administer it in the first eight hours after an overdose with paracetamol.
The problem is that the teenager can hide that he is beginning to feel bad because he has a feeling of guilt or even fear of the consequences that his actions may have on his parents. This is why it may be the case that you arrive late to a hospital to receive treatment and that the window available to do a stomach lavage or even for a liver transplant to arrive is very small.
Raise awareness. The “paracetamol challenge” is not just another Internet hoax, but rather it is a direct fight against the biology of the human body in which the prize for “lasting longer in the hospital” can be multiple organ failure or ending up on the waiting list to receive a transplant.
In this way, the most important thing is always to make minors aware of how serious it can be to take too much paracetamol, since it is possible that they do not know that something that a priori ‘cures’ their fever or discomfort can end up killing them.
Images | danilo.alvesd
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