Talk:Opioid epidemic in the United States/Archive 1

Famous people section
With regards to the 'famous people' section — is it relevant to the article at hand? I think it is not, and have removed it for the time being. This subject deals with a recent event largely affecting underprivileged Americans. Listing deceased celebrities does not expand on this situation. Feel free to reverse if I have misjudged the situation.

2607:FEA8:55F:FCB2:1D02:5873:F4D0:34B9 (talk) 00:38, 30 March 2017 (UTC)

Requested move 20 March 2017

 * The following is a closed discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review. No further edits should be made to this section. 

The result of the move request was: Moved. The supporters referred to usage in news sources whereas opposers cited their opinions only &mdash; Martin (MSGJ · talk) 20:51, 5 April 2017 (UTC)

Opioid crisis → Opioid epidemic – The term "epidemic" is being heavily used by most of the recent news sources and more accurately reflects this medical article's topic. Light show (talk) 03:47, 20 March 2017 (UTC) --Relisting. TonyBallioni (talk) 15:26, 28 March 2017 (UTC)

Survey

 * Support for a number of reasons: The word "epidemic" is a medical term, whereas "crisis" is a general term that can be used for any subject; Although most of the news stories about it describe it as primarily an American problem, including foreign publications like The Economist (U.K.), recent reports from other countries show they are also being affected; The leading American medical sources including the CDC and HHS are calling it an epidemic; While the article Opioid use disorder describes the medical condition and treatment, it does not focus on the much broader national aspects.--Light show (talk) 03:52, 20 March 2017 (UTC)
 * Support the title should reflect the most popular use of the term (which epidemic is). And like others point out, "epidemic" need not be an actual medical epidemic. For instance, the crack epidemic is referred to as such because that's how it was framed. CartoonDiablo (talk) 03:26, 1 April 2017 (UTC)
 * Oppose. The word "epidemic" is indeed a medical term and it refers to the rapid spread of infectious diseases.  Its use here is inaccurate and hyperbolic.  —  AjaxSmack   02:53, 22 March 2017 (UTC)
 * Oppose per AjaxSmack.  This is not a medical epidmeic. If any renaming is needed here, it should be to clarify that the scope of this article is restricted solely to the United States. -- Brown HairedGirl (talk) • (contribs) 14:44, 30 March 2017 (UTC)
 * Support I'm seeing "epidemic" used most often in major national media and in scholarly sources. A search in Google Scholar on "opioid epidemic" generates 31,700 results. TimidGuy (talk) 10:15, 1 April 2017 (UTC)

Discussion

 * Any additional comments:


 * While the word "epidemic" usually refers to an infectious disease, it also refers to other medical topics. A current definition from Merriam-Webster: affecting or tending to affect a disproportionately large number of individuals within a population, community, or region at the same time; excessively prevalent; characterized by very widespread growth or extent.  WHO describes an  "obesity epidemic"; the CDC uses it for  opioids. Leading publications have used the term for a "suicide epidemic." Definitions can change over time. --Light show (talk) 20:02, 22 March 2017 (UTC)
 * I think it should be based on what is the more popular usage and I agree that there's no reason why "epidemic" has to only be medical. Similar to the crack epidemic how it's framed in popular discourse is how it should be titled. CartoonDiablo (talk) 03:23, 1 April 2017 (UTC)


 * The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page or in a move review. No further edits should be made to this section.

Include a little about heroin use?
Prescription opioids often cause users to become addicted which leads them to cheaper street drugs like heroin to feed their addiction. Should a section on heroin use or the transition to heroin use be included? It is briefly mentioned in "History of use" but that mostly talks about Vietnam veterans. Heroin is still very prevalent now so maybe some statistics on heroin use after opioid addiction would be useful. Aaron tam97 (talk) 01:44, 8 November 2017 (UTC)

"In the Media" section not very neutral?
This section talks about how media portrayal of the opioid epidemic was more favorable to white people. While this may be true, this does not seem to fit into the article that well since it is more opinionated. Also citation links in that section (83, 84) don't work. Aaron tam97 (talk) 02:12, 8 November 2017 (UTC)

So many specific examples
It is necessary to include multiple specific examples like "In March 2017, New Jersey police arrested a person possessing nearly 31 pounds (14 kg) of fentanyl (14 kg would yield 7 million lethal doses). Another 31 lbs. was seized on November 6, 2017, near the U.S.-Mexico border." and " In British Columbia, police discovered a lab making 100,000 fentanyl pills each month, which they were shipping to Calgary, Alberta. 90 people in Calgary overdosed on the drug in 2015"? These don't seem to fit with background information, which should be an overview. Natureium (talk) 21:04, 8 November 2017 (UTC)
 * Most of that section is a general overview, so a few actual real-world examples doesn't hurt.--Light show (talk) 00:38, 9 November 2017 (UTC)

Minor edit question
The following sentence (from the section: Countermeasures / State and local governments) is unintelligible:

The Office of Senator request that Trump Provide their offices with a list of his political appointees to key drug policy positions and those appointees' relevant qualifications, ...

What is the correct information? Is it the following?

The letter requested that Trump provide their offices with a list of his political appointees to key drug policy positions and those appointees' relevant qualifications, ...

Thanks. MarkGoldfain (talk) 16:00, 13 March 2018 (UTC)

How did drug companies push to make opioids so popular?
Opioids were largely considered dangerous or risky and many doctors were skeptical about prescribing them to patients at one point. How did this opinion change in the medical community? Aaron tam97 (talk) 01:41, 8 November 2017 (UTC)

ANSWER: Well, users don't take pills, they abuse the pills. They crush them to get all of the medicine in one large dose. With the introduction in 1995 of Oxycotin, this pill was "long lasting" which meant it had much more opiates in it and crushing it was a much bigger quick dose. — Preceding unsigned comment added by 2600:100C:B02E:90A:C8BB:B498:7DD2:5E45 (talk) 19:34, 17 April 2018 (UTC)

Edit question
I noticed that the "Countermeasures" section has 'In the media' and 'prescription drug monitoring'. Then below there is a second 'countermeasures' section with its own 'In the media' and 'prescription drug monitoring'. Wondering if and or how we should combine the information to flow together, asking first as I did not want to unnecessarily delete or tamper with another editors work. — Preceding unsigned comment added by Retiws (talk • contribs) 20:28, 21 April 2018 (UTC)

MEDRS
Parts of the article were just removed for failing MEDRS, but the passages in question were making claims about social issues, not biomedical ones. Natureium (talk) 13:46, 21 June 2018 (UTC)
 * Thanks for the bcc. I don't agree, obviously -- that content was especially epidemiological and about causation.  Some person who doesn't like meat-eating had added some badly sourced UNDUE content blaming meat-eating as well. Jytdog (talk) 15:25, 21 June 2018 (UTC)
 * Is MEDRS applicable to statistics on drug abuse and disease any more than it is applicable to the cost of drug abuse and disease? I must have missed the meat-eating one. That's quite an unusual hypothesis. Natureium (talk) 15:33, 21 June 2018 (UTC)

My last few additions were reverted, and I can understand why after reviewing policy further myself so I take no issue with the reversions. Per what Natureium brings up regarding social issues, a couple recent articles came to my attention and I'm wondering A) if the sourcing is adequate and B) if they belong on this page or elsewhere. The first article has to do with China's criticism of the U.S. market's own role in the epidemic, and the second is about a number of retailers experimenting with the use of blue light bulbs in bathrooms, which can apparently deter drug use. I don't want to create ill will for myself on this topic so instead of moving forward with adding this information, I would rather get some feedback so I can move forward with more confidence about my sourcing. Thanks in advance! PcPrincipal (talk) 17:48, 25 June 2018 (UTC)
 * The way I read it, neither of those articles are making health claims, so as long as they are added in a context that doesn't try to support health-related claims, they shouldn't be subject to MEDRS. Natureium (talk) 17:53, 25 June 2018 (UTC)
 * The content in this diff is epidemology/outcomes - it says "survivors of an opioid overdose were 132 times more likely to die of drug-use associated diseases in the succeeding year, as well as 24 times more susceptible to all-cause mortality."  That is WP:Biomedical information. Jytdog (talk) 21:07, 25 June 2018 (UTC)
 * To clarify, Jytdog, the diff you mention is what I was referring to regarding reversions, of which I understand. The two articles I linked in my last post aren't related to that study. Sorry for the confusion. PcPrincipal (talk) 18:57, 26 June 2018 (UTC)

Opioid epidemic (United States)
Has there been discussion in the past to consider changing the title to Opioid epidemic (United States)? Almost all the agencies mentioned are American. Entire sections deal such as "Federal Government", "State and Local Governments", "In the media", "Demographics", etc are exclusively American. Canada has a crisis as well but it has its own unique characteristics and responses. An overarching article could be created that summarizes this one, but is more generalized to include the opioid crisis globally.Oceanflynn (talk) 15:27, 26 October 2017 (UTC)


 * The subsection Opioid_epidemic touches on the issue, but there doesn't seem to be much media coverage. When that section grows it might be worth splitting. --Light show (talk) 04:25, 27 October 2017 (UTC)


 * Agreed, the article is written in a very american tone. The epidemic is a global problem- the article should be rewritten or the existing article moved to a 'Opioid epidemic (United States)' qualifier because the US is not the only country in the world. 92.1.172.148 (talk) 20:44, 2 February 2018 (UTC)

Actually, in many developing countries, there is an opioid shortage. See this It seems to me that millions of people dying in horrifying pain and suffering various injuries in horrifying pain, including innocent little children with cancer, with no opioids to give them any relief, is a bigger crisis than a few incautious people who are so eager to get as high as they can as soon as they can that they don't try a small amount first, before they take their hammer-blow dose, to make sure the street-drug they just bought isn't stronger than they think. Nomenclator (talk) 17:41, 5 September 2018 (UTC)

Include section on pill mills.
Pill mills were one of the ways opioids were so widely distributed to patients and to people who did not need the painkillers. A section on pill mills would help people understand the spread of opioid addiction. Aaron tam97 (talk) 02:00, 8 November 2017 (UTC)

There were never any pill mills. That is a myth propagated by people who want to spread fear and hatred. Propaganda with no basis in fact.Nomenclator (talk) 18:00, 5 September 2018 (UTC)

Pharmacy Students: Proposed Wiki Edits
After going over this article, we would like to add on to the following sections: Under the local government section, we would like to add opioid legislations that California had just passed and related efforts from other states (Andrea King, Beatrice Huang, Stephanie Seav, Alishia King). We will add in subsections for hydrocodone (Alishia) in the section where heroin, oxycodone, and fentanyl are located, since that is a commonly prescribed opioid medication. We would also like to expand on the treatment options by adding in suboxone (Andrea, Alishia) and non-pharm treatments (Beatrice, Stephanie) for opioid dependence. We will also include more updated statistic (from both the U.S and Canada) along with opioid epidemic information from Canada since it is not really mentioned in the article (Beatrice). Finally, we will add in more relevant articles (Andrea, Beatrice, Stephanie, Alishia). — Preceding unsigned comment added by Beatrice1223 (talk • contribs) 19:40, 16 October 2018 (UTC)

Does the draft submission reflect a neutral point of view? If not, specify
I believe this draft submission regarding increased legislation as a result of the opioid epidemic reflects a neutral point of view. Multiple states have implemented legislation to help prevent and address the opioid epidemic and this post provides neutral information to help readers better understand the extent to which different states have responded. It does not attempt to support one piece of legislation over another, but rather provides a broad overview. Stephanie Pang — Preceding unsigned comment added by 2601:640:8002:2A70:FD39:F2F:DBBB:395A (talk) 06:55, 7 November 2018 (UTC)

I believe that for the most part this group did a great job in reflecting a neutral point of view. However, I think since the opioid crisis also includes Canada, including some information about legislation in Canada (if any) would be helpful! Xcindy huynh (talk) 19:20, 8 November 2018 (UTC)

Peer Review: I reviewed your section and examined the quality of the sources and their availability. All of the citations were from reputable sources such as news reports, guidelines, information provided by organizations, and review journals. However, the difficulty with using journals and reviews is that the public often does not have access to more than the abstract. I do not know if there is a remedy to this, but maybe trying to use pieces of information that are readily available in the abstract. Other than that, these are quality sources. Allison Nguyen (talk) 08:57, 7 November 2018 (UTC)

The citations used to support their claims were secondary sources and verifiable. However, I noticed one of the sources were not appropriately cited. Citation [98] does not have an access date included in the reference. The editor should go back to fix the issue. Wikipedia has a great tool for posting citations! Anthony Lui (talk) 23:26, 9 November 2018 (UTC)

I did not detect any evidence of plagiarism or copyright infringement. Each statement that this group added is appropriately cited. Pharmacy9876 (talk) 23:12, 7 November 2018 (UTC)

Based on the recent additions, there does not seem to be any plagiarism or copyright infringement. All statements were adequately cited. Albert63093 (talk) 08:05, 9 November 2018 (UTC)

Manual of style: the edits are consistent with most of the Wikipedia's manual of style. The information flowed smoothly and had a close structural framework that was synergistic with the other subsections. A recommendation is too split SB 1109 discussion into new paragraph from SB 482, in order to separate the topics. Lastly, consider writing out the full version and the abbreviation of SB at the first occurrence to comply to the Wikipedia's manual script style format. Bcpham549 (talk) 23:04, 8 November 2018 (UTC)

DYK Nomination
I've submitted a nomination for the Main Page Did You Know...? section:
 * Template:Did you know nominations/Opioid epidemic — Preceding unsigned comment added by Zoms101 (talk • contribs) 16:00, 16 November 2018 (UTC)

Not a crisis
As of 2017, approx. 1 in 21,000 people die due to prescription opioid abuse each year. (Contrast: 1 in 3600 die of alcohol abuse each year directly. Where's the concern?) This is a drug scare, not a crisis.

Donald Trump mentioned that 116 opioid abuse deaths occur daily. I compute the average to be a bit higher at approx. 135. Trump is not incorrect here. But a sense of proportion is required. This number represents an extremely small percentage (4.1795665634675E-5%) of the US population. 71.35.127.126 (talk) 14:16, 5 April 2018 (UTC)

Good point. Also, the first sentence of the article says "The opioid epidemic or opioid crisis is the rapid increase in the use of prescription and non-prescription opioid drugs in the United States and Canada beginning..."

A rapid increase in the use of a drug does not necessarily constitute a crisis. It is only a crisis if this drug has been doing more harm than good. We don't know that that is the case. While the amount of opioids prescribed per year has steadily increased since the 1990's, the number of deaths each year per each morphine-equivalent gram of opioids, has not necessarily increased. It is hard to tell exactly how much each has increased. About 1/4 of a gram of hydromorphone has the same amount of analgesia as 1 gram of morphine. That is, morphine equivalency for 1 gram of hydromorphone, is 4 grams of morphine. Every opioid has a morphine equivalency. But except for morphine, records are not kept for morphine equivalency. You would have to do the calculations to determine how much, from a practical standpoint, the prescriptions of opioids went up, or down. For example if one year there were 1000 grams of morphine prescribed, and 1000 grams of hydromorphone, and the next year there were 2000 grams of morphine prescribed, and 200 grams of hydromorphone, you might think that opioid prescriptions went up from 2000 grams of opioids the first year, to 2,200 grams of opioids the next year. But in actuality, the effective amount went down, from 5000 grams of morphine equivalency the first year, to 2,800 grams of morphine equivalency, the next year. In some cases, the concept that prescriptions went up, statistically, is even stupidier, with only figures for the number of pills being counted in the statistics, rather than the number of milligrams of drug being counted. Morphine is available in pills containing 5, 10, 15, 30, 60, or 100 milligrams each. You can see how stupid it is to just count pills. But that's what people usually do when they produce statistics saying say prescriptions, or usage, went up, or down. Probably no-one really has a good idea how many overdose deaths have occurred per gram of morphine equivalecny, or whether the number of deaths per grams of morphine equivalency have been going up, going down, or staying the same. It seems that the main cause of overdose deaths had not been an increase in opioid prescriptions. Rather, it seems to be a result of illegal street drugs being marketed as containing heroin, actually containing fentanyl, and in unknown amounts. It seems to me that making heroin, and fentanyl, completely legal and available to buy over the counter like aspirin or tylenol, and properly labeled as to dosage, would greatly decrease the number of overdose deaths. Nomenclator (talk) 17:24, 5 September 2018 (UTC)

The previous comment suggests that it is difficult or impossible to calculate deaths per morphine equivalents. It is very possible- the DEA publishes annual production quotas (maximum amount to be produced per year) in the federal register. Multiplying these quotas by their equivalency factor and then graphing deaths vs. morphine equivalents per year would do the job. The 2019 quotas were decreased by 10% for all opioids. https://www.justice.gov/opa/press-release/file/1087591/download?utm_medium=email&utm_source=govdelivery

In fact, the trend line for opioid deaths is clearly positive, while the trend line for opioid production quotas is negative for the past several years. — Preceding unsigned comment added by 2605:A601:A028:13B4:2DCB:65BA:5684:E68D (talk) 05:40, 31 December 2018 (UTC)

Opioid Epidemic
Approximately 47,450 Americans die every year from opioid-related overdoses, and 2.1 million people suffer from some form of opioid habit (U.S. Department of Health and Human Services, 2018). Pharmaceutical companies failed to caution both prescribers and users about the high addiction dangers (Haffajee & Mello, 2017). Opioid manufacturers acted very deceitfully by withholding the harmful addictive information from the public. Furthermore, there were reports that organizations neglected to monitor and report questionable opioid supply orders. Opioid-induced deaths have reached epidemic levels due to the overprescribing of opioid medications. Prescriptions for opioid medication and illegal opioids are being misused nationally which has increased overdoses and deaths. The opioid crisis is worsening. Our country can overcome this epidemic by using better pain management techniques, educating and training the dangers of opioids, and improve when and how physicians prescribe opioids. References: Haffajee, R. L., & Mello, M. M. (2017, December 14). Drug Companies' Liability for the Opioid Epidemic. The New England Journal of Medicine, 377(24), 2301-2305. doi:10.1056/NEJMp1710756 U.S. Department of Health and Human Services. (2018, September 18). What is the U.S. Opioid Epidemic?. In About the Epidemic. Retrieved from https://www.hhs.gov/opioids/about-the-epidemic/index.htmlRschwarz4 (talk) 14:56, 3 January 2019 (UTC)Rochelle Schwarz


 * That’s interesting. How should we note this, if at all? Roxy, the dog . wooF 15:05, 3 January 2019 (UTC)

Opioid Crisis
In the United States the opioid epidemic has continued to get worse, and related overdoses continues to increase. Doctors were taught that it is unnecessary for people to suffer and have continued to prescribe this highly addictive painkiller to their patients even when they knew the patients were abusing the drug (Lembke, 2012). Luckily, the new Prescription Drug Monitoring Program (PDMP) has helped to alleviate many the over prescriptions, this is not to say that there are not more programs that need to be put in place to help with overdose, recovery and addiction prevention. A great first step in decreasing the number of related deaths through overdose is to ensure that all first responders, even non-medical sectors, which many states have already began to consider, be equipped with overdose reversing drugs such as Naloxone (Davis, 2014). Naloxone is a drug that reverses the respiratory repression caused by an overdose when administered in time (Davis, 2014). Through providing this drug to first responders, many overdoses can be non-fatal and allow recovery.

Other options for beginning to end the crisis include creating more education on opioid addiction and preventing overdoses, as well as creating easy access to recovery and rehabilitation facilities and enacting further scientific research on different therapies for those that suffer from chronic pain to reduce those who are dependent on the drug.

References

Davis, C.; Ruiz, S., Glynn, P.; Picariello, G.; Walley, A. (2014). Expanded access to naloxone among firefighters, police officers, and emergency medical technicians in Massachusetts. Am J Public Health. 104(8), e7-e9. doi: 10.2105/AJPH.2014.302062 Lembke, A. (2012). Why doctors prescribe opioids to known opioid abusers. The New England Journal of Medicine, 367(17), 1580-1581. doi:http://dx.doi.org.csuglobal.idm.oclc.org/10.1056/NEJMp1208498Marie90001 (talk) 02:48, 4 January 2019 (UTC)

Move
Seperating the situation in the USA from the rest of the world.Rathfelder (talk) 11:29, 30 March 2019 (UTC)


 * The opioid epidemic in Canada is very linked with the opioid epidemic in the United States. Why did you separate these when they're essentially the same topic? Natureium (talk) 14:37, 30 March 2019 (UTC)

New User to this Article
I am a new user to Wikipedia and I am excited to get started editing. If anyone has any feedback or recommendations for me feel free to be honest and let me know. I am open to criticism and new ideas. — Preceding unsigned comment added by Chickennuggetenthusiast (talk • contribs) 01:54, 19 February 2020 (UTC)

Edit in the section "Heroin"
I would like to make an edit in the Heroin section of the article by changing "Men are more likely to overdose on heroin." to "Women are at a higher risk of overdosing on heroin than men." The original information does not have a source that supports it and statistically speaking the amount of women that overdosed on heroin increased more than it did with men. The information I would add is supported by the journal "Increasing Prescription Opioid and Heroin Overdose Mortality in the United States, 1999–2014: An Age–Period–Cohort Analysis" by Xiwen Huang. This edit is important to the article because the new information that I would add would provide more reliable information on the statistics of heroin overdoses between male and females. — Preceding unsigned comment added by Chickennuggetenthusiast (talk • contribs) 02:22, 26 February 2020 (UTC)

Adding Information to "Prescription Drug Monitoring"
I plan on adding more information to the section "Prescription Drug Monitoring" with regards to the CDC's Guideline for Prescribing Opioids for Chronic Pain. I would like to add how the CDC highlights physical therapist intervention as a leading strategy for pain management instead of prescribing opioids. This information is supported by the editorial "Responding to the Opioid Epidemic in the United States." by Alan M Jette. This information would benefit the article by adding some more context to the CDC's Guideline for Prescribing Opioids for Chronic Pain and also highlighting one of the alternatives to prescribing opioids in regards to pain management. — Preceding unsigned comment added by Chickennuggetenthusiast (talk • contribs) 16:44, 19 March 2020 (UTC)

Adding two pieces of information in the "Demographics" section
The first piece of information I plan to add to the "Demographics" section will be the average number of deaths per day caused by opioid overdoses. The information I will add will explain how in 2016 roughly 91 people died everyday from an opioid overdose. This information is supported by the review titled "A Review of the Opioid Epidemic: What Do We Do About It?" by Edward Shipton. This information would be beneficial to the article because it can help put the number of deaths into perspective for the reader. It is harder to fully understand the number of death rates when they are put into a broader range such as number of deaths per year. Putting the average number of deaths into a smaller range such as the average number of deaths per day helps the reader grasp how many deaths there are. The second piece of information I plan to add to the "Demographics" section will be the percentiles of teenagers and young adults that report abusing prescribed opioids. This information will be supported by the journal "Nonmedical use of prescription drugs in adolescents and young adults: not just a Western phenomenon." by Silvia S Martins and Lillian A Ghandour. This information will benefit the article because it explains that the opioids being abused can also be prescribed. It also gives background on the demographics regarding the ages of opioid abusers. — Preceding unsigned comment added by Chickennuggetenthusiast (talk • contribs) 17:27, 19 March 2020 (UTC)

Suggestions
Overall, I really enjoyed reading this article. The article is very strong in its comprehensive content. All the sections and sub-sections present relevant information, building the article thoroughly with various aspects of the opioid epidemic in the United. The article has many links throughout, which is helpful given the scientific/medical nature of the topic. Furthermore, the many citations give its reliability. My main suggestion would be to reconsider organizing the article differently by breaking up the information in the “History” and “Countermeasures” sections. Perhaps you could create a new section (e.g. types of opioids) to organize the dense information. I feel that that would give a better balance to the article. The fourth paragraph in the Lead section may contain some charged words/phrases, so either adding citations or considering changing the words “uniquely American” and “worst” are some ideas. Overall, great job! Jk956 (talk) 22:01, 30 March 2020 (UTC)

Adding Information to "Codeine" Section
I plan on adding more information to the "Codeine" section by incorporating statistics that illustrate how many abusers of opioids also use alcohol or marijuana. This information is supported by the article "Purple drank prevalence and characteristics of misusers of codeine cough syrup mixtures" by Laura E. Agnich. This information would benefit the article by relating the abuse of codeine to the abuse of other substances. This would help show that opioids are being abused and sometimes mixed with other drugs. Not only being abused by themselves. — Preceding unsigned comment added by Chickennuggetenthusiast (talk • contribs) 17:52, 9 April 2020 (UTC)

"Opioid crisis" listed at Redirects for discussion
A discussion is taking place to address the redirect Opioid crisis. The discussion will occur at Redirects for discussion/Log/2021 January 9 until a consensus is reached, and readers of this page are welcome to contribute to the discussion.  Crazy Boy  826  19:10, 9 January 2021 (UTC)

Northwest Florida Daily News databases
Northwest Florida Daily News has a site:

....0mtwb9gd5wx (talk) 04:52, 22 April 2021 (UTC)

Racial Disparities
Hello! We are two students at Georgetown University taking a class called Medicine, Race, and Gender. As part of our class, we have done research on racial disparities in the opioid epidemic that we felt would be a helpful contribution to this page.

The demographics section of this page focuses on the opioid epidemic as it relates to white Americans, and while the U.S. opioid epidemic primarily affects whites in rural areas, there are specific racial disparities that are important to note. As of 2018, opioid-involved overdose death (OOD) rates are increasing at a faster rate in African American populations than in white populations (Furr-Holden et al., 2020), revealing a failure of public health initiatives to curb overdoses in these communities. The opioid epidemic is not just a problem among white people-- it affects racial minority groups as well, particularly Black and Indigenous people of color (BIPOC), and this page doesn’t have much information on its impact on these groups.

The Minnesota Department of Health found that Black Minnesotans are 2 times more likely and Native Americans in Minnesota are 7 times more likely to die of an opioid overdose than white Minnesotans are (Minnesota Department of Health, 2019). A 2021 report published by the DC Office of the Chief Medical Examiner found that 84% of those who died from an opioid overdose in Washington, DC from 2016 to 2021 were Black (Office of the Chief Medical Examiner, 2021). Due to a common media portrayal of the opioid epidemic as a problem primarily for whites in rural areas, prevention strategies are often targeted to those areas and thus fail to include initiatives to assist BIPOC who are abusing opioids, often lacking culturally sensitive practices. Furthermore, given the history of the “War on Drugs”-- which originally targeted the crack epidemic, primarily perceived as a Black epidemic-- and its impacts on Black Americans abusing opioids like heroin, culturally sensitive approaches are needed to prevent further opioid abuse in BIPOC communities. When prevention strategies are targeted only at rural, white communities, people of color are deprived of essential resources (Drake et al., 2020).

In order to fully understand the opioid epidemic in the United States, this information must be included on this Wikipedia page.

References

Drake, J., Charles, C., Bourgeois, J. W., Daniel, E. S., & Kwende, M. (2020). Exploring the impact of the opioid epidemic in Black and Hispanic communities in the United States. Drug Science, Policy and Law, 6. https://doi.org/10.1177/2050324520940428.

Furr-Holden, D., Milam, A.J., Wang, L., Sadler, R. (2020). African Americans now outpace whites in opioid-involved overdose deaths: a comparison of temporal trends from 1999 to 2018. Addiction, 116(3), 677-683. https://doi.org/10.1111/add.15233.

Minnesota Department of Health. (2019). Differences in Rates of Drug Overdose Deaths by Race. https://www.health.state.mn.us/communities/opioids/data/racedisparity.html#Example1.

Office of the Chief Medical Examiner. (2021). Opioid-related Fatal Overdoses: January 1, 2016 to January 31, 2021. Government of the District of Columbia. https://ocme.dc.gov/sites/default/files/dc/sites/ocme/page_content/Opioid%20related%20Overdoses%20Deaths%204.20.21%20FINAL.pdf.

--Laurenasl (talk) 00:54, 6 July 2021 (UTC) --Emilyadeliade (talk) 00:57, 6 July 2021 (UTC)

Article too long
This article is more than twice the size of the recommended page size. The countermeasures section is taking up most of this page, can we split this into its own article?--Megaman en m (talk) 22:55, 2 August 2021 (UTC)

Suggestion for adding to the lead
Hello! I was thinking of adding new information to the lead about a Federal case related to the opioid epidemic. This new information would make the introduction more current compared to its current state. The information is about how this is going to be handled and who is going to be held responsible according to the jury for solving the opioid epidemic financially. Currently, the lead has no information after 2019, so this will bring it up to date. Mrchongyun (talk) 23:45, 2 November 2021 (UTC)

Undisclosed paid edits
I have added an undisclosed paid tag to this article because of extensive editing by a UPE sockfarm, please see Sockpuppet investigations/Frost joyce for evidence.{{#if:Letita Bodicia| Users relevant to this page include: {{#invoke:String|sub|{{For nowiki|| {{#if:{{{1|}}}|{{Np2|{{{1}}}}},&#32;||}} |Letita Bodicia|Evilleavenger|Swunalightyear|Bert Bowler|||||||||||||||}}}|1|-8}}|}} The article will need a thorough review ensuring due weight, neutral language, and use of reliable sources before the tag is removed. MarioGom (talk) 19:38, 17 November 2021 (UTC)

COVID-19 Pandemic section is blatantly false and misleading
This entire section should be completely rewritten, or alternatively deleted entirely. It completely misrepresents what we know, and is clearly motivated by a desire to minimize the effects of the COVID pandemic on overdose deaths. It states: "But there is no national reporting system on overdose mortality to confirm these reports." The citation provided is a dead link. This data is in fact compiled by the CDC and is readily available here: https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm. The unprecedented increase in overdose deaths shown in that data is summarized in this CDC press release: https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/20211117.htm. The section continues into even more nonsense, claiming that the pandemic will start health policies that will decrease overdose deaths. It is absurd to assert this while ignoring the enormous increase in overdose deaths that has already been documented. Won't bother wasting anymore time on the rest of the nonsense in this ridiculous section. 12.35.192.132 (talk) 23:57, 3 January 2022 (UTC)

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Adding Definition of Homicide by Overdose
I plan on adding the definition of homicide by overdose in the section titled "Homicide by Overdose". I will be using the document titled "SYMPOSIUM: FROM THE CRIME SCENE TO THE COURTROOM: THE FUTURE OF FORENSIC SCIENCE REFORM: THE OVERDOSE/HOMICIDE EPIDEMIC." by Valena Beety to write the definition. This will help benefit this specific section because it will explain what it actually is as opposed to only stating information in regards to the laws surrounding it.

Adding Information to "In the media" Section
I plan on adding information regarding ALiEM's online discussion board of the opioid epidemic in 2014. I am using the source "The Prescription Opioid Epidemic: Social Media Responses to the Residents' Perspective Article" by Dr. Esther Choo to support the information. This information will benefit the article by providing more information with how the epidemic was viewed on social media.

Adding information under the "State and local governments" sections
I plan on adding a subsection about Kansas to the section "State and local governments". The information I will use is supported by the document "Kansas to Receive Federal Funds to Fight Opioid Epidemic". The information will cover what Kansas has done to help stop and prevent the epidemic from continuing. This will benefit the article because it provides information on what another state government has done to help stop the opioid epidemic.

False information: use did not increase
The sources provided for "use has increased since 2006" DO NOT say it has increased dramatically. The biggest reason behind cause of this overdose radical increase is not an epidemic of use, it is heroin being adulterated with fentanyl.

Adding Photos
I would suggest adding photos of the different medications such as Naloxone because the general public may come into contact with this medication. Seeing a photo representation of the medication would be helpful.

Formatting of Further Reading
I added two new sources to the Further Reading section, and the formatting does not match the sources that are already there. I would appreciate any advice or help on how to fix this formatting problem.

"How the opioid crackdown is backfiring"
Is the opposite POV, how the opioid crackdown is backfiring, covered enough? If not we should look into adding it. This google search has 3 million hits, including many reliable sources. – Novem Linguae (talk) 09:22, 4 May 2023 (UTC)


 * Agreed. Let’s make a section. But hard to find journal or academic scholarly research on that unfortunately. Raiders88 (talk) 23:32, 17 July 2023 (UTC)

Spin out "State coutermeasures" section?
Article is quite big, and that section has a lot of subheadings. Seems ripe for a WP:SPINOUT. Any objections? – Novem Linguae (talk) 09:18, 4 May 2023 (UTC)


 * ✅. Decided to just spin out the states. State government response to the opioid epidemic in the United States – Novem Linguae (talk) 23:48, 17 July 2023 (UTC)

Demerol?
Oxycodone is on the article, Demerol is not? Does that seem realistic? Alien4 (talk) 21:34, 14 August 2023 (UTC)

Tag team deleting relevant images
See diff.

One image was missing an archive link. Which I added. The other image was obviously relevant to the article. Here are the images:





--Timeshifter (talk) 00:47, 17 August 2023 (UTC)
 * Thanks for adding the source for the penny image. I couldn't find that information on the current DEA page and didn't think to check the archive. However, I'm curious to know whether this is a form of fentanyl that one is likely to encounter on the street or in a medical setting - Is it actually useful to illustrate a lethal dose of "pure" fentanyl?
 * As for the map, it's unclear how it illustrates the opioid epidemic. Does a higher prescription rate indicate abuse or does it simply mean that those counties have more patients who need pain medication? Also, how exactly do disability claims statistics relate to this article? This map was made for a specific purpose and I'm not sure that it makes sense to include outside of that context. –dlthewave ☎ 02:09, 17 August 2023 (UTC)
 * The fentanyl illustration shows how unbelievably dangerous it is. Much more dangerous than heroin. Many people have no idea as to how little can kill them. That is one reason so many are dying from it. People just breathing in some powder blown their way have overdosed. Videos on Youtube. One second standing up, next second on the ground with another cop administering naloxine. People often don't know what % of the drug they are taking is fentanyl. It is not hard at all to take in 2 mg.
 * Here is another map showing the relevance of the map you removed:
 * Drug overdose death rates per 100,000 by state. US map.svg
 * Overlay the maps and see what I mean. --Timeshifter (talk) 03:10, 17 August 2023 (UTC)
 * "People just breathing in some powder blown their way have overdosed" We're gonna need a MEDRS source for that, not just something you saw on YouTube.
 * We shouldn't be overlaying maps from different sources to make a point, that would be WP:SYNTH. –dlthewave ☎ 03:54, 17 August 2023 (UTC)
 * We don't have to make the claim. Just post the maps on the page. Separate them from each other if you want. Let people draw their own conclusions. And the map is still important to show where a lot of opioids are coming from. The prescription opioids get distributed all over the US.
 * And we don't need the Youtube videos. The DEA image is enough, and is authoritative. --Timeshifter (talk) 04:03, 17 August 2023 (UTC)
 * I don't feel the visualization of amount of lethal dose of fentanyl is all that helpful and seems and screams recentism because it's what's trending on media. Imagine having pictures of every type of poison conceivable in the article poisoning. Per WP:IG, image should help with understanding of the topic. I don't know how this picture really helps with understanding of opioid epidemic, so my preference would be to omit. Graywalls (talk) 02:48, 17 August 2023 (UTC)
 * Fentanyl has been in the news a long time. Overdoses from it on a steep incline up since 2016. This screams that you are uninformed. I am posting an image of the opioid killing the most people by far. Not all opioids. And see my reply to Dlthewave. Note the top line in this chart:
 * US_timeline_-_Drugs_involved_in_overdose_deaths.svg


 * --Timeshifter (talk) 03:10, 17 August 2023 (UTC)

Kratom given the same weight as opiate replacement therapy?
I was reading through this article. The "treatment" section lists KRATOM as a "popular" treatment for opiate addiction? I have knowledge about opiate replacement therapy. No serious medical practioner today would prescribe kratom if a patient entered their clinic with opiate dependence/substance use disorder. Giving it the same weight is just not due. Methadone is the gold standard in opiate addiction treatment. Followed by buprenorphine. Kratom doesn't rank even like 10th on the most commonly used medications to treat it. After that would be clonidine.

If nobody objects I'll be changing this in two days. Chuckstablers (talk) 05:45, 25 October 2023 (UTC)


 * Seriously; the methadone section is seriously lacking. I can cite literally like a dozen studies talking about how methadone carries work (in like 90% of states methadone practicioners can allow patients to take home doses as so called carries pending certain numbers of state regulated drug tests, etc).
 * Going to be working on this section a LOT over then next few weeks. If anybody wants to chime in, be my guest. I am not American, but am doing research on American laws regarding carries/methadone prescription. In my country you can take home up to a months worth of doses at a time as long as you have quarterly clean drug tests and have no history of diversion. Methadone is considered to be the gold standard in opiate treatment currently. No other treatment works like methadone, and it has been shown to essentially double the lifespan of about 40% of patients with severe opiate use disorder who are homeless. Better rates than any other treatment that exists short of heroin replacement therapy. Chuckstablers (talk) 06:09, 25 October 2023 (UTC)

Opioid crisis content

 * Note. This was moved from a user talk page to here.

Perhaps you could take a look at this revert. It seems grossly unfair to say that this was a rebuttal to the letter itself. The problem was the way the letter was being misrepresented. Also, take a look at the editing history of the article about that letter. None of the reverts have anything to do with actual content. 201.71.2.255 (talk) 10:05, 26 October 2023 (UTC)