The Chicago Tylenol murders in 1982 were a cataclysmic crime that drove development of tamper-evident packaging. The series of deaths were caused by poisoning from potassium cyanide being laced in Tylenol-branded acetaminophen capsules. At least seven deaths resulted from this crime. While a suspect was never charged for the poisonings, a man named James Lewis was convicted of extortion for having sent a letter to Johnson & Johnson in which he took responsibility for the deaths and demanded $1 million from the company. Johnson & Johnson ultimately recovered from the scare and reintroduced Tylenol capsules in a triple-sealed package to prevent tampering, marking the beginning of many changes in how medications were packaged.
In 1983, Congress passed the Federal Anti-Tampering Act, also dubbed the “Tylenol Bill,” which made it a felony to tamper with consumer products. The FDA also updated their policy in 1989 to make medications more resistant to tampering, requiring tamper-evident seals on over-the-counter medications. This also led to the manufacturing of medication dosage forms transitioning from capsules to modern caplets. Some capsules can be opened to access the medication inside, whereas the same cannot be done for caplets because they have a film or gelatin coating that cannot easily be modified without leaving behind evidence of tampering.
The goal is not to make packaging completely “tamper-proof,” as considering that since the buyer must access the medication themself, this is nearly impossible. Instead, packaging design has evolved so that any interference with the container would be obvious to the buyer, discouraging them from buying or using the product. The triple-sealed package that Johnson & Johnson debuted after the Tylenol murders is one example. Most modern over-the-counter medications now reflect this triple-seal package, adopting a plastic shrink around the cap, a foil or paper seal glued to the bottle mouth and a breakaway cap. These simple but effective features have become a standard in modern pharmaceuticals by functioning as a safeguard for the integrity of the medication and the consumer’s health.
Laura Bix, Michigan State University, the impact of the tylenol murders on drug packaging in the Inspired to Heal episode Drug Packaging Protects Patients