Recent news reports on the Trump administration’s recommendation for women to avoid Tylenol during pregnancy have renewed a long-term concern at the FCHS Clinic: whether students are taking too much Tylenol at school.

According to FCHS Nurse Ashley Hudgins, some students write passes to the clinic to get Tylenol (the best-known name brand of the painkiller acetaminophen), not because they truly have a headache, but so they can get out of class. This is an ongoing problem, because although Tylenol has long been considered one of the safest painkillers on the market, it is not always good for the liver.

Why is Tylenol use in the news?

At a news conference on Sept. 22, the Trump Administration announced that there is evidence of a possible link between Tylenol use during pregnancy and increased rates of autism and ADHD in children. They cited meta-studies from Harvard and Mount Sinai, to name a few.

“There is mounting evidence finding a connection between acetaminophen use during pregnancy and autism — and that’s why the Administration is courageously issuing this new health guidance,” said Trump Administration Press Secretary Karoline Leavitt.

The Federal Drug Administration (FDA) responded by initiating the label change process for acetaminophen, reflecting evidence that use during pregnancy poses the increased risk of neurological conditions like autism and ADHD.

“[We are] taking action to make parents and doctors aware of a considerable body of evidence about potential risks associated with acetaminophen,” said FDA Commissioner Marty Makary, M.D.

However, some members of the medical community pushed back, saying that other studies, including a Swedish study involving 2 million Swedish children, found no such link.

Why Tylenol use in school remains a problem

Putting aside the question of whether there is a definitive link between Tylenol use during pregnancy and autism, Hudgins says that the problem with students taking Tylenol too much or too often is that it can damage the liver. While most people don’t mean to take too much acetaminophen, it can easily happen, especially if they are taking multiple flu and cold medications, which may also contain the drug.

“I have had students ask to go to the nurse to get Tylenol and I usually ask them if they have had something to eat, have they had water, and how long have they had a headache. Usually those questions will deter the students who are just trying to get out of class versus the students that really need to go,” said math teacher Rachael Newsom.

“I am sure it has happened more often than I would like. Not that the students actually admit to this, though,” said English teacher Amy Bower

Hudgins said that the safe limit of Tylenol is no more than 3,000 mg in 24 hours. “Too much can seriously hurt your liver. At school, we give just one regular dose (usually 250–500 mg) at a time and wait at least four hours before giving more,” she said

Part of the problem, she says, is students asking for Tylenol when they don’t really need it. “Sometimes kids take Tylenol to get out of class. We understand that school can be stressful, but we want to make sure medicine is used only when truly needed,” said Hudgins. “At [FCHS], we can only give Tylenol up to twice a week. This is to keep students safe and to make sure we are not covering up a bigger health issue that needs a doctor’s attention,” she added.

Some question whether schools should even provide Tylenol to students, with some school districts in Virginia, like Henrico, refusing to supply the medication. However, their websites note that they will administer it to students if parents bring it to the nurse in a marked bottle.

When possible, choose a non-Tylenol alternative

“Alternatives to Tylenol for headaches are drinking water, eating a snack if you haven’t had food in a while, taking a few deep breaths or a short break to relax, or resting your eyes from screens for a few minutes,” Hudgins said.

One thing you can do if you have a cold or other respiratory virus is to make sure you carefully read the labels of multi-symptom cold medications to make sure you are not taking more than 3,000 mg of acetaminophen in a 24-hour period.