It’s the most common over-the-counter medication in the UK – a drug taken by millions of Britons every day.
Paracetamol is usually the first thing people reach for when they’re struck down by a cold, or a headache that won’t budge.
But many are unaware of the deadly risks that come with taking too much.
For one student last year, an accidental overdose almost cost him his life – and left him having to learn to walk and talk again.
Riley Lubas, 20, was new to his creative media degree at the University of Bath when he began suffering with what he assumed was the dreaded ‘freshers’ flu‘.
Like thousands of other students each year, he went to his local pharmacy and purchased some medicines: cold and flu tablets, and 500mg paracetamol tablets.
But he didn’t realise that the cold and flu tablets also contained 250mg of paracetamol. And, within days, the simple mistake would plunge him into organ failure.
Paracetamol overdose is, unfortunately, common in the UK – responsible for around 100,000 visits to A&E every year.
An accidental paracetamol overdose almost cost 20-year-old Riley Lubas his life
The mistake plunged Riley into organ failure and left him having to learn to walk and talk again
Around one in four people have exceeded the maximum recommended dose for adults of eight 500mg tablets per day, studies show, which can have fatal consequences.
Around 150 to 250 people die every year in the UK as a result of overdosing.
Taking too much causes the build-up of a toxic liver by-product called N-acetyl-p-benzoquinone imine, or NAPQI.
Normally, the body can neutralise small amounts of NAPQI, but in excess it overwhelms the liver and can cause catastrophic organ damage.
An overdose can initially feel similar to a cold – the very thing most people take paracetamol for – with symptoms including sickness, vomiting and stomach pain.
But in the most severe cases, it can lead to liver failure.
Riley, a bartender from Newport, Wales, says he had no idea he’d taken too much of the drug last March.
He had been taking two tablets of each drug every four hours for four or five days – meaning he had more than doubled the recommended intake of 4000mg to around 9000mg.
‘It wasn’t until I felt my stomach hurting and couldn’t keep food down that my flatmates suggested I call 111,’ Riley says.
It was a decision that ultimately saved his life.
After being told to go to the Royal United Hospital’s emergency department, medics ran tests and discovered problems with his liver.
Soon afterwards he was admitted to a ward. Worried about their son, Riley’s step-father Chris, 40, and mother Kate, 39, rushed to the scene.
‘I think the doctors were concerned it was hepatitis at first (inflammation or swelling of the liver),’ said Chris. ‘It got to the end of the day, so we went home after visiting hours closed.’
But the ordeal was only just beginning for the Lubas family.
‘Hours later, at half one in the morning, I got a call from the ICU staff at the hospital saying we had to get there immediately,’ Chris said.
‘All they could say at the time was they were doing everything they could.’
Chris and Kate feared they were going to lose their son due to the distressing ordeal
When they arrived back at the hospital in the early hours, doctors delivered devastating news: his liver was heading towards failure, which can prove fatal within days.
As medics fought to save him, Chris and Kate could only watch as Riley slipped into a state of delirium and hallucination – a sign of severe liver damage.
Doctors then transferred him to specialists at King’s College Hospital in London, where the situation became critical.
‘By 6pm that night, he was sedated and on life support and dialysis in multiple organ failure,’ Chris says.
Up to 80 per cent of people who suffer multiple organ failure – when more than two organs shut down – do not survive, studies show.
The staff at King’s College Hospital began asking Riley’s family about his medicine intake.
The family then realised he had been unwell for a couple of weeks and contacted a friend at university, who found packets of paracetamol and cold and flu medication in his room.
Riley was immediately placed at the top of the UK’s liver transplant list because doctors suspected an overdose.
However, damage to his heart meant he couldn’t safely undergo the transplant for two full days, during which time he remained under constant monitoring.
Riley thought he had been struck down by freshers flu but accidentally overdosed on the painkillers
Medics told Chris and Kate the damage to Riley’s liver was ‘as good as irreversible’ – leaving them on the brink of losing their son.
But against all the odds, Riley’s liver slowly began to improve.
Doctors credited Riley’s youth and underlying good health for his recovery, and he was able to come off dialysis and life support after a week.
‘I think the doctors were more surprised than us,’ Chris continued. ‘There’s no exact answer for why it happened this way, but they think that his health and age would have supported the liver’s recovery.
‘But just seeing him up and alive again was unbelievable.’
The recovery, though, was gruelling.
Having undergone a tracheostomy – a surgical procedure to help air reach the lungs – combined with the toll organ failure had taken on his body, Riley had to learn to walk and speak again.
‘That was really hard,’ said Chris. ‘He physically couldn’t move once he’d come out of sedation.
‘And they had to get him used to being able to breathe without the tracheostomy again. It was like he was suffocating when he was trying to breathe.’
After weeks of recovery, Riley was transferred to a hospital back in Newport, where he initially battled severe swelling and muscle loss after being confined to a hospital bed.
A turning point came when he was finally able to breathe independently again – a huge boost to his confidence before he began intensive physiotherapy, re-learning to walk with the help of mobility aids.
After several weeks in intensive care, followed by a further stint on a rehabilitation ward, he was finally discharged home.
Over the following year, he attended regular follow-up appointments – including heart, liver and blood tests – until doctors eventually confirmed he had made a full recovery.
Now, a year-and-a-half on, Riley is back to normal life.
Chris and Kate, meanwhile, have just completed a 50km (31 miles) hike across the Gower Peninsula in south-west Wales to raise money for King’s College ICU.
The family are now calling for greater awareness of paracetamol overdose – and urging young people in particular to understand the risks.
‘It’s just scary because it’s so accessible, it’s so cheap, and it’s seen as a safe drug to take,’ says Chris.
‘I think the biggest issue is that when you’re unwell – whether you’re older, younger or at university – it can be difficult to keep track of how often you’re taking medication.’
