User:Alexloopy/Opioid overdose/Grahtreas Peer Review

General info

 * Whose work are you reviewing?

alexloopy


 * Link to draft you're reviewing
 * Opioid overdose


 * Link to the current version of the article (if it exists)
 * Opioid overdose

Evaluate the drafted changes
This looks great! Below are my thoughts (following the guiding questions).

Lead
I know you haven't edited this section too much yet, so I'll keep my comments brief and broad.

--Overall, I feel like the lead is concise, and has good information within it. However, the order of information makes it a little difficult to follow (especially the first few sentences).

--I would also pay attention to the use of jargon in the lead. I feel like it'd be good to contain all the jargon to one paragraph of the section (to talk about mechanisms, epidemiology, and studies), and then in the others, swap out terms like 'respiratory depression' for slow and shallow breathing.

''Thanks for these suggestions. I cleaned up some inaccurate claims in the Lead and clarified some jargon.''

Content
Overall, the sections are great, and I really like the work you did to build out the treatments section (it makes a lot more sense). My personal hunch (backed by no evidence) is that this page may also have some traffic from non-medical people (e.g. if someone is concerned their loved one is currently overdosed, or learning about this after their loved one has had an overdose). With these people in mind, I'd think about several other sections (note that these are loosely held opinions, choose whatever you think is relevant):

--What to do if you are afraid that someone close to you is overdosing: This section could be written in the simplest of english, and tell people to where to seek medical care, how to monitor ABCs (but elaborate more than just saying basic life support). Additionally (if this is true), you could include say that medical professionals will not report you to law enforcement if you seek care.

--Natural History: Perhaps a (brief) overview of the types of cognitive deficits that can persist after opioid overdose. I am biased when I want people to know about this and have a story to tell (perhaps not in this review). Can also talk about additional risks (bacteremia, endocarditis, etc.)

--Government response (essentially what is being done): Can talk about new prescribing databases, giving people home naloxone, lawsuits agains pharmacies and manufacturers, etc.

--Grief: Brief overview of how loved ones find support after this happens (this section could mostly be links)

**** Would also mention the risks of unnecessary naloxone (essentially none) and stress the point of "give it if you think they might need it."

>> Thanks for this suggestion, added

Sources and References:
Excellent work. Your references are very thorough and from the right types of sources. I do not perceive a bias. Well done.

Organization
I know you have not edited the following sections yet, but wanted to provide some ideas.

Signs and Symptoms:
I'd break the toxidrome triad into each of the 3 symptoms, each with their own header. I'd then talk about what "normal" is, and how to know if they are abnormal. For example, I'd bring in the pictures of the pupils, talk about responsiveness for consciousness, and then say what a normal respiratory rate is, and how to tell if volume is low (e.g. chest rise). I'd think most providers would probably skip this section, so I'd write it for the concerned friend audience.

Causes:
Maybe mention the synthetics? I imagine there may be a higher risk of overdose if you buy something off the street vs. take too many of something that a doctor prescribed. Can also touch on increase in overdoses since synthetic opioids have become popular.

Images and Media
Consider adding an image of the pinpoint pupils. I feel like people don't know what a normal pupil size is until they look weird.

>>Added image of miosis

Overall impressions
I really like the changes that you made to the treatments section, particularly in splitting out the types of Naloxone. I'd stress within that section that Naloxone doesn't have many risks to a sober person, so it should be given without hesitation if opioid overdose is even a possibility.

>>Thanks or this suggestion, added that naloxone is safe and side effects are rare.

The overall flow of the article is great, and it is at a good length where all the information is useful, but no so repetitive and overly detailed.

I think you do a great job of making sure that there is good information for both a medical and non-medical audience!

Excellent work!

~