Talk:Stephen Paddock/Archive 2

Benzodiazepines

• @Dlthewave and Anythingyouwant: Here is what we know. On June 21st a Henderson physician prescribed him 50 tablets of diazepam, 10 milligrams each.^[1] It was the highest dose possible (short term relief only).^[2] The prescription was filed with the Nevada Prescription Monitoring Program as required. Paddock purchased Valium without insurance at Walgreens in Reno on the same day. He was prescribed one treatment of one pill a day according to Dr. Winkler’s office.^[1] All else falls within the patient confidentiality laws. — The manufacturer's brochure says: "If you are to take diazepam regularly, you could be asked to take one, two, or three doses a day ... up to a maximum of four weeks of treatment."^[3] The treatment cannot exceed four weeks apparently which means, Paddock could not have been prescribed more pills. In total, the last 10 days of June plus the months of July, August, and September (ahead of massacre) amounts to 102 days since the purchase of Valium. After 50 days, Paddock was on his own: "There is naturally a high potential for benzodiazepine abuse, even with those who are given a prescription by a doctor overseeing their case" says the Addiction Help Center.^[4] Benzos are a popular street drug in all of North America. Paddock did not have to go back to Dr. Winkler's office to get it, and there's no need for speculations about what he did afterwards. However, the prescribed period of treatment between June 21 and mid-August coincided with his preparations for the attack. This is not WP:SYNTH but a simple math without opinion about whether he took the drug or not, which would have been original research by our standards. Quote: “If somebody has an underlying aggression problem and you sedate them with that drug, they can become aggressive,” said Dr. Mel Pohl, chief medical officer of the Las Vegas Recovery Center. … “It is much like what happens when you give alcohol to some people … they become aggressive instead of going to sleep.” Pohl … said the effects of the drug also can be magnified by alcohol.^[1]

Please note: article makes references to a 2015 study published in World Psychiatry.^[5] Poeticbent talk 19:23, 9 October 2017 (UTC)

Statements we should be allowed to make

Referenced to reliable third party sources about Paddock.

• On June 21 Paddock was prescribed 50 tablets of diazepam – the highest dose of 10 milligrams each,^[1][2] and filed his prescription the same day.^[1][6]
• The prescribed period of diazepam treatment between June 21 and mid-August coincided with his preparations for the attack.^[1]
• The side effects of diazepam treatment, in case of an underlying aggression problem, can also be magnified by alcohol according to chief medical officer of the Las Vegas Recovery Center.^[1]

Notes

There’s more info about him and Valium here. But I am satisfied with what’s in this Wikipedia article now, and don’t favor adding to it at this time. Doing so could be stirring a hornet’s nest, disrupting a careful compromise, and inadvertently result in all of this material being stricken. Anythingyouwant (talk) 19:34, 9 October 2017 (UTC)

I agree that these are all well-sourced statements. My question is, why would you choose to put them together in this article? The only reason I can think of is to lead the reader toward the conclusion that he combined Valium and alcohol, which has not been established by reliable sources. –dlthewave ☎ 22:43, 9 October 2017 (UTC)

• Once we agree that the above information is compliant with the WP:RS policy guideline and that it relates to Paddock's lifestyle specifically, we can also ask ourselves, how is this different from the inclusion of his father's psychopathic tendencies in this article? Why did we choose to put it here? — What is the reason for it ... other than to lead the reader toward the conclusion that Stephen Paddock inherited psychopathic tendencies from his father, which has not been established. The autopsy is not going to help resolve this. We are allowed to provide relevant and confirmed facts about the subject in accordance with WP:BIO, but we should not be attempting to make ourselves look smarter than the reader.

@Fuzheado, GreenC, John from Idegon, and FreeKnowledgeCreator: please let us know what you think about this. Poeticbent talk 23:46, 9 October 2017 (UTC)

Responding to the ping. What y'all are failing to discern here is what makes a source secondary. Just because it is reported in a newspaper magazine or on the idiot box does not automatically make it a reliable secondary source for our use. If the source is reporting that the investigation is looking into a drug alcohol connection, we should report that (but no analysis of the meaning of that - unquestionably that would be WP:OR, and that is what the referenced bit above appears to me to be). However, if the media is postulating that as a contributing factor, then the media report is primary and we shouldn't be using it. And I'm not aware of the experience level of the editor's here, so apologies in advance if it appears I'm "talking down" to y'all. But you do realize that this whole line is well past the point where WP:MEDRS would apply, right? If for no other reason, I'm opposed to this bit completely on those grounds. I think the primacy of sourcing is a more important argument. It isn't our place to solve this; we simply report what reliable secondary sources say. John from Idegon (talk) 02:46, 10 October 2017 (UTC)

User:John from Idegon, we can easily get reliable medical sources that say mixing alcohol with valium is a no-no, but they don't mention Paddock, and so using them here might be synthesis. Additionally, we have a reliable non-medical source that says the same thing but does describe Paddock. Is all of that insufficient for us to mention in this article that mixing alcohol and valium is a no-no? If so, it's difficult to see how this article can ever mention that mixing these two substances is a no-no. Incidentally, the reliable non-medical source links directly to this reliable medical source. Anythingyouwant (talk) 04:34, 10 October 2017 (UTC)

I have yet to see a reliable source that actually draws a connection between Paddock's Valium use and the alcohol contraindication. It is very common for the media to quote medical sources and interview experts in the field for general background information, even though these statements are not specific to the case at hand. –dlthewave ☎ 04:49, 10 October 2017 (UTC)

Right, and we can convey some of that general background information. Anythingyouwant (talk) 05:10, 10 October 2017 (UTC)

No. See John from Idegon's response above. –dlthewave ☎ 12:29, 10 October 2017 (UTC)

• I like what you said, John from Idegon, quote: "If the source is reporting that the investigation is looking into a drug alcohol connection, we should report that (but no analysis of the meaning of that...)." The operative word is 'reporting' what the investigation is 'looking into'. Here's a relevant quote from the article in Review Journal (Oct. 5, 2017 update): Washington, D.C., attorney Paul Kamenar said: “An autopsy may help us get some toxicology answers as to why Paddock did what he did in Las Vegas.” Officials with the Clark County coroner’s office have not said whether an autopsy has been done of Paddock. The office did not respond to requests from the Review-Journal for comment on Tuesday and Wednesday.^[1] — In other words, we just have to wait for what is being reported next. However, the information about the prescribed period of diazepam treatment between June 21 and mid-August still holds.^[2] The period coincided with his preparations for the attack. Poeticbent talk 16:41, 10 October 2017 (UTC)

Notes

Report what the sources say, but remember that they may have more than one interpretation, so be cautious. Did Paddock start treatment and get turned psycho by it, or did he turn psycho and say what he needed to a doctor to get Valium to steady his nerves while he prepared an arsenal and explosives with some left over to keep him confident the day of the attack? We don't know unless sources go out and hang one or both of those lanterns for us. Wnt (talk) 21:39, 10 October 2017 (UTC)

Semi-protected edit request on 15 October 2017

This edit request to Stephen Paddock has been answered. Set the |answered= parameter to no to reactivate your request.

Please change X

According to a Business Insider article, “As it stands now, the link between diazepam and Paddock's actions is tenuous at best — though some celebrities have said otherwise.”[43]

to Y

According to a Business Insider article, “As it stands now, the link between diazepam and Paddock's actions is tenuous at best — though some celebrities have said otherwise.”[43]

The Justice Department fact sheet on benzodiazepines, the general class in which Valium is found, states, "Adverse effects include ... delirium, aggression, depression, hallucinations, and paranoia..."^[1]

Some medical authorities believe that the adverse psychiatric effects of Valium are common, defined as affecting beween 1% to 10% of users. "Common (1% to 10%): Confusion, withdrawal symptoms, euphoria, increased anxiety/anxiety, panic, irritability, delirium, aggressiveness/aggression, numbed emotions, instability, restlessness, agitation, inappropriate behavior, delusions, rage, hallucinations, nightmares, confusional or paranoid psychosis/psychoses."^[2] Zaitzeff (talk) 16:49, 15 October 2017 (UTC)

• Thanks for mentioning this, user Zaitzeff (talk · contribs), but the general rule to follow here is: no WP:SYNTH meaning, Paddock needs to be mentioned there as well. However, the current write-up needs to be revised (no question about it), mainly because the Business Insider is not a proper source for the subject of drugs and alcohol abuse, and the article is old in the timeline of developing stories. I will look into this, thanks. Poeticbent talk 17:37, 15 October 2017 (UTC)
• The more I read online about "AGGRESSION, VIOLENCE & BENZODIAZEPINES" (Facts, Figures & Quotations By Susan Bibby & Ray Nimmo, 2001) the more I see that: "The implications of the combination of anti-anxiety agents and aggressiveness are astounding." — However, the magic word "Paddock" is still missing from there, and so is the connection with alcohol. The Las Vegas shooting may as well lead to a major shakedown in the psychiatric community's attitude toward the side effects of excessive prescriptive use of Valium but that is way beyond the scope of our article. Poeticbent talk 19:59, 16 October 2017 (UTC)

Business Insider article

Article uses unreliable source: "According to a Business Insider article, “The drug should not be taken with alcohol....As it stands now, the link between diazepam and Paddock's actions is tenuous at best — though some celebrities have said otherwise.”[37]" This is a medical question which requires a medical or pharmacological citation. (PeacePeace (talk) 17:48, 9 October 2017 (UTC))

Why? The cited source is generally reliable, cites the National Library of Medicine, and links to this study. Anythingyouwant (talk) 17:50, 9 October 2017 (UTC)

Then am I wrong for thinking that the Business Insider is at best a tertiary, not secondary source, for drug interaction information. And isn't the opinion of "some celebrities" just gossip? BTW, you are aware that the hotel manager claimed that Paddock & his GF were remarkably teetotal? (PeacePeace (talk) 18:04, 9 October 2017 (UTC))

That he was a heavy drinker has been pretty well established, but if you’d like to dispute it then probably the best place would be at the pertinent discussion in the shooting article’s talk page. I doubt the article cited here is a tertiary source as opposed to secondary, but anyway “Reliable tertiary sources can be helpful in providing broad summaries of topics that involve many primary and secondary sources”. Anythingyouwant (talk) 18:12, 9 October 2017 (UTC)

We have RS saying that he was a heavy drinker, that he had a Valium prescription and that Valium and alcohol should not be mixed. What we don't have is an RS that ties those facts together or states that he was actually combining Valium and alcohol. The sources about Valium list a number of restrictions and side effects, so I'm not sure why we would include only the alcohol one. –dlthewave ☎ 19:21, 9 October 2017 (UTC)

We cannot use “the sources about Valium” unless they also discuss Paddock, due to WP:OR. Anythingyouwant (talk) 19:28, 9 October 2017 (UTC)

Should we really mention Valium at all?

I originally argued against mentioning Valium at all. Now that more information is known, and it seems he had an alcohol problem, it becomes slightly more relevant in my opinion.

However, there is only one source claiming that he was prescribed Valium, and all other sources refer to that source. The original source is the Las Vegas Review-Journal, which cites an unnamed person who provided the newspaper with illegally obtained information from the Nevada PDMP (prescription drug monitoring program). Whoever accessed the Nevada PDMP, they did so illegally. During the press conference on Monday, October 9th, Sheriff Lombardo of the LVMPD repeatedly refused to answer questions about Valium, saying the LVMPD and the FBI are investigating any and all physical and mental health records and they will release information if and when it is appropriate.

Unless a doctor or a law enforcement official confirms that Stephen Paddock was prescribed Valium, I am of the opinion that we should not print this information. I think it is likely true that he received 100 pills over the course of 2 years, but the person who provided that information to the press was violating the law. I can easily forge a report from the Nevada PDMP saying that Stephen Paddock took any controlled substance that I care to put in the forgery, and it might never be uncovered as a forgery unless law enforcement officials decided to specifically address it. Sheriff Lombardo has explicitly stated that he is not going to answer questions about the alleged Valium prescriptions, so I think this is possibly not fit for inclusion on Wikipedia. I am not sure, though. Sometimes illegal leaks are good for the world, even if law enforcement wishes the leak had not happened. As I said before, I suspect Stephen Paddock actually was prescribed Valium, and it has received a fair amount of media attention, so I am not removing it from the article at this time. However, I did clarify the language. Fluoborate (talk) 03:33, 10 October 2017 (UTC)

• Please read what has already been established, before speculating and casting aspersions. You have no proof on any-kind that the Las Vegas Review-Journal (est. 1909), the main source of info about Paddock's Valium prescription: "illegally obtained information from the Nevada PDMP (prescription drug monitoring program)." This is your own speculation of no significance to our Wikipedia article. The Las Vegas Review-Journal (which obtained the records) is a reliable third-party source by our standards. Since the attack, the Las Vegas Review-Journal published a series of articles by different authors interviewing medical doctors about Paddock, including (originally) Dr. Mel Pohl, chief medical officer of the Las Vegas Recovery Center, and Dr. Michael First, a clinical psychiatry professor at Columbia University. Our write-up is not about the psychiatric drugs and violence but about the psychiatric drugs ... alcohol abuse and violence with no relation to those patients who benefit from their use. — On a side note: information about Watergate was obtained by the Post from the anonymous Deep Throat. Does is sound like a 'reliable source' to you? Poeticbent talk 15:41, 10 October 2017 (UTC)

I've added sources and updated accordingly. Here's what the paragraph looks like now:

During his last months, he reportedly smelled of alcohol, was despondent,^[1] and he is reported to have filled prescriptions for the anti-anxiety drug Valium (diazepam) in 2013,^[2] 2016, and 2017.^[3][4][5] According to a Business Insider article, “As it stands now, the link between diazepam and Paddock's actions is tenuous at best — though some celebrities have said otherwise.”^[6]

References

1. [1]

   Geller, Adam; Balsamo, Michael; Cooper, Jonathan; Melley, Brian (October 7, 2017). "Stephen Paddock: Las Vegas shooter was 'the king of microaggression', brother says". The Independent. Retrieved October 7, 2017.
2. [2]

   Glover, Scott and Lat, Kyung. “Exclusive: Vegas killer described his unusual habits in 2013 testimony”, CNN (October 9, 2017).
3. [3]

   Brean, Henry; Millward, Wade Tyler; Lopez, Sandy (October 7, 2017). "Las Vegas Strip shooter prescribed anti-anxiety drug in June". Las Vegas Review-Journal. Retrieved October 9, 2017.
4. [4]

   Hayes, Christal. “Las Vegas Gunman Had a Valium Habit, Would Gamble $1 Million a Night”, Newsweek (October 9, 2017).
5. [5]

   Osborne, Mark et al. “5 days after Las Vegas massacre many questions remain, few answers”, ABC News (October 6, 2017).
6. [6]

   Ramsey, Lydia (October 6, 2017). "The Las Vegas shooter was reportedly prescribed a common anxiety medication — here's what you need to know about it". Business Insider. Retrieved October 6, 2017.

There seem to be at least three pieces of evidence for valium use: a 2013 deposition, info from the Nevada Prescription Monitoring Program, plus a valium bottle was found in his room. It's been reported in dozens (if not more) reliable sources. Anythingyouwant (talk) 04:06, 10 October 2017 (UTC)

Photo

Wouldn't it be better to use his driver's license photo where his eyes are open? http://i.dailymail.co.uk/i/pix/2017/10/04/14/4503E82400000578-4948306-image-a-5_1507123248839.jpg — Preceding unsigned comment added by 165.166.226.254 (talk • contribs) 18:12, 12 October 2017 (UTC)

 Not done. The current photo of Paddock holding a drink is telling a bigger story. Poeticbent talk 15:28, 16 October 2017 (UTC)

Fair Use photo vs free alternative

The current photo is Fair Use because no free alternative exists. However according to this source (NBC News) there is a photo of him attributed to the "U. S. Government" which would make it free and clear of copyright. However some other sources attribute this photo as a drivers license photo issued by a state (NV I suppose). Any thoughts or ideas? -- GreenC 15:41, 17 October 2017 (UTC)

• I have two comments to make. Firstly, the photo of him drinking tells a bigger story. Secondly, his driver's license photo might not be in the public domain, because "US passport photos are supplied by the passport's subject, and the copyright is almost always actually held by the photographer..." said Jameslwoodward, our Commons' bureaucrat, checkuser, sysop, and OTRS-member. Poeticbent talk 23:16, 17 October 2017 (UTC)

Please read WP:Fair use. 'Telling a bigger story' has nothing to do with copyright law. If there is a free version available a Fair Use claim is invalid and the current picture would be removed from Wikipedia as a copyright violation. The only question is if there is a free version available. Also the picture in question is not a passport photo you seem to be confusing it with a different photo. -- GreenC 04:40, 18 October 2017 (UTC)

I'm afraid I didn't make myself clear enough, GreenC. I don't think a drivers license photo is free. The choice we have, in all likelihood, is between two WP:Fair use images. Poeticbent talk 04:58, 18 October 2017 (UTC)

• I can’t imagine why the federal government would have issued him a driver’s license. Must be a mistake. Anythingyouwant (talk) 23:37, 17 October 2017 (UTC)

How does a pic showing a guy holding a drink imply something if you don't know what is in the drink? BTW, did Paddock have a pilot's license?(PeacePeace (talk) 02:07, 23 October 2017 (UTC))

you don't know what is in the drink - How do we know your not a foreign agent trying to sow doubt about the official narrative in order to spread uncertainty about the US government? Because we assume good faith and don't introduce complicated and unusual theories without strong evidence. -- GreenC 18:29, 24 October 2017 (UTC)