Tylenol and alcohol a dangerous mix: Nunavut’s coroner

Nunavut’s Office of the Chief Coroner is warning Nunavummiut to watch their use of the over-the-counter painkiller acetaminophen. (IMAGE FROM FAMILIES.COM)

Nunavut’s Chief Coroner, Padma Suramala, is warning Nunavummiut to watch their use of the over-the-counter painkiller acetaminophen in combination with alcohol following the deaths of three people this year.

So far in 2014, the coroner’s office says it has registered three fatalities due to overdoses of prescription acetaminophen, a pain reliever commonly packaged under the brand name Tylenol.

All of those cases were in Iqaluit.

In March 2014, a 45-year-old woman died from acetaminophen toxicity, or poisoning, Suramala said in a news release.

A month later a 71-year-old elder died at Qikiqtani General Hospital due to acetaminophen toxicity and liver failure.

The coroner said investigations later confirmed the two people had received prescriptions for Tylenol.

And just this month, a 45-year-old man died from an acetaminophen overdose along with liver and kidney failure, while a fourth possible case of acetaminophen overdose is under investigation.

In an effort to prevent similar deaths in the future, the coroner’s office said Nov. 5 that it will recommend that the Government of Nunavut’s Department of Health look at its prescribing and monitoring protocols for Tylenol.

“Tylenol is effective in treating pain, but the risk of harm, when used in error, is high,” said a Nov. 5 release from the coroner’s office.

“[The] drug is available in lethal amounts over the counter. People are assuming that because it’s available over the counter [it’s] safe to take at any dose.”

But exceeding the daily maximum dose can cause liver failure and death, the coroner’s office warns. And when taken in combination with alcohol, even lower doses of acetaminophen can cause death.

Nunavummiut need to understand how to use the painkiller before it’s consumed, the coroner’s office urged.

The coroner’s office confirmed that two of Nunavut’s acetaminophen overdose cases have been classified as suicides.

And that’s not uncommon — Statistics Canada shows the medication was taken in nearly 300 suicides across the country between 2000 and 2009.

But in a Toronto Star investigation published earlier this year, the newspaper revealed the high risk of adverse reactions to acetaminophen or unintentional overdose.

The Star found that since 2006, medical examiners have investigated at least 156 deaths in Canada where acetaminophen was deemed to be the sole or contributing cause in accidental or unclassified deaths.

And between 2000 and 2009, Statistics Canada has tracked 253 accidental deaths where acetaminophen was a major or contributing cause of death.