If 2 Painkillers Are Banned, What Next?(ng abused. We want to get tighter contr...),Health

Using two pills instead of one, if needed, would enable physicians to better fine-tune the amount of each drug that their patients would be getting, reducing the risk of an overdose of acetaminophen. An estimated 42,000 Americans are treated in hospitals each year for acetaminophen overdoses, half of which are accidental.

"I agree in theory with what they [the FDA advisers] are doing because ... even though experts say 4,000 milligrams [of acetaminophen] is a toxic dose, some people believe as little as 2,000 can cause liver problems," said Dr. Joseph Shurman, chairman of pain management at Scripps Memorial Hospital in La Jolla, Calif.

And some people can achieve pain relief from just one of the components in Percocet, he explained.

Oxycodone alone is "probably just as effective for pain," Shurman said. "Tylenol [acetaminophen] theoretically is for pain and fever, but some people question if it has an anti-inflammatory effect. We're not sure of the exact mechanism."

Currently there is no pill that contains hydrocodone alone, but Shurman said that a slow-release version is close to arriving on the market.

Patients and doctors do need to guard against using too much of either the narcotic or the acetaminophen if only one is being taken at a time, Shurman said.

But an even bigger concern, he said, is use of over-the-counter acetaminophen products, of which Tylenol and Excedrin are among the most popular.

"People can walk into [a store] and buy a bottle of Tylenol and take 10 pills of 500 milligrams each so it's over the toxic level," Shurman said. "We know that a significant number of patients don't follow doctor's directions, especially if they're in pain."

The FDA panel called for lowering the recommended maximum daily dose of nonprescription acetaminophen, which is currently 4 grams -- equal to eight 500-milligram
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