Concurrent Opioid and Benzodiazepine Prescriptions Among Older Women Diagnosed With Breast Cancer

J Natl Cancer Inst. 2020 Jul 1;112(7):765-768. doi: 10.1093/jnci/djz201.

Abstract

Guidelines recommend using caution in co-prescribing opioids with benzodiazepines, yet, in practice, the extent of concurrent prescribing is poorly understood. Notably, no population-based studies, to our knowledge, have investigated concurrent prescribing among patients with cancer. We conducted a retrospective cohort study using data from the Surveillance, Epidemiology, and End Results (SEER) database linked with Medicare claims (2012-2016) for women diagnosed with breast cancer. We used modified Poisson regression to examine predictors of any concurrent prescriptions in the year post-diagnosis and Poisson regression to examine predictors of the number of overlapping days. We found that 13.0% of the 19 267 women in our sample had concurrent prescriptions. Women who underwent more extensive treatment and those with previous use of opioids or benzodiazepines were at increased risk for concurrent prescriptions (adjusted risk ratio of previous benzodiazepine use vs no previous use = 15.05, 95% confidence interval = 13.19 to 17.19). Among women with concurrent prescriptions, overlap was most pronounced among low-income, rural, and Hispanic women (adjusted incidence rate ratio of Hispanic vs non-Hispanic white = 1.25, 95% confidence interval = 1.20 to 1.30). Our results highlight opportunities to reduce patients' unnecessary exposure to this combination.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Analgesics, Opioid / administration & dosage*
  • Benzodiazepines / administration & dosage*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / epidemiology
  • Cohort Studies
  • Drug Prescriptions / statistics & numerical data*
  • Female
  • Humans
  • Retrospective Studies
  • SEER Program
  • United States / epidemiology

Substances

  • Analgesics, Opioid
  • Benzodiazepines