17 ms·

But the "Active dose" to "lethal dose" ratio, aka "therapeutic index" of alcohol is pretty bad.

by aeonik 6d ago

fc417fc802 6d ago
Don't you mean that it's quite good? It's easily more than an order of magnitude for many people (not sure about chronic alcoholics with high tolerance). How many medications can you 5x your dose and not have some risk of ending up in the hospital?
- aeonik 6d ago
  Heroin (IV) ~6x GHB ~8x Ethanol ~10x Methamphetamine ~10x DXM ~10x Cocaine ~15x MDMA ~16x Codeine ~20x Methadone ~20x Mescaline ~24x Flunitrazepam ~30x Ketamine ~40x Phenobarbital ~50x Nitrous oxide ~150x LSD ~1000x Cannabis/THC ~1000x or greater Citation: Gable RS. Comparison of acute lethal toxicity of commonly abused psychoactive substances. Addiction. 2004;99(6):686–696. doi:10.1111/j.1360-0443.2004.00744.x
  - fc417fc802 6d ago
    Well given "therapeutic index" I had said "medication" as opposed to "commonly abused substances". I think your list skews heavily due to psychedelics tending not to be acutely toxic to the same extent as other chemical species. Statins for example are probably 10x to 20x (quick napkin math based on an animal study I found). Tylenol is 10x and is OTC. Personally I consider alcohol to be much safer than many other substances given the form it typically takes. Utterly irresponsible binge drinking aside, most people will suffer serious adverse effects long before they're in danger. Compare that with pills or injections where an OD can be entirely inadvertent even when observing basic common sense.
    - aeonik 5d ago
      Two things: 1. Half of those drugs on the list do have medicinal uses. Even methamphetamine and cocaine are used medicinally (admittedly rarely). 2. Tylenol poisoning is the leading reason for poison control center calls. >80,000 U.S. Poison Control exposure cases in 2021 involving acetaminophen or an acetaminophen-containing product. https://poisoncenters.org/news-alerts/13244374 https://poisoncenters.org/news-alerts/13244374
      - LoganDark 5d ago
        > an acetaminophen-containing product Careful because that's some opioids as well.
      - ButlerianJihad 5d ago
        7-Up contained lithium citrate until 1950. The soda jerks were literally treating manic depression during WWII. There were advertising signs for it at crosswalks on city streets. Make 7-Up Yours, Baby! Any product that contains ethanol but is not intended for consumption will be adulterated with ingredients that make it really unpleasant to consume. Any drug, OTC or sometimes even prescription, that has a risk of abuse, will be combined with another drug that makes it impractical or dangerous to use it recreationally, or isolate it for manufacturing. So the next time you wonder why all your cough medicine has to come with guaifenesin, or you need a psychiatrist to prescribe your lithium carbonate, you can blame all the addicts and Walter Whites out there who ruined it for honest people.
        ButlerianJihad 5d ago
        By the way, Wikipedia attempts to contradict the claim about 7Up containing lithium citrate and says it was never an ingredient. There is no source supporting this claim. An unreliable source, by "Bill Lockhart and Bob Brown" never makes any claim about 7Up's ingredients, but focuses on weirdly-long names that had never been used by the company. On the contrary, multiple sources insist that lithium citrate was in 7Up for decades, and in fact that the FDA had banned this usage in 1948, and that is why it was removed! If it was never in 7Up to begin with, it seems odd to ban a thing that wasn't going on! https://www.snopes.com/fact-check/7up/ https://www.snopes.com/fact-check/7up/ https://medium.com/wise-well/lithium-the-nonessential-element-saving-brains-483e085355b0 https://medium.com/wise-well/lithium-the-nonessential-elemen...

But the "Active dose" to "lethal dose" ratio, aka "therapeutic index" of alcohol is pretty bad.

by aeonik 6d ago

But the "Active dose" to "lethal dose" ratio, aka "therapeutic index" of alcohol is pretty bad.

Don't you mean that it's quite good? It's easily more than an order of magnitude for many people (not sure about chronic alcoholics with high tolerance). How many medications can you 5x your dose and not have some risk of ending up in the hospital?

aeonik 6d ago
Heroin (IV) ~6x GHB ~8x Ethanol ~10x Methamphetamine ~10x DXM ~10x Cocaine ~15x MDMA ~16x Codeine ~20x Methadone ~20x Mescaline ~24x Flunitrazepam ~30x Ketamine ~40x Phenobarbital ~50x Nitrous oxide ~150x LSD ~1000x Cannabis/THC ~1000x or greater Citation: Gable RS. Comparison of acute lethal toxicity of commonly abused psychoactive substances. Addiction. 2004;99(6):686–696. doi:10.1111/j.1360-0443.2004.00744.x
- fc417fc802 6d ago
  Well given "therapeutic index" I had said "medication" as opposed to "commonly abused substances". I think your list skews heavily due to psychedelics tending not to be acutely toxic to the same extent as other chemical species. Statins for example are probably 10x to 20x (quick napkin math based on an animal study I found). Tylenol is 10x and is OTC. Personally I consider alcohol to be much safer than many other substances given the form it typically takes. Utterly irresponsible binge drinking aside, most people will suffer serious adverse effects long before they're in danger. Compare that with pills or injections where an OD can be entirely inadvertent even when observing basic common sense.
  - aeonik 5d ago
    Two things: 1. Half of those drugs on the list do have medicinal uses. Even methamphetamine and cocaine are used medicinally (admittedly rarely). 2. Tylenol poisoning is the leading reason for poison control center calls. >80,000 U.S. Poison Control exposure cases in 2021 involving acetaminophen or an acetaminophen-containing product. https://poisoncenters.org/news-alerts/13244374 https://poisoncenters.org/news-alerts/13244374
    - LoganDark 5d ago
      > an acetaminophen-containing product Careful because that's some opioids as well.
    - ButlerianJihad 5d ago
      7-Up contained lithium citrate until 1950. The soda jerks were literally treating manic depression during WWII. There were advertising signs for it at crosswalks on city streets. Make 7-Up Yours, Baby! Any product that contains ethanol but is not intended for consumption will be adulterated with ingredients that make it really unpleasant to consume. Any drug, OTC or sometimes even prescription, that has a risk of abuse, will be combined with another drug that makes it impractical or dangerous to use it recreationally, or isolate it for manufacturing. So the next time you wonder why all your cough medicine has to come with guaifenesin, or you need a psychiatrist to prescribe your lithium carbonate, you can blame all the addicts and Walter Whites out there who ruined it for honest people.
      - ButlerianJihad 5d ago
        By the way, Wikipedia attempts to contradict the claim about 7Up containing lithium citrate and says it was never an ingredient. There is no source supporting this claim. An unreliable source, by "Bill Lockhart and Bob Brown" never makes any claim about 7Up's ingredients, but focuses on weirdly-long names that had never been used by the company. On the contrary, multiple sources insist that lithium citrate was in 7Up for decades, and in fact that the FDA had banned this usage in 1948, and that is why it was removed! If it was never in 7Up to begin with, it seems odd to ban a thing that wasn't going on! https://www.snopes.com/fact-check/7up/ https://www.snopes.com/fact-check/7up/ https://medium.com/wise-well/lithium-the-nonessential-element-saving-brains-483e085355b0 https://medium.com/wise-well/lithium-the-nonessential-elemen...