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In fact, the human toll of acetaminophen, in terms of both fatal overdoses and chronic liver toxicity to habitual abusers of pain medication, likely far exceeds the damage caused by the opioids themselves.[38 Chronic excessive alcohol consumption can induce CYP2E1, thus increasing the potential toxicity of paracetamol.[39] For this reason, analgesics such as aspirin or ibuprofen are often recommended over paracetamol for relief of hangovers when other factors, such as gastric irritation, are not involved

In more detail, Zhou et al

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J Neurochem 120:7892 Gennuso F, Fernetti C, Tirolo C, Testa N, LEpiscopo F, Caniglia S, Morale MC, Ostrow JD, Pascolo L, Tiribelli C, Marchetti B (2004) Bilirubin protects astrocytes from its own toxicity by inducing up-regulation and translocation of multidrug resistance-associated protein 1 (Mrp1)