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What Are the Signs of an Acetaminophen Addiction?

Acetaminophen addiction can be subtle, often starting with exceeding recommended doses for pain relief. Watch for signs like increased tolerance, withdrawal symptoms, and neglect of responsibilities. If you're taking more pills than prescribed or using them compulsively, it's time to seek help. Are you recognizing any of these patterns in yourself or a loved one? Let's examine the next steps together.
Valerie Goldberg
Valerie Goldberg

Acetaminophen, used to treat pain and fevers, is found in many over-the-counter and prescriptions medications. Many people use some form of acetaminophen on a regular basis for headaches, colds, toothaches and other common ailments. It generally is considered safe if taken as directed, though excessive use can cause health concerns and lead to acetaminophen addiction. Signs of addiction include using the medication even when no symptoms are present, withdrawal effects and liver problems.

If a person has a headache or a backache, he or she may choose to take the proper dosage of acetaminophen as listed on the medication's container. For over-the-counter acetaminophen medications, the dosage typically is one or two pills for an adult every four to six hours. People who take a regimen of pills multiple times a day even though they feel fine may be suffering from an acetaminophen addiction. These people also may keep an abnormally large supply of the pain killers on hand.

Adults should typically only take 1-2 Acetaminophen pills at a time to relive pain.
Adults should typically only take 1-2 Acetaminophen pills at a time to relive pain.

People who abuse acetaminophen medications may suffer from withdrawal symptoms if they stop taking the drugs cold turkey. A person who only takes acetaminophen when appropriate, such as for an occasional headache, should not experience any symptoms as the pill wears off. A person suffering from acetaminophen addiction, on the other hand, may suffer from nausea, anxiety, excessive sweating and other withdrawal symptoms if he or she stops taking the pills. These symptoms of withdrawal and similar symptoms can occur when a person is addicted to over-the-counter acetaminophen or a much stronger prescription medication containing acetaminophen.

Taking large amounts of pills multiple times a day is a sign of an acetaminophen addiction.
Taking large amounts of pills multiple times a day is a sign of an acetaminophen addiction.

A person who secretly abuses acetaminophen medications for a great length of time may eventually show signs of acetaminophen addiction in the long-term damage the medicine can cause to the body. Acetaminophen can cause severe liver damage if a person overdoses on the drug or uses too much of it for too long of a time period. A person who is having liver trouble may show visible signs by developing jaundice. Jaundice sufferers have a yellow tint to their skin and eyes. If a person is addicted to acetaminophen and develops jaundice, then he or she should see a doctor immediately to get treatment and prevent the problem from worsening.

A person suffering from an acetaminophen addiction may experience anxiety and excessive sweating.
A person suffering from an acetaminophen addiction may experience anxiety and excessive sweating.

Even if a person has legitimate pain, taking too much acetaminophen can have a negative impact on his or her liver. Patients with chronic pain should work with a doctor to develop a pain management plan. Abusing over-the-counter acetaminophen medications to control the pain is not an appropriate alternative.

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Discussion Comments


I have fibromyalgia and chronic pain. The past six months, I've been taking between four and six 500- mg. acetaminophen every three to four hours, thinking that they were the regular strength. I had been on the internet looking for rebound headaches from taking acetaminophen (which is said to occur) and when I saw the severe possible damage of taking too much of it, I stopped abruptly out of fear. I don't have any of the classic overdose symptoms (nausea, vomiting, jaundice, upper gut pain, diarrhea), but now that I've stopped taking it, I'm feeling very "odd" and not myself. Naturally, the pain that was being blocked by it is still there, strangely, it's not as severe.

I had talked to my son who is very knowledgeable about natural remedies, and he said to do a detoxifying cleanse for my liver. That made sense to me, so I'm in the process of finding the right combination of naturals to do that for me. But, this being day two of not taking the high doses of the drug, I just feel fidgety and hyperactive, and of course, I'm in more pain than when I was taking them. However, I am on Ultram (tramadol) for my moderate to severe pain, and I take one to two a day of them, should probably add a third, as I was originally prescribed.

I am aware that there is acetaminophen in the Ultram, but I am not as concerned about that because I believe it may do a couple of things. One, help me "wean" off of the over the counter form of acetaminophen, and two, come back to control the pain it was intended for in the first place. I feel that by taking the additional doses of the acetaminophen, I had cancelled out the Ultram's effectiveness. Now, I fear for the upcoming days and weeks as I avoid the over the counter version, because withdrawal isn't something I'm a stranger to. I just never would have ever dreamed I'd be withdrawing from something seemingly as innocuous as acetaminophen. I can only pray I haven't already done damage to my liver and other internal organs.


I was taking Tylenol extra strength for about five or six months and Ibuprofen before that, taking about eight to 10 caps a day. At the time, I didn't think anything of it because it would help with the pain from a labor intensive job I had.

So around the end of December, my wife convinced me to stop taking them because they were terrible for my liver. After reading about them, I agreed to stop. Well, the first week of January was my first week without them, I was having panic attacks, anxiety, no appetite really sick, no sleep -- you name it. I went to the doctor thinking something was very wrong with me, but all the tests came back negative.

I had panic attacks and anxiety once before and that was from quitting smoking pot. I had them for about two or three weeks and then they subsided.

So I talked to doctors and different people who all told me that there was "no way" I could be having withdrawals from Tylenol extra strength. This was very demoralizing because now I believed I was losing my mind.

After hunting around on the internet, I've found a few articles, including this one, about long term use of acetaminophen, pain killer abuse and withdrawal effects.

So my question is, I had one week of solid anxiety and panic attacks after I stopped taking the pills, but it tapered off at the end of that week and then I went a whole week feeling a little crappy but no panic attacks. I thought,"Yay, it's over," but now this past Monday I had it start up again and this week have felt crappy. I don't miss the pills or feel like, "Oh God, I need a Tylenol," but I think my body might feel differently.

Is it possible to have withdrawals taper off for a week and then come back on the third week?

I'm so glad I found this article, because I was beginning to think I was just losing my mind. --J


@myharley - I understand what you are going through as I used to take acetaminophen for headaches on a regular basis.

When I read on the box and heard several news stories of possible liver damage, I decided I needed to find another way to control my headaches.

I have found a couple natural things that work for me. One of them is taking some Feverfew capsules. This is a natural herb that is supposed to help with headaches.

I also have some wintergreen essential oil that I rub on my temples if I feel a headache coming on. This oil contains an ingredient that is similar to aspirin.

I was desperate to find something else to use as I didn't want to feel like I was addicted to the acetaminophen. There are days though, that these natural products don't cut it, and I breakdown and take some acetaminophen.

I don't worry about it as much because I am no longer taking it on a regular basis though.


I don't think I am addicted to acetaminophen, but am always worried about possible liver damage from taking it on a long term basis.

I have had headaches for as long as I can remember. Several members of my family also struggle with these.

I used to take ibuprofen for my headaches, but began having stomach problems, so needed to switch to something else.

I don't think any of the over the counter pain medications are good for you over the long term, as all of them have their side effects.

I began taking one acetaminophen every morning to keep my headache at bay. I found that if I took it first thing in the morning, that is all I needed to take.

If I waited until I had been up for a couple of hours, then my headache was really bad and I could hardly function.

My doctor said that taking just one a day like that would not have long term side effects for me. If I was prescribed other medications, they could be worse.

My dad just learns to live with the nagging headache he has all the time, but I can't function when I have a headache like that. When they get really bad I get nauseated and sick to my stomach.

Since I take this to prevent a headache from coming on, I wonder if I possibly am addicted to them?


@Mae82 - If your mother is really struggling to quit taking acetaminophen I would give your pharmacist and family doctor a call and let them know what is going on. It may be an issue of needing to wean your mother off the pain killers she is familiar with so she can transition to something that won't hurt her.

I know when my dad was fighting with his addiction to pain killers that it was really hard for him to break his habit. Some of the addiction can actually be a fear of the pain the medicine is seen as protecting them from. If you and your mother have a good relationship, try talking to her about things in a non-threatening way. Ask her why she needs the pills, and why won't another one do.


I am at no risk of ever becoming addicted to acetaminophen. It causes a strange side effect when I take it, and even the doctors I have told about it are puzzled.

Acetaminophen makes my throat sore. It kind of resembles the slight swelling at the beginning of a sickness, but it goes away on its own. If I take it at night, my throat will be sore in the morning.

I don't think I'm allergic to it, because it doesn't swell much. When I take acetaminophen mixed with other drugs, like cough syrups with pain medicine in them, I don't suffer the same effect.

Has anyone else noticed this strange side effect? One good thing about it is that it makes me avoid taking the drug whenever possible.


My mother has been using acetaminophen for years to deal with her chronic headache and I am worried that taking so much of it may have some adverse affects on her health. She seems to not want to give up her medication and despite her doctor telling her to switch to another pain pill she hasn't yet.

If my mother continues to take acetaminophen, even after being told to stop, is there anything I can do to get her to quit?

She is in real pain so I don't want to make her think that I am not just going to sit back while she suffers. I really want to help her, but not at the expense of her liver getting damaged.


@orangey03 – I was addicted to painkillers containing acetaminophen, and the withdrawal symptoms kept me from trying too hard to quit taking them. The pills soothed not only my pain but also my nerves. Without them, I was shaky and panicky.

I started taking them after a car wreck that injured my leg. I loved the feeling that they gave me so much that I lied to my doctor and told him that I was still in pain long after the pain had gone away. I got more pills this way.

When I finally decided that using painkillers for a long time would probably kill me in the end, I tried to quit. I got really hot and nervous. I felt like something was wrong, but I could not define it.

I went back to the pills several times before finally enduring the withdrawal symptoms until I had kicked the addiction. I never want to feel that way again, so I stay far away from the painkillers.


I had no idea that regular old acetaminophen could be addictive! I used to take it quite often for headaches, and I never felt weird without it.

I understand how higher doses could cause addiction. I have taken a prescription pain pill containing acetaminophen before, and it made me feel happy. My pain was gone, and I suddenly got the sensation that everything in the world was exactly as it should be.

Low dose acetaminophen does not make me feel this way at all. In fact, it only gets rid of minor headaches. If I ever had a migraine, it would do nothing for it.


My father-in-law was injured severely during combat overseas decades ago. After he got through the initial surgery and recovery, his doctor told him to take over-the-counter acetaminophen for his pain.

His body had been so traumatized that he stayed in pain all the time. He took acetaminophen every day as often as he could. Today, he has liver damage because of it.

He will likely die at a much younger age than normal because of his compromised liver function. He did not realize all those years ago that taking acetaminophen regularly and often would have this effect.

He has since started taking a different medication for pain. He does not want to risk further damage to his liver.

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    • Adults should typically only take 1-2 Acetaminophen pills at a time to relive pain.
      By: Johan Larson
      Adults should typically only take 1-2 Acetaminophen pills at a time to relive pain.
    • Taking large amounts of pills multiple times a day is a sign of an acetaminophen addiction.
      By: emiliau
      Taking large amounts of pills multiple times a day is a sign of an acetaminophen addiction.
    • A person suffering from an acetaminophen addiction may experience anxiety and excessive sweating.
      By: camrocker
      A person suffering from an acetaminophen addiction may experience anxiety and excessive sweating.
    • Excessive use of acetaminophen may lead to liver damage and numerous other health problems.
      By: Alliance
      Excessive use of acetaminophen may lead to liver damage and numerous other health problems.
    • People most often reach for acetaminophen to combat headache pain.
      By: vladimirfloyd
      People most often reach for acetaminophen to combat headache pain.
    • Long-term use of acetaminophen may cause severe liver damage.
      By: acherst
      Long-term use of acetaminophen may cause severe liver damage.