# Understanding and Addressing Opioid and Benzodiazepine Co-prescribing among Older Adults with Cancer

> **NIH NIH R21** · DUKE UNIVERSITY · 2022 · $263,370

## Abstract

PROJECT SUMMARY/ABSTRACT
After a cancer diagnosis, the potential for overlap in opioid and benzodiazepine prescriptions is substantial,
with up to 30% of patients concurrently prescribed both types of drugs. Opioids continue to be the mainstay of
cancer-related pain management, and benzodiazepines are frequently prescribed to help patients manage
other common symptoms of cancer and its treatment. When prescribed in combination, opioids and
benzodiazepines can have the unintended consequence of compromising patient safety and well-being—
particularly for older patients. Among older members of the general population, co-prescribing of opioids with
benzodiazepines has been linked to a substantially increased risk of injurious falls, fractures, and opioid
overdose events. The risks of opioid and benzodiazepine co-prescribing may be compounded in older adults
with cancer, who are more vulnerable to the effects of opioids and benzodiazepines on postural stability and
cognition due to the neurological effects of chemotherapy. In addition, older adults with cancer frequently
experience breathing difficulties (i.e., dyspnea), which can further predispose them to opioid- and
benzodiazepine-related respiratory depression—the cause of overdose death. At present, there are critical
knowledge gaps that hinder efforts in the older adult population to (1) reduce avoidable co-prescribing of
opioids and benzodiazepines after a cancer diagnosis and (2) prevent harms among those who are exposed to
this drug combination after a cancer diagnosis. First, we lack fundamental knowledge about population-level
patterns of opioid and benzodiazepine co-prescribing among older adults with cancer. Second, no studies have
examined the burden of harms resulting from co-prescribing among members of this population. Third, no
studies have explored providers’ perspectives with respect to opioid and benzodiazepine co-prescribing among
older patients with cancer. Our proposed study uses an explanatory sequential mixed-methods design to
address these evidence gaps. The quantitative phase of our study will use SEER-Medicare data to (a)
Characterize patterns of opioid and benzodiazepine co-prescribing among older adults diagnosed with breast,
colorectal, or lung cancer (Aim 1) and (b) Examine the risks of avoidable harms associated with opioid and
benzodiazepine co-prescribing among members of this population (Aim 2). In the qualitative phase of the
study, we will conduct semi-structured interviews with
providers to identify factors that influence their practices
with respect to co-prescribing and mitigating associated risks among older adults with cancer (Aim 3). At the
conclusion of this study, we will have a contextually rich understanding of the extent of co-prescribing and
harms potentially resulting from co-prescribing among older adults with cancer, and factors that may facilitate
or hinder efforts to reduce unnecessary co-prescribing and improve the use of risk mitigation strate...

## Key facts

- **NIH application ID:** 10371456
- **Project number:** 1R21AG072688-01A1
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Devon Check
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $263,370
- **Award type:** 1
- **Project period:** 2022-02-15 → 2023-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10371456

## Citation

> US National Institutes of Health, RePORTER application 10371456, Understanding and Addressing Opioid and Benzodiazepine Co-prescribing among Older Adults with Cancer (1R21AG072688-01A1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10371456. Licensed CC0.

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