APhA Conference Addresses Depression, Benzos

CONFERENCE REPORTER

The following poster presentations at the American Pharmacists Association (APhA) Annual Meeting & Exposition highlighted a number of changes facing psychiatry today.

Concurrent Benzodiazepine, Opioid Use Risks

Erin O'Brien

Because more than 30% of overdoses involve a combination of benzodiazepines and opioids, and more than 115 Americans die from opioid overdose every day, the investigators conducted this study to assess how much patients know about the increased risk of adverse events, overdose, and death associated with taking benzodiazepines and opioids concurrently. They also focused on the role of education, surveying study participants both before and after educational intervention. The study included 9 participants (33% male; 66% female; median age 59 years) who had been prescribed a benzodiazepine (Xanax [alprazolam], 77%; Klonopin [clonazepam], 22%; or Ativan [lorazepam], 11%) and an opioid (Norco [hydrocodone/acetaminophen], 55%; Percocet [oxycodone/acetaminophen], 22%; Roxicodone [oxycodone], 11%; or Roxanol [morphine sulfate], 11%). Participants were surveyed both before and after receiving information detailing the increased risks associated with concurrent benzodiazepine and opioid use. Each survey asked them to rank their knowledge of the medications, the potential adverse effects and overdose risk of the medications, and the risks of alcohol consumption on a scale from “unaware” to “minimal” to “good” to “excellent.”

In the presurvey, each knowledge category was divided among “excellent,” “good,” and “unaware” rankings, with “minimal” only appearing in the knowledge of overdose category at a little over 20%. Most participants ranked their knowledge as “excellent” in only the knowledge of medications category (a little more than 40%), with “good” leading the rankings in the potential adverse effects and alcohol consumption categories nearly 60% and a little more than 40%, respectively. Around 20% of participants ranked their knowledge as “unaware” across all 4 knowledge categories. In the postsurvey, no participants ranked their knowledge as “unaware” or “minimal” in any category. In both the knowledge of medications and the potential adverse effects categories, patients ranked their knowledge as “good” or “excellent” at around 80% and around 20%, respectively. In knowledge of alcohol consumption risks, the majority of participants (around 90%) ranked their knowledge as “excellent,” with the remaining 10% ranking it as “good,” and 100% of participants ranked their knowledge of overdose—the category with the most varied results in the presurvey—as “excellent.”

Although patient education resulted in clear improvement of self-reported knowledge and understanding, only 1 participant changed their medication regimen to lower the risks of adverse events. According to the investigators, this means that patients are reluctant to change their prescribed medications even with greater awareness of the risks.

“Overall, patients can have a good baseline knowledge, but the results of this study demonstrate how pharmacists can further improve patient understanding… and knowledge of the medications [patients] are currently prescribed,” the investigators concluded.

Depression Among Sexual Minorities

Leah Kuntz

In their poster presentation, Kafi Friday, BA, PharmD candidate 2023; and Prashant Sakharkar, PharmD, MPH, explained that sexual minorities, or individuals with nonheterosexual sexual orientation, face increasing challenges in achieving health equity, due to stigma and discrimination.¹ Via a retrospective cohort study, the investigators sought to examine health disparities and level of depression among sexual minorities; compare the prevalence of sexually transmitted infections, smoking, illicit drug use, and alcohol use in use in sexual minorities; and determine predictors of depression among sexual minorities.

The study’s results painted a grim picture for sexual minorities: sexual minorities were 3 times more likely to have gonorrhea and chlamydia infection, 65% more likely to use illicit drugs, 52% more likely to be a smoker, 3 times more likely to experience severe depression, and 2 times more likely to see a mental health clinician.

These findings suggest that depression can be a consequence of health and behavioral disparities. Screening—particularly in females who identify as a sexual minority, smoke, use illicit drugs, are under the age of 45, and are poor—might help in early intervention. Furthermore, the investigators noted future research should examine the association of depression, gender, and sexual minority status.

Want to learn more on the advances in psychiatry? Join us this August at the 2022 Annual Psychiatric Times™ World CME Conference. For more information and to register, visit gotoper.com/psych22.

Reference

1. Baciu A, Negussie Y, Geller A,alWeinstein JN, eds. Communities in Action: Pathways to Health Equity. National Academies Press; 2017. ❒