As I have noted a couple of times here, acetaminophen is definitely not the cause of the enormous increase in autism diagnoses in recent decades. However, it is wrong to entirely dismiss the possibility that it could be a risk factor for neurodevelopmental problems such as ADHD and, yes, autism -- although we're talking about non-profound autism, as I discussed recently.
The evidence for this is conflicting, but it's not an absurd proposition. Stephen A. Hoption Cann, PhD, discusses it here. The evidence is weak, and the effect, if any, is weak or a signal would emerge more clearly from the noise, but it might be real. I would classify Hoption Cann as being on the more worried about it end of the spectrum than many, but maybe that's the right place to be. The reason I say that is because, although Hoption Cann doesn't discuss it, acetaminophen is problematic regardless. It has a very narrow therapeutic window, i.e. the therapeutic dose is not much smaller than a toxic dose. Specifically, it's a liver toxin, and it is in fact responsible for a substantial amount of liver damage. People who drink any amount of alcohol should avoid it entirely. I actually think it should only be administered in hospitals.
We used to think that pain relief was an easy problem. Give opioids for severe pain, take aspirin -- in fact, take two and call me in the morning -- for mild pain. However, we now know that opioids can be very problematic. In addition to the risk of addiction, they just don't work for long-term, chronic pain. We have also discovered that children should not take aspirin, so heed the label! Physicians have also backed off of long-term use of small dose aspirin for primary prevention of heart attacks, because of the small but real risk of gastro-intestinal bleeding. However, there's nothing wrong with taking the recommended dose of aspirin for short-term pain, such as a headache or muscle pull.
But for longer term use -- I'm not a real doctor, I'm a doctor of philosophy, so I hereby declare that I am not offering medical advice* -- ibuprophen doesn't present any known substantial dangers, and I can tell you that it works. It can cause an upset stomach, which you can counteract with omeprazole. Here I am talking about taking one drug to counteract the side effects of another, which is normally against my religion, but when I had hand surgery a while back that's what I did, and it was very effective.
Having said all that, the point I'm getting to is that these questions are not simple and the claim by the nutjobs who are running the country that they've found the One True Answer to autism is just despicable. They are ignorant idiots who think they're geniuses, which is the worst kind of idiot to be.
*Same goes for Dr. Hoption Cann, of course.
1 comment:
You touched on one of my pet peeves: The assumption that there are simple answers to most questions. High school physics is misleading since physicists generally chose to work on problems that suggest clean solutions. "Turbulence" is a physical manifestation, but physics punted on understanding it for centuries since scientists knew they lacked to tools to study it - and realized that any theories they produced wouldn't be pretty.
Medicine and social sciences are dealing with multiple intertwined phenomena, some of which are the result of a billion years of random mutations operating on changing criteria for survival and reproduction. The end products do work, but often in some screwy way. Fold in complex neural nets and cultures formed under varying conditions, and it is clear that there will never be a Grand Unified Theory of us. That's why social science experiments generally require sophisticated statistics to show that the hypothesis actually is close to one of the many threads that sometimes helps cause the condition being studied. Claiming that you've identified the major cause of anything is enough, in itself, to prove that you are wrong. RFK Jr. couldn't make a bigger fool of himself in front of thinking people if he claimed that the earth was flat. I'm embarrassed that I'm a member of the same species as his.
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