Talk:Naloxone

Nalaxone is used to counter many fentanyl overdoses

See diff.

How is this image not relevant:

Fentanyl. 2 mg (white powder to the right) is a lethal dose in most people. 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.

References

--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)

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)

Source 132's archive is broken

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)

Does it link to archive.org Luhanopi (talk) 20:50, 20 October 2024 (UTC)

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

@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. 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.

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

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)

Possible source

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)

Library sign pic

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

UK legislation change

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)

Showcasing one company's brand name in the first sentence of lede

The drug has been around since 1961 or so. There has been public relations editing activity on various articles by Emergent BioSolutions, including the naloxone product under the Narcan branding, which came into market around 2015. To showcase this particular company's North America product branding that started in 2015 on a pharmaceutical compound invented in 1961 ish seems unreasonably North America and Emergent BioSolutions favoring coverage. It appears to have been used for opioid overdose by ambulance personnel since the 1970s per https://www.euda.europa.eu/system/files/publications/2089/TDXD15020ENN.pdf Is it appropriate to recognize it by Emergent BioSolutions brand name in the lede when it's merely just one of the brands that just happens to be the most recognized in the US? Courtesy ping to @Whywhenwhohow: Graywalls (talk) 00:36, 22 December 2024 (UTC)

Narcan injection was approved in the US in 1971, and as a nasal spray in 2015. The OTC nasal spray was approved in 2023. --Whywhenwhohow (talk) 05:38, 22 December 2024 (UTC)

@Whywhenwhohow: English Wikipedia should not spin around the United States. It's English Wikipedia, not United States pedia. In England, it doesn't appear that Narcan is even avaialble, but Nyxoid is. I fail to see why the United States of America branding should be prominently adorned in the lede in the way it is. Since listing out "brands such as A, B, C, D, E F, G.. is not desirable, I think in this particular case, omitting particular brand is the best thing to do. There's no such thing as Narcan injection, because it is not a genericized trademark. Narcan specifically refers to naloxone nasal product marketed in the North American market by Emergent BioSolutions. Graywalls (talk) 05:43, 22 December 2024 (UTC)

According to WP:MEDMOS and WP:PHARMMOS, the initial brand name appears in the lead. Naloxone injection was approved as Narcan in 1971. --Whywhenwhohow (talk) 06:02, 22 December 2024 (UTC)

Is Narcan the first brand name ever to be used in the entire world for naloxone then? Graywalls (talk) 06:20, 22 December 2024 (UTC)

Yes.[4] Bon courage (talk) 06:40, 22 December 2024 (UTC)

It talks about approved, FDA, a government agency of the US. So, it was never commercialized anywhere in the world prior to this approval? Graywalls (talk) 06:43, 22 December 2024 (UTC)

At this point "Sorry I was wrong" would be the correct stance. That this is the initial brand name is well sourced; if there are counter sources produce them. Otherwise we are done. Bon courage (talk) 06:49, 22 December 2024 (UTC)