PSA: Don't take 4 packets of paracetamol in one day

I think the reason is that both acetaminophen and opioids are processed by the liver and that acetaminophen will overwhelm it allowing more time for opioids to be effective.

You can take acetaminophen and nsaids together because they work differently and are processed differently.

But, if you're a heavy drinker, both are dangerous for very different reasons. Liver vs digestive tract.

This is one aspect which is stupid, agreed, and based on a terrible and possibly willful misunderstanding of how addiction works. It’s also based on an assumption that the average person is educated on medicine in a way that is wholly out of touch with reality (“you mean the average person doesn’t know the max dose of acetaminophen off hand and keep meticulous track of dosage? But I do that, of course, I’m a doctor/pharmacist”)

but in addition there is added pain relief from the combo of acetaminophen + hydrocodone/oxycodone vs the opioid on its own so there is some justification for it outside of punitive approach for addicts. If you’re going to prescribe both anyway after something like a broken arm or wisdom tooth extraction there are also benefits to this: cheaper overall to just have one pill, easier to manage for the patient, etc

not sure what you mean by opioid+nsaid prescription painkillers, so I'll assume it's a mix of opiods plus NSAIDs. wouldn't make much sense to add aspirin/naproxen/ibuprofen on top of that, as they are also NSAIDs and that role's already been filled

paracetamol is also a fairly good painkiller so my guess is they're probably going for some synergy there as well