In the recent article by Kuffner et al,1 the authors examined the effect of alcohol abuse on the hepatotoxicity of a standard dose of acetaminophen. In their study they administered the recommended dose of 1 g/d to individuals who reported chronic excessive alcohol intake. They reported that based on the failure of the aspartate aminotransferase and alanine aminotransferase levels to increase, there was no evidence of liver injury. They also stated that their results would suggest that, contrary to a large number of reports from other workers, high alcohol consumption does not enhance acetaminophen toxicity. I do not believe that they have sufficient data to warrant this conclusion.
Holtzman JL. The Effect of Alcohol on Acetaminophen Hepatotoxicity. Arch Intern Med. 2002;162(10):1193. doi: