Can a Painkiller Kill Empathy?

Pharmacists are well aware of the risks associated with acetaminophen overuse.

Acetaminophen has been implicated as the No. 1 cause of acute liver failure in the United States, and its presence in multiple OTC products only amplifies this risk in the general population.¹ For this reason, pharmacists are trained to counsel patients on the maximum daily dose of acetaminophen and help them identify products that include acetaminophen.

Pharmacists shouldn’t focus solely on potential hepatocellular damage, however, as a recent study suggests empathy may also be negatively affected by acetaminophen overuse.²

Empathy, or the ability to understand and share the feelings of others, is an important characteristic of health care providers, but can frequent use of acetaminophen cause us to become more callous? To answer this question, a team of researchers exposed study participants to situations aimed at eliciting empathy.²

A total of 80 college students were randomized to receive an acetaminophen 1000 mg solution or placebo solution. After an hour elapsed, the researchers asked the participants to review several short stories. These stories consisted of varying sad scenarios, including one describing an individual battling to overcome the loss of his father.

Each study subject was asked to rate the severity of the pain of the individual in the scenario. While the placebo group rated it highly, the acetaminophen group didn’t.²

In a second study, noise blasts ranging from 75 to 105 decibels were sounded over a period of 2 seconds. Study participants were asked how unpleasant they perceived the situation and how unpleasant it would be for others.

Those in the acetaminophen group neither deemed the noises highly unpleasant, nor believed they would be unpleasant for others.²

Although these findings are interesting, pharmacists’ inherent need to identify the mechanism of action for an effect remains, begging the question: what’s the reason for this reduction in empathy after a single dose of acetaminophen?

It’s been hypothesized that there’s an overlap between empathizing with another individual’s pain and processing our own. Evidence for this hypothesis stems from previous neuroimaging studies revealing activation in the same area of the brain during the experience of actual physical pain and during an empathetic response, and the recent findings seem to correlate with this evidence.

Acetaminophen not only dulls our physical pain, but could also limit our ability to empathize with the pain of others. This information is troubling for health care providers because empathy is the cornerstone on which patient-centered care is built.

References

1. Shega JW, Morriseey MB, Reid MC. An interdisciplinary look at labeling changes for acetaminophen and the implications for patient care. The Gerontological Society of America. tylenolprofessional.com/assets/v4/gsa-report-acetaminophen.pdf. Published 2011.

2. Mischkowski D, Crocker J, Way BM. From painkiller to empathy killer: acetaminophen (paracetamol) reduces empathy for pain. Soc Cogn Affect Neurosci

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2016 May 5. doi: 10.1093/scan/nsw057.