I know that in the UK painkillers that contain codeine as an additive are common, which makes them stronger. I don’t believe it’s possible to get it in the USA.
To make up for it, it’s very difficult to buy painkillers in the UK in quantities of more than about 8, while Costco sells jars of literally hundreds of tablets.
In the UK you can buy 16 tablets of paracetamol off the shelf. You can buy 32 tablets over the counter. You can have a discussion with a pharmacist if you want to buy more - up to about 100.
This is a useful suicide prevention measure and we've seen deaths by suicide from paracetamol reducing a bit as a result.
Their over the counter paracetamol are usually 1000mg per tablet whereas ours are limited to 500mg per tablet.
In an average dose, thy only take one, whereas we take two.