A young woman in the late teens called 911 after she swallowed a whole bottle (100 pills) of a common fever and pain medicine called Tylenol (generic Acetaminophen). She was depressed and despondent because her family didn’t understand her. She also took another bottle (more than 3/4 full, unknown quantity) of Tylenol PM (acetaminophen + diphenhydramine) a common OTC (over the counter) drug sold as a non-habit forming pain reliever and nighttime sleepaid. She said she wanted to end it all, but then got scared and called for help.
She had ingested these pills about 6 hours ago and had begun to vomit before calling. She admitted to vomiting some pill fragments.
When I talked to her, she admitted she had made a mistake, and wanted to live not die.
Fortunately her vitals signs were normal, she was alert and completely with it but her blood work showed an elevated acetaminophen level and signs of liver injury. Her EKG (electrocardiogram) was normal.
RM is only 21. “Don’t be surprised doc. He’s tiny!” His nurse informed me before I stepped into the room. So he was. Tiny (barely over 5 ft, under a hundred lbs) and young. His innocent face belied the colorful life he’d led so far. RM had been admitted because he had popped a couple of fentanyl tablets he’d bought on the street (the same drug that was found in Prince’s and Tom Petty’s system). When I inquired why, he said he’d been taking the drug for the past 6 months or so; 2 to 3 a day “to get high that’s all” he informed me as if talking about the weather. “No, I don’t want to kill myself but I get depressed sometimes;” was his response when I asked if he’d had any intention to cause harm to himself. I tried to maintain a straight professional face but I was flabbergasted. I was shocked he was still alive. The lethal dose of fentanyl is very small– a quarter of a milligram, and this young man had consumed several times that. He was one hell of a lucky boy.