Jump to content

Talk:Naloxone

Page contents not supported in other languages.
From Wikipedia, the free encyclopedia

Nalaxone is used to counter many fentanyl overdoses[edit]

See diff.

How is this image not relevant:

Fentanyl. 2 mg (white powder to the right) is a lethal dose in most people.[1] US penny is 19 mm (0.75 in) wide.

Naloxone is most used on fentanyl overdoses. Since fentanyl is the illicit drug killing the most people by far. Note the top line in this chart:

US yearly overdose deaths, and the drugs involved.[2]

References

  1. ^ Fentanyl. Image 4 of 17. US DEA (Drug Enforcement Administration). See archive with caption: "photo illustration of 2 milligrams of fentanyl, a lethal dose in most people".
  2. ^ Overdose Death Rates. By National Institute on Drug Abuse (NIDA). See links section near the bottom of the page for the latest data link, and a PowerPoint link.

--Timeshifter (talk) 03:18, 17 August 2023 (UTC)[reply]

It isn't irrelevant, but it doesn't really someone understand what naloxone is useful for. You wouldn't include a photo of every conceivable application of hammers into hammer. That photo of fentanyl would be appropriate in fentanyl. I would oppose to putting a photo of various types of naloxone into fentanyl, oxycodone, hydrocodone just as I would oppose your addition of this photo here. Graywalls (talk) 03:28, 17 August 2023 (UTC)[reply]
Naloxone is mentioned in all 3 of the opioid articles you linked to. An image showing the size of the naloxone dose would serve no purpose. Whereas the size of the lethal Fentanyl dose is very relevant here. Because it shows a big reason why naloxone is used mostly for Fentanyl. And why there has been a steep increase in availability of Naloxine. As documented here in the article:
Naloxone#Legal status and availability to law enforcement and emergency personnel
Naloxone#Community access
The above graph would illustrate the reason for the rapidly increasing demand for wider availability of Nalaxone.
--Timeshifter (talk) 03:44, 17 August 2023 (UTC)[reply]
That doesn't mean having a photo of naloxone would be useful and I would oppose to it. Graywalls (talk) 03:45, 17 August 2023 (UTC)[reply]
You seem to have stopped reading and/or understanding my posts. And you are not addressing most of my points. You seem to have descended to Wikipedia:I just don't like it. --Timeshifter (talk) 03:52, 17 August 2023 (UTC)[reply]
I have given you my side on why I don't find a picture of fentanyl next to a penny useful in this article, or in plethora of articles you inserted the same picture into. Graywalls (talk) 06:54, 17 August 2023 (UTC)[reply]
You wrote: "It isn't irrelevant, but it doesn't really [help] someone understand what naloxone is useful for." I explained clearly how it helps someone understand what naloxine is for. --Timeshifter (talk) 07:13, 17 August 2023 (UTC)[reply]
It seems to me like the image is mostly meant to elicit an emotional reaction, not really to help illustrate anything about naloxone. The image may be fine on the fentanyl article, but probably not many other articles. Vontheri (talk) 22:04, 30 January 2024 (UTC)[reply]

Reaction following reversal with naloxone[edit]

A study was conducted with sufficient number of patients by a study that I believe rage reaction was adequately documented. The sources are mainstream as opposed to advocacy groups like Drug Free Australia or Harm Reduction International. They're scholarly journals and mainstream media. One editor says these are undue. Since the reactions follow reversal specifically after administration of naloxone, I think it is relevant and on topic. The sources used are credible. Trimming out contents that are based on pro-harm reduction advocacy or anti-harm reduction oppositional groups as POV would be reasonable. My addition may need some copy-editing but I believe the general contents is reasonable to have in here. Graywalls (talk) 07:05, 5 September 2023 (UTC)[reply]

I’m sure there are situations where people have become violent after receiving naloxone, but having a lengthy section devoted to this phenomenon, with multiple examples, seems undue to me, not to say stigmatizing. However I don’t expect to convince you of this, so I’m more interested in hearing other people’s opinions. Prezbo (talk) 08:10, 5 September 2023 (UTC)[reply]
  • Came here after seeing this at WT:MED. So far as I could see, all the sourcing for this was unreliable (we would need WP:MEDRS). Thus removed. Why are we using rubbish sources when there are recent quality review articles available (I added one such)? Bon courage (talk) 08:24, 5 September 2023 (UTC)[reply]
    Why do you say The International Journal on Drug Policy would be unreliable? Graywalls (talk) 08:27, 5 September 2023 (UTC)[reply]
    If you mean PMID:32304981, then that's primary research. Bon courage (talk) 08:32, 5 September 2023 (UTC)[reply]
    PMC7572435 Graywalls (talk) 08:35, 5 September 2023 (UTC)[reply]
    Yes: Parkin S, Neale J, Brown C, Campbell AN, Castillo F, Jones JD, Strang J, Comer SD (April 2020). "Opioid overdose reversals using naloxone in New York City by people who use opioids: Implications for public health and overdose harm reduction approaches from a qualitative study". Int J Drug Policy. 79: 102751. doi:10.1016/j.drugpo.2020.102751. PMC 7572435. PMID 32304981. Bon courage (talk) 08:37, 5 September 2023 (UTC)[reply]
    And something like this, along with rxlist.com, drugs.com materials in article is acceptable?
    Some poison control centers recommend naloxone in the setting of clonidine overdose, including intravenous bolus doses of up to 10 mg naloxone.[1][2] Graywalls (talk) 08:38, 5 September 2023 (UTC)[reply]

References

  1. ^ "Poison Alert: Clonidine" (PDF). missouripoisoncenter.org. Missouri Poison Center. Archived (PDF) from the original on 4 August 2020. Retrieved 10 June 2019.
  2. ^ Seger DL, Loden J (26 March 2018). "Does naloxone reverse clonidine toxicity?". Vanderbilt University Medical Center. Tennessee Poison Center. Archived from the original on 25 July 2023. Retrieved 25 July 2023.

Graywalls (talk) 08:38, 5 September 2023 (UTC) [reply]

References

The article is full of junk; it needs a major raking through with an eye to sourcing. I'll tag it. Bon courage (talk) 08:40, 5 September 2023 (UTC)[reply]

Why did you not remove those specifics mentioned above despite removing the others? Graywalls (talk) 08:58, 5 September 2023 (UTC)[reply]
WP:CHOICE. Bon courage (talk) 09:01, 5 September 2023 (UTC)[reply]
I think it's important to note the potential for adverse effects, but I don't think we need stories about individual incidents.
An ideal source would be a practice guideline (e.g., from American College of Emergency Physicians) about naloxone. I don't know if any such sources exist, but provider safety is not an unusual thing for such guidelines to cover. WhatamIdoing (talk) 16:54, 5 September 2023 (UTC)[reply]
There's honestly no reliability issues with the sources I've used as long as it isn't framed as "medical claim". Do we really need to use highest of the highest standard source to cite caustic soda may burn you? I doubt it! Graywalls (talk) 02:37, 6 September 2023 (UTC)[reply]
It's an obscure primary source. We won't be using it. Bon courage (talk) 04:45, 6 September 2023 (UTC)[reply]
I disagree with your most recent addition calling it "misinformation". We won't be using it without some of what you've removed adding it so both sides are presented. Graywalls (talk) 07:02, 6 September 2023 (UTC)[reply]
See WP:GEVAL. We're not going to be putting unreliable sources against reliable ones. Bon courage (talk) 07:04, 6 September 2023 (UTC)[reply]
Then, I OPPOSE your most recently added contents. Graywalls (talk) 07:46, 6 September 2023 (UTC)[reply]
You've said you don't agree with what it says. But that doesn't count towards WP:CONSENSUS so can be disregarded. Bon courage (talk) 07:51, 6 September 2023 (UTC)[reply]
I disagree with your accusation of "POV pushing". Advocacy coalition source you're adding is POV. As you demonstrated in Special:Diff/1174083816, establishing consensus falls on those wishing to include stuff. Graywalls (talk) 18:14, 7 September 2023 (UTC)[reply]
We have consensus. Your obvious personal views don't count. Bon courage (talk) 18:17, 7 September 2023 (UTC)[reply]
I don't believe that we do, with regard to the newest example related to Canadian universities following up in certain ways, which you sourced to an advocacy coalition. Please look closely at what I've removed. Graywalls (talk) 18:32, 7 September 2023 (UTC)[reply]
The Canadian Mental Health Association is good source, for reasons that people have tried to explain to you at RSN. But other sources are available. I added one such. Bon courage (talk) 18:39, 7 September 2023 (UTC)[reply]
The text you introduced in Special:Diff/1174321452 is more reasonable and general enough, so I have no objection to this. Graywalls (talk) 18:42, 7 September 2023 (UTC)[reply]

Source 132's archive is broken[edit]

redirects to a bot protection page. I don't have the time to fix it right now, but if anyone passing by can give it a go let me know. Word of warning, look for a crawler that doesn't parse JS. - MountainKemono (talk) 14:00, 5 December 2023 (UTC)[reply]

Naloxone efficacy in combination with Buprenorphine (Is this reference MEDRS?)[edit]

@Bon courage Are you following me around, now? Quite impressive how quickly you can appear. You were able to read my edit, and read the citation, and declare it non-MEDRS (without giving any reason to explain why it isn't MEDRS) all within two minutes of time?

Did you actually even read the citation I used? I seriously doubt you read it in only two minutes, which is the time from my edit until your revert. The citation I used is from a medical journal that is NOT deprecated and articles from that journal are used in plenty of other medical articles on Wikipedia, and the journal article that I used for the citation itself referenced a list of 41 studies and other articles. It seems like exactly the kind of ideal secondary source that should be used as a Wikipedia medical reference.

I really hope this doesn't waste another two months of my life like our last dispute did...

Here is the relevant edit I made and Bon Courage's revert: https://en.wikipedia.org/w/index.php?title=Naloxone&diff=1201013579&oldid=1201012906

Primarily, I added this in the section "Preventing recreational opioid use":

Non-medical use by injection or use in the nose still occurs, and the efficacy of naloxone in preventing misuse by injection has been brought into question and preparations including naloxone could even be less safe than preparations containing solely buprenorphine.[1] Posters on drug-related online forums have been documented as stating that they feel no subjective difference in effects when injecting buprenorphine combined with naloxone as compared to injecting buprenorphine alone.[1]

Of course I'm open to changing of specific wording, but the issue Bon Courage raised was regarding the reference and whether or not it is MEDRS.

Anyone else care to weigh in on this? It is a significantly growing minority view amongst addiction experts that adding naloxone to sublingual preparations of buprenorphine does more harm than good. This point of view deserves at least a sentence or two in this article, surely? Vontheri (talk) 20:13, 30 January 2024 (UTC)[reply]

References

  1. ^ a b Blazes CK, Morrow JD (11 September 2020). "Reconsidering the Usefulness of Adding Naloxone to Buprenorphine". Frontiers in Psychiatry. 11: 549272. doi:10.3389/fpsyt.2020.549272. PMC 7517938. PMID 33061915.
Opinion pieces in dodgy journals are not WP:MEDRS, obviously. And stop it with the bad-faith blather. Bon courage (talk) 20:26, 30 January 2024 (UTC)[reply]
Please show me what specifically on WP:MEDRS makes this specific reference non-MEDRS. Personally, I cannnot find anything at all on MEDRS that sounds like it could possibly be interpreted as saying that this reference is non-MEDRS--not even anything borderline.
I hope a third party can give input here, because I seriously doubt that the two of us are likely to come to a consensus on this, although wouldn't it be nice if we actually could come to a consensus between just the two of us? Vontheri (talk) 20:41, 30 January 2024 (UTC)[reply]
Read the whole guideline, but for a quick answer see WP:MEDASSESS. Editors should rely on high-quality evidence (systematic reviews, reviews, etc.) and not opinion pieces, which are at the absolute base of the quality pyramid. Bon courage (talk) 20:45, 30 January 2024 (UTC)[reply]
I have read all of MEDRS before and am familiar with it. It doesn't say expert opinion journal articles cannot be used at all, only that they are less preferred than many other types of sources.
That said, there are other sources I can use that perhaps would pass your extremely strict and limited interpretation of MEDRS. It will just take more time for me to sort through them all. The source I chose seemed to me to be the best available summary of the relevant information, and it itself listed dozens of sources if anyone actually bothers to look at the reference. My preference would still be to use the original reference that I used, with additional references if time permits. Vontheri (talk) 21:08, 30 January 2024 (UTC)[reply]
It's simply not reliable for WP:BMI. Any good sources, OTOH, would be welcome. Bon courage (talk) 21:11, 30 January 2024 (UTC)[reply]
I see nothing in WP:MEDRS that I interpret as meaning the article I used is not usable as a source. I interpret the pyramids as very general guidelines of hierarchies as to what sources are better or not as good as other sources: higher up is preferred than lower down (unless something else about about a specific source makes it not usable.) Something that is not on the pyramids to begin with is by default generally not acceptable for MEDRS.
Now I have nothing more to say unless a third party gives input. In our discussion at Bryan Johnson it seemed we kept talking to each other until there was a huge wall of text of just the two of us to the point that other editors wouldn't have the time to read through it all to even begin to give their own input. I'd prefer that not happen again. And the Bryan Johnson article wasn't even something I cared very much about; I just didn't want any article to be ruined. Addiction medicine is something I actually do care about and have more knowledge of. So Let's please try to give a chance for someone else to give input now. Vontheri (talk) 21:57, 30 January 2024 (UTC)[reply]
You think opinion pieces are WP:MEDRS? As the guideline says, such low-quality sources are to be avoided. If in doubt, check at WT:MED. Bon courage (talk) 05:17, 31 January 2024 (UTC)[reply]
Your idea of what does or doesn't meet MEDRS seems that of a Pharisee...
I think the original reference I used is preferable as it is more exhaustive, but I have used a different reference and changed the wording now. I intend to add additional references and prose as well as time permits. I trust you will find a clinical guidelines manual published by SAMHSA meets your interpretation of MEDRS?
See my new addition in the "Preventing recreational opioid use" section. I still hope a third party can see this discussion and give input about whether or not they think the original reference is acceptable. Vontheri (talk) 10:22, 31 January 2024 (UTC)[reply]
As I said, you can always check at WT:MED. The new source is fine; thanks for adding it! Bon courage (talk) 11:24, 31 January 2024 (UTC)[reply]

Possible source[edit]

I haven't read this book, but I'll post it here as a probably resource. OD: Naloxone and the Politics of Overdose Prezbo (talk) 12:24, 15 February 2024 (UTC)[reply]

Looks like WP:MEDPOP; could be useful but not for hard WP:BMI. Bon courage (talk) 12:25, 15 February 2024 (UTC)[reply]

Library sign pic[edit]

[1] Any other opinions on whether or not this picture adds to the article? Prezbo (talk) 12:53, 15 February 2024 (UTC)[reply]

UK legislation change[edit]

The government is planning to change Naloxone from prescription-only to being able to be given without a prescription needed. Can someone tell me if I'm allowed to change the legal status and add some information to relevant sections? Or should I wait until the full legislation is released? I just don't want to make changes that I'm not completely sure of but I would love to type up information and make changes for a page like this because I rarely get to.

Sources: [2]BBC, [3]BMJ JJPlays (talk) 19:12, 14 May 2024 (UTC)[reply]

Retrieved from "https://en.wikipedia.org/w/index.php?title=Talk:Naloxone&oldid=1235054973"