I am a practicing doctor and I don't know where this is coming from.

Paracetamol and Ibuprofen while they have potentially lethal side effects are incredibly safe and effective in daily practice and consequently are very widely used. Every known drug has side effects and if you ever read a drug insert you would never pop a pill again. In the case of ibuprofen/paracetamol we are careful to avoid use in patients with ulcers, elevated blood pressure, liver or kidney disease, alcoholics or allergy to either drug.

Unlike opioids they don't cause dependence and their anti-inflammatory effect is very useful post trauma. Most patients self regulate their dosage and usually taper down within a few days. Used in combination a more nuanced effect can be achieved with lower doses.

Paracetamol toxicity in particular frequently occurs in the context of attempted suicide, alcohol abuse or mental impairment and requires a huge pill burden 20 - 24 pills ingested at once or about a 6 - 12 pills in repeated doses over multiple days. This is not as common as you would assume.

Surgery without anaesthesia is cruel and abusive. NSAIDS are not always the right call,but given a choice they are a good alternative.

Tldr: they are dangerous in theory but safe in practice.

No I would not.

> I am a practicing doctor and I don't know where this is coming from.

Well, on the front page at the moment is this: Ibuprofen alters human testicular physiology including testosterone production https://news.ycombinator.com/item?id=16254760

And this has been doing the rounds as well: Acetaminophen reduces empathy for pain https://news.ycombinator.com/item?id=14683173

I'm fortunate enough to never had need to take either, except after having my wisdom teeth out I took a few paracetamol with hydrocodone tablets.

I'm not suggesting that taking a few doses here and there is anything to be concerned about.

What worries me is that some people are consuming probably too much over probably too long and having subclinical negative health outcomes as a result.

> the lethal dosage is equivalent to about 20 pills.

It's really hard to accidentally eat 20 pills, especially when the usual does is about 4 per day...

Recommended dosage, which most people take more of – take two every couple of hours, and you're going to need a new liver. And when you're in pain, it's easy to loose count.

Which is why in some countries, the maximum amount allowed over the counter is 16ct or so (sometimes a bit more when bought from a pharmacist who can make sure the buyer is aware of the dangers). It is irresponsible to sell a 1,000 ct bottle of pills, yet the grocery store near my house does, over the counter even.

I just looked at my ibuprofen bottle and it says to take one 200mg tablet every 4-6 hours. That's 800-1200mg per day, which is not something to worry about.

Certainly if you ignore that and take a higher dose or take it more frequently you can have problems, but assuming you don't have existing liver issues and aren't drunk all the time, you need to take like 5x (or more) the recommended dose to run into any trouble. If you're that stupid, you deserve what's coming to you.

What I'm getting at is: what happens if you take 800-1200mg per day for, say, ten of days at a time, or even hundreds of days.

What if they buy the 16ct packs over multiple days and overdose on them?

the idea is to reduce risk, not eliminate it. thinking is, if you need 1000ct of any drug, you should probably see a health professional first; if you're going through the effort (and extra cost) of buying 63 packs of it, then there's probably nothing that could be done to stop you from whatever you are trying to do.