Evidence map›Paper›PMID 40111845›Full record

ArticleJournal of the National Cancer Institute2025

Association of opioid and benzodiazepine coprescribing with adverse events among older adults with cancer.

Devon K Check, Samir Soneji, Harvey Jay Cohen, Andrea Des Marais, Katie F Jones, Charles E Gaber, Jessica S Merlin, Amy O'Regan, Nicole Fergestrom, Lauren E Wilson and 1 more

Abstract read
In one paragraph

Article in Journal of the National Cancer Institute, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Changes in opioid prescribing and high-risk co-prescribing after implementation of the 2016 CDC opioid guideline among older adults with and without cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Devon K CheckDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States.ORCID 0000-0002-0673-879X
Samir SonejiDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States.
Harvey Jay CohenDuke Cancer Institute, Duke University, Durham, NC, United States.
Andrea Des MaraisDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States.ORCID 0000-0002-2914-0109
Katie F JonesNew England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA, United States.ORCID 0000-0002-0825-8394
Charles E GaberDepartment of Pharmacy Systems, Outcomes, and Policy, College of Pharmacy, University of Illinois Chicago, Chicago, IL, United States.ORCID 0000-0002-6752-2968
Jessica S MerlinDepartment of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.ORCID 0000-0003-3207-4875
Amy O'ReganDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States.ORCID 0000-0001-6788-5673
Nicole FergestromCorEvitas, LLC, Waltham, MA, United States.ORCID 0000-0001-9455-1329
Lauren E WilsonDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States.ORCID 0000-0002-5953-2293
Aaron N WinnDepartment of Pharmacy Systems, Outcomes, and Policy, College of Pharmacy, University of Illinois Chicago, Chicago, IL, United States.ORCID 0000-0003-2906-3913

Funding

Mentoring the next generation of researchers at the intersection of opioid use disorder and chronic painK24DA056837 · NIDA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Megan Hamm, Jessica S Merlin · 2023 to 2026
$771k
Understanding and Addressing Opioid and Benzodiazepine Co-prescribing among Older Adults with CancerR21AG072688 · NIA · DUKE UNIVERSITY · PI CHECK, DEVON, WINN, AARON N · 2022 to 2023
$466k
AstraZenecaNCI NIH HHS HHSN261201800009CNCI NIH HHS HHSN261201800009INCI NIH HHS HHSN261201800015CNCI NIH HHS HHSN261201800015INCI NIH HHS HHSN261201800032CNCI NIH HHS HHSN261201800032INIA NIH HHS R21 AG072688NIA NIH HHS R21AG072688NIDA NIH HHS K24 DA056837NIDA NIH HHS K24DA056837NIH
6 · The paper itself

Abstract

backgroundMany older adults with cancer are coprescribed opioids/benzodiazepines; evidence on harms is lacking.

methodsUsing SEER-Medicare (2012-2019), we identified patients with breast, colorectal, or lung cancer. Cox proportional hazards models estimated the adjusted hazard ratios (HRs) of coprescribing (measured from claims, at the day level) with the immediate risk of overdose, fall/fracture, and all-cause hospitalization. In a secondary analysis, models were stratified by ≥90 days of continuous medication supply.

resultsIn our cohort of 107 288 patients, compared with those prescribed neither medication, those prescribed benzodiazepines had an increase in the immediate risk of falls/fractures (HR = 1.17, 95% CI = 1.02 to 1.34) and all-cause hospitalizations (HR = 1.08, 95% CI = 1.04 to 1.12). Patients prescribed opioids had an increase in the immediate risk of overdose (HR = 5.62, 95% CI = 4.86 to 5.62), falls/fractures (HR = 1.56, 95% CI = 1.41 to 1.73), and all-cause hospitalizations (HR = 1.26, 95% CI = 1.23 to 1.30). HRs were similar for patients coprescribed opioids/benzodiazepines. For patients without continuous exposure to 1 or both medications, effects were larger for coprescribed opioids/benzodiazepines vs opioids for overdose (HR = 15.22, 95% CI = 8.79 to 26.35 vs HR = 6.85, 95% CI = 6.85 to 26.35) and all-cause hospitalization (HR = 3.21, 95% CI = 2.60 to 3.96 vs HR = 1.98, 95% CI = 1.87 to 2.10).

conclusionsOverall, compared with no prescribing, benzodiazepine prescribing and opioid prescribing were each associated with an increase in the immediate risk of adverse events. Effects were similar for those prescribed opioids and those coprescribed opioids/benzodiazepines. For patients with intermittent vs long-term medication exposure, coprescribing additionally increased the risk of overdose and all-cause hospitalization.

Indexed as

Analgesics, OpioidBenzodiazepinesNeoplasmsAccidental FallsAgedAged, 80 and overDrug OverdoseDrug PrescriptionsFemaleHospitalizationHumansMaleMedicareProportional Hazards ModelsSEER ProgramUnited StatesAnalgesics, OpioidBenzodiazepines

Identifiers

PMID40111845
PMCPMC12229463

What OpenQuestion holds

Textmetadata
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.