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Since narcan became more widely available there have been people (mostly outside the addiction medicine/public health field, but maybe not entirely) arguing that it "enables" addiction. My perception is that there were more "experts" (police officers, economists) making this criticism in the 2010s, then the public health authorities pushed back against it strongly and you hear it less now, though I'm sure there are still plenty of regular people who feel this way. But of course I can't find a source that lays out that recent history clearly. Prezbo ( talk) 14:22, 19 June 2023 (UTC)
police officers
- the same people that claim touching fentanyl will make you OD. -- WikiLinuz { talk} 18:00, 19 June 2023 (UTC)- Is the underlying problem that narcan prevents addicts from dying, so whatever saves their lives is "enabling" their addictions? I would expect such a sentiment to have been thoroughly excoriated and debunked in the proper literature.
WhatamIdoing (
talk) 13:49, 17 July 2023 (UTC)
- I think that’s one version of this idea. Another less reprehensible version is the idea that people will use drugs in more unsafe ways because they have the safety net of naloxone—a moral hazard kind of argument. This is kind of like arguing that people will ride bikes less safely if they have helmets, but it could be true for all I know. Finally there’s the argument (leveled against all harm reduction interventions) that making naloxone more available sends a harmful message that drug use is safe or acceptable.
Prezbo (
talk) 16:06, 17 July 2023 (UTC)
- Or that people will drive unsafely if they have an Anti-lock braking system, which has been true in (at least) one study, but not overall.
- I wonder if the people who believe that having naloxone available makes it sound like drug use is safe feel the same way about other life-threatening remedies. We could ban firefighters, to reinforce the message that fires are unsafe and unacceptable. WhatamIdoing ( talk) 17:19, 17 July 2023 (UTC)
- I think that’s one version of this idea. Another less reprehensible version is the idea that people will use drugs in more unsafe ways because they have the safety net of naloxone—a moral hazard kind of argument. This is kind of like arguing that people will ride bikes less safely if they have helmets, but it could be true for all I know. Finally there’s the argument (leveled against all harm reduction interventions) that making naloxone more available sends a harmful message that drug use is safe or acceptable.
Prezbo (
talk) 16:06, 17 July 2023 (UTC)
This page is about the medication. Naming various agencies that hand them out is WP:UNDUE. If laundromats were handing out Tide for free and that happens to be covered in the media, you wouldn't put that in Tide, or laundry detergent page. Graywalls ( talk) 20:40, 14 July 2023 (UTC)
If detergent was regulated the way that naloxone is regulated, and there was one laundromat distributing it by mail in the United States, and it had received a lot of media coverage...it probably would be appropriate to mention it by name. Prezbo ( talk) 20:43, 14 July 2023 (UTC)
- I've requested Wikiproject Medicine for additional perspectives. Thanks,
Graywalls (
talk) 21:05, 14 July 2023 (UTC)
- Thus far, I'm seeing no consensus in favor of mentioning by name, ON POINT NYC. They're just one of many organizations around the world who hands out naloxone. Certainly not the first, nor were they the pioneer. I strongly object to including their mention by name in this article, or in
harm reduction
Graywalls (
talk) 07:59, 16 July 2023 (UTC)
- This comment at WT:MED from @ Vontheri seems to me to be a good path forward. We shouldn't list every org, or even dozens of them, but I think that the article will be incomplete until it mentions a few milestones (e.g., the first orgs to distribute it in a few key countries, or the one that does the most work in this area). WhatamIdoing ( talk) 14:00, 17 July 2023 (UTC)
- Thus far, I'm seeing no consensus in favor of mentioning by name, ON POINT NYC. They're just one of many organizations around the world who hands out naloxone. Certainly not the first, nor were they the pioneer. I strongly object to including their mention by name in this article, or in
harm reduction
Graywalls (
talk) 07:59, 16 July 2023 (UTC)
- Is this organization the only organization that distributes naloxone by mail? If so, then that is something that makes it unique, so it could possibly be notable due to it being the only organization to distribute naloxone in that manner. If other organizations also distribute naloxone by mail, then this specific organization would be just one of many, and would probably not be notable in this article. However, I don't see any reason why a new article in list form couldn't be started called something like "list of naloxone distributors" which could include this organization along with any other organizations that distribute naloxone.
Vontheri (
talk) 15:01, 17 July 2023 (UTC)
- NEXT Harm Reduction was the first org to do this in the US and remains the leader in this area, though it has partnerships with state-specifics organizations. It’s probably not literally the only one. Prezbo ( talk) 15:47, 17 July 2023 (UTC)
- I believe NEXT is a dropship fulfillment service that started to send out "harm reduction" supplies to clients on behalf of state syringe exchange services due to in-person service suspension during COVID. Putting specific vendors that did X in Y place or in Z way is undue. Sweetwater Sound has been known to include candy with every order. Even with sources, saying they're the first to do so, longest etailer to do so, in United States.. into the article candy could be truthful, yet undue. If the person who created the article did so to both candy, and eCommerce, well that's even more undue. This aside, this sort of trivia attracts more such thing. It would be unreasonable to be ok with some including "first in US" and not allow the same for "first in China", "first in India" if the "first in US" was not the first in the world. Since trivia like this doesn't add value to the article candy, omitting is the right answer. Graywalls ( talk) 18:10, 17 July 2023 (UTC)
See diff.
How is this image not relevant:
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:
References
- ^ 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".
- ^ 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)
- 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)
- 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)
- 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)
- 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)
- 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)
- 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)
- 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)
- 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)
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)
- 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)
- 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)
- Why do you say The International Journal on Drug Policy would be unreliable?
Graywalls (
talk) 08:27, 5 September 2023 (UTC)
- If you mean
PMID:32304981, then that's primary research.
Bon courage (
talk) 08:32, 5 September 2023 (UTC)
- PMC7572435
Graywalls (
talk) 08:35, 5 September 2023 (UTC)
- 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)
- 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)
- PMC7572435
Graywalls (
talk) 08:35, 5 September 2023 (UTC)
- If you mean
PMID:32304981, then that's primary research.
Bon courage (
talk) 08:32, 5 September 2023 (UTC)
- Why do you say The International Journal on Drug Policy would be unreliable?
Graywalls (
talk) 08:27, 5 September 2023 (UTC)
References
- ^ "Poison Alert: Clonidine" (PDF). missouripoisoncenter.org. Missouri Poison Center. Archived (PDF) from the original on 4 August 2020. Retrieved 10 June 2019.
- ^ 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)
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)
- Why did you not remove those specifics mentioned above despite removing the others?
Graywalls (
talk) 08:58, 5 September 2023 (UTC)
- WP:CHOICE. Bon courage ( talk) 09:01, 5 September 2023 (UTC)
- 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)
- 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)
- It's an obscure primary source. We won't be using it.
Bon courage (
talk) 04:45, 6 September 2023 (UTC)
- 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)
- See
WP:GEVAL. We're not going to be putting unreliable sources against reliable ones.
Bon courage (
talk) 07:04, 6 September 2023 (UTC)
- Then, I OPPOSE your most recently added contents.
Graywalls (
talk) 07:46, 6 September 2023 (UTC)
- 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)
- 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)
- We have consensus. Your obvious personal views don't count.
Bon courage (
talk) 18:17, 7 September 2023 (UTC)
- 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)
- 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)
- 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)
- 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)
- 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)
- We have consensus. Your obvious personal views don't count.
Bon courage (
talk) 18:17, 7 September 2023 (UTC)
- 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)
- 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)
- Then, I OPPOSE your most recently added contents.
Graywalls (
talk) 07:46, 6 September 2023 (UTC)
- See
WP:GEVAL. We're not going to be putting unreliable sources against reliable ones.
Bon courage (
talk) 07:04, 6 September 2023 (UTC)
- 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)
- It's an obscure primary source. We won't be using it.
Bon courage (
talk) 04:45, 6 September 2023 (UTC)
- 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)
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)
@ 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/?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)
References
- ^ 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)
- 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)
- 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)
- 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)
- It's simply not reliable for
WP:BMI. Any good sources, OTOH, would be welcome.
Bon courage (
talk) 21:11, 30 January 2024 (UTC)
- 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)
- 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)
- 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)
- 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)
- 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)
- It's simply not reliable for
WP:BMI. Any good sources, OTOH, would be welcome.
Bon courage (
talk) 21:11, 30 January 2024 (UTC)
- 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)
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)
- Looks like WP:MEDPOP; could be useful but not for hard WP:BMI. Bon courage ( talk) 12:25, 15 February 2024 (UTC)
[1] Any other opinions on whether or not this picture adds to the article? Prezbo ( talk) 12:53, 15 February 2024 (UTC)
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| This is the
talk page for discussing improvements to the
Naloxone article. This is not a forum for general discussion of the article's subject. |
Article policies
|
| Find medical sources: Source guidelines · PubMed · Cochrane · DOAJ · Gale · OpenMD · ScienceDirect · Springer · Trip · Wiley · TWL |
|
Archives:
1Auto-archiving period: 1 year
|
|
| This article is rated B-class on Wikipedia's
content assessment scale. It is of interest to the following WikiProjects: |
|||||||||||||||||||||||||||||||||
| ||||||||||||||||||||||||||||||||||
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| Ideal sources for Wikipedia's health content are defined in the guideline
Wikipedia:Identifying reliable sources (medicine) and are typically
review articles. Here are links to possibly useful sources of information about Naloxone.
|
Since narcan became more widely available there have been people (mostly outside the addiction medicine/public health field, but maybe not entirely) arguing that it "enables" addiction. My perception is that there were more "experts" (police officers, economists) making this criticism in the 2010s, then the public health authorities pushed back against it strongly and you hear it less now, though I'm sure there are still plenty of regular people who feel this way. But of course I can't find a source that lays out that recent history clearly. Prezbo ( talk) 14:22, 19 June 2023 (UTC)
police officers
- the same people that claim touching fentanyl will make you OD. -- WikiLinuz { talk} 18:00, 19 June 2023 (UTC)- Is the underlying problem that narcan prevents addicts from dying, so whatever saves their lives is "enabling" their addictions? I would expect such a sentiment to have been thoroughly excoriated and debunked in the proper literature.
WhatamIdoing (
talk) 13:49, 17 July 2023 (UTC)
- I think that’s one version of this idea. Another less reprehensible version is the idea that people will use drugs in more unsafe ways because they have the safety net of naloxone—a moral hazard kind of argument. This is kind of like arguing that people will ride bikes less safely if they have helmets, but it could be true for all I know. Finally there’s the argument (leveled against all harm reduction interventions) that making naloxone more available sends a harmful message that drug use is safe or acceptable.
Prezbo (
talk) 16:06, 17 July 2023 (UTC)
- Or that people will drive unsafely if they have an Anti-lock braking system, which has been true in (at least) one study, but not overall.
- I wonder if the people who believe that having naloxone available makes it sound like drug use is safe feel the same way about other life-threatening remedies. We could ban firefighters, to reinforce the message that fires are unsafe and unacceptable. WhatamIdoing ( talk) 17:19, 17 July 2023 (UTC)
- I think that’s one version of this idea. Another less reprehensible version is the idea that people will use drugs in more unsafe ways because they have the safety net of naloxone—a moral hazard kind of argument. This is kind of like arguing that people will ride bikes less safely if they have helmets, but it could be true for all I know. Finally there’s the argument (leveled against all harm reduction interventions) that making naloxone more available sends a harmful message that drug use is safe or acceptable.
Prezbo (
talk) 16:06, 17 July 2023 (UTC)
This page is about the medication. Naming various agencies that hand them out is WP:UNDUE. If laundromats were handing out Tide for free and that happens to be covered in the media, you wouldn't put that in Tide, or laundry detergent page. Graywalls ( talk) 20:40, 14 July 2023 (UTC)
If detergent was regulated the way that naloxone is regulated, and there was one laundromat distributing it by mail in the United States, and it had received a lot of media coverage...it probably would be appropriate to mention it by name. Prezbo ( talk) 20:43, 14 July 2023 (UTC)
- I've requested Wikiproject Medicine for additional perspectives. Thanks,
Graywalls (
talk) 21:05, 14 July 2023 (UTC)
- Thus far, I'm seeing no consensus in favor of mentioning by name, ON POINT NYC. They're just one of many organizations around the world who hands out naloxone. Certainly not the first, nor were they the pioneer. I strongly object to including their mention by name in this article, or in
harm reduction
Graywalls (
talk) 07:59, 16 July 2023 (UTC)
- This comment at WT:MED from @ Vontheri seems to me to be a good path forward. We shouldn't list every org, or even dozens of them, but I think that the article will be incomplete until it mentions a few milestones (e.g., the first orgs to distribute it in a few key countries, or the one that does the most work in this area). WhatamIdoing ( talk) 14:00, 17 July 2023 (UTC)
- Thus far, I'm seeing no consensus in favor of mentioning by name, ON POINT NYC. They're just one of many organizations around the world who hands out naloxone. Certainly not the first, nor were they the pioneer. I strongly object to including their mention by name in this article, or in
harm reduction
Graywalls (
talk) 07:59, 16 July 2023 (UTC)
- Is this organization the only organization that distributes naloxone by mail? If so, then that is something that makes it unique, so it could possibly be notable due to it being the only organization to distribute naloxone in that manner. If other organizations also distribute naloxone by mail, then this specific organization would be just one of many, and would probably not be notable in this article. However, I don't see any reason why a new article in list form couldn't be started called something like "list of naloxone distributors" which could include this organization along with any other organizations that distribute naloxone.
Vontheri (
talk) 15:01, 17 July 2023 (UTC)
- NEXT Harm Reduction was the first org to do this in the US and remains the leader in this area, though it has partnerships with state-specifics organizations. It’s probably not literally the only one. Prezbo ( talk) 15:47, 17 July 2023 (UTC)
- I believe NEXT is a dropship fulfillment service that started to send out "harm reduction" supplies to clients on behalf of state syringe exchange services due to in-person service suspension during COVID. Putting specific vendors that did X in Y place or in Z way is undue. Sweetwater Sound has been known to include candy with every order. Even with sources, saying they're the first to do so, longest etailer to do so, in United States.. into the article candy could be truthful, yet undue. If the person who created the article did so to both candy, and eCommerce, well that's even more undue. This aside, this sort of trivia attracts more such thing. It would be unreasonable to be ok with some including "first in US" and not allow the same for "first in China", "first in India" if the "first in US" was not the first in the world. Since trivia like this doesn't add value to the article candy, omitting is the right answer. Graywalls ( talk) 18:10, 17 July 2023 (UTC)
See diff.
How is this image not relevant:
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:
References
- ^ 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".
- ^ 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)
- 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)
- 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)
- 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)
- 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)
- 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)
- 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)
- 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)
- 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)
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)
- 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)
- 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)
- Why do you say The International Journal on Drug Policy would be unreliable?
Graywalls (
talk) 08:27, 5 September 2023 (UTC)
- If you mean
PMID:32304981, then that's primary research.
Bon courage (
talk) 08:32, 5 September 2023 (UTC)
- PMC7572435
Graywalls (
talk) 08:35, 5 September 2023 (UTC)
- 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)
- 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)
- PMC7572435
Graywalls (
talk) 08:35, 5 September 2023 (UTC)
- If you mean
PMID:32304981, then that's primary research.
Bon courage (
talk) 08:32, 5 September 2023 (UTC)
- Why do you say The International Journal on Drug Policy would be unreliable?
Graywalls (
talk) 08:27, 5 September 2023 (UTC)
References
- ^ "Poison Alert: Clonidine" (PDF). missouripoisoncenter.org. Missouri Poison Center. Archived (PDF) from the original on 4 August 2020. Retrieved 10 June 2019.
- ^ 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)
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)
- Why did you not remove those specifics mentioned above despite removing the others?
Graywalls (
talk) 08:58, 5 September 2023 (UTC)
- WP:CHOICE. Bon courage ( talk) 09:01, 5 September 2023 (UTC)
- 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)
- 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)
- It's an obscure primary source. We won't be using it.
Bon courage (
talk) 04:45, 6 September 2023 (UTC)
- 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)
- See
WP:GEVAL. We're not going to be putting unreliable sources against reliable ones.
Bon courage (
talk) 07:04, 6 September 2023 (UTC)
- Then, I OPPOSE your most recently added contents.
Graywalls (
talk) 07:46, 6 September 2023 (UTC)
- 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)
- 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)
- We have consensus. Your obvious personal views don't count.
Bon courage (
talk) 18:17, 7 September 2023 (UTC)
- 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)
- 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)
- 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)
- 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)
- 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)
- We have consensus. Your obvious personal views don't count.
Bon courage (
talk) 18:17, 7 September 2023 (UTC)
- 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)
- 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)
- Then, I OPPOSE your most recently added contents.
Graywalls (
talk) 07:46, 6 September 2023 (UTC)
- See
WP:GEVAL. We're not going to be putting unreliable sources against reliable ones.
Bon courage (
talk) 07:04, 6 September 2023 (UTC)
- 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)
- It's an obscure primary source. We won't be using it.
Bon courage (
talk) 04:45, 6 September 2023 (UTC)
- 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)
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)
@ 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/?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)
References
- ^ 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)
- 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)
- 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)
- 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)
- It's simply not reliable for
WP:BMI. Any good sources, OTOH, would be welcome.
Bon courage (
talk) 21:11, 30 January 2024 (UTC)
- 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)
- 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)
- 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)
- 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)
- 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)
- It's simply not reliable for
WP:BMI. Any good sources, OTOH, would be welcome.
Bon courage (
talk) 21:11, 30 January 2024 (UTC)
- 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)
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)
- Looks like WP:MEDPOP; could be useful but not for hard WP:BMI. Bon courage ( talk) 12:25, 15 February 2024 (UTC)
[1] Any other opinions on whether or not this picture adds to the article? Prezbo ( talk) 12:53, 15 February 2024 (UTC)
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