Marijuana, Prescription Opioid, or Prescription Benzodiazepine Drug Use Among Older Adults (R21 Clinical Trial Optional) | PA 18 079

Opportunity Information: Apply for PA 18 079

The National Institutes of Health (NIH) funding opportunity titled "Marijuana, Prescription Opioid, or Prescription Benzodiazepine Drug Use Among Older Adults (R21 Clinical Trial Optional)" (Funding Opportunity Number PA-18-079) is a discretionary grant program designed to push forward what is still a relatively thin evidence base: why and how drug use affects people later in life. Even with decades of progress in substance use disorder research, NIH notes that the specific causes (determinants) and downstream effects (consequences) of marijuana use and the misuse or problematic use of prescription opioids and prescription benzodiazepines among older adults are not well understood. This announcement targets that gap directly by inviting innovative, early-stage or exploratory projects under the R21 mechanism, with clinical trials allowed but not required.

A central feature of the opportunity is its focus on adults age 50 and older, and it explicitly recognizes that "older adults" is not a single uniform group. The FOA highlights two key populations that may have very different risk profiles and outcomes. The first group includes individuals whose drug use began earlier in life and who are now aging into later adulthood, potentially bringing long-term exposure and cumulative health effects with them. The second group includes individuals who initiate drug use after age 50, a pathway that may be shaped by later-life events such as chronic pain, sleep problems, anxiety, bereavement, social isolation, retirement-related stress, or increased access to prescribed controlled medications. By separating these populations conceptually, the FOA encourages applicants to think carefully about distinct trajectories of use and distinct intervention or prevention needs.

In terms of research goals, NIH is looking for projects that either (1) examine determinants of marijuana, prescription opioid, and/or prescription benzodiazepine use in later life, and/or (2) characterize the neurobiological changes, behavioral outcomes, and broader public health consequences associated with that use. "Determinants" can include a wide range of drivers, such as medical prescribing practices, comorbid mental health conditions, pain and disability, cognitive changes, socioeconomic stressors, access to health care, stigma, policy environment, and patterns of polysubstance use (including alcohol or other medications). On the consequences side, the FOA emphasizes the aging brain and behavior, signaling interest in how these substances may interact with age-related neurological vulnerability, cognitive functioning, mood, sleep, falls and injury risk, driving safety, medication interactions, and the progression of neurodegenerative or cerebrovascular conditions. Public health consequences can also extend to health service utilization, overdose risk, emergency department visits, hospitalization, long-term care needs, and caregiver burden.

Methodologically, the announcement is deliberately broad and inclusive. NIH encourages applications that draw from basic science, clinical research, and epidemiological approaches, reflecting an interest in everything from mechanistic laboratory studies to real-world population-level analyses. That means a competitive application could involve neuroimaging, biomarker work, preclinical models relevant to aging processes, clinical observational cohorts, secondary analyses of large datasets, qualitative studies that clarify motivations and contexts for use, or pragmatic clinical investigations that document outcomes and risk patterns. Because the FOA is labeled "Clinical Trial Optional," applicants have flexibility: they may propose a clinical trial if it fits the research question, but they are not required to do so, which is often important for exploratory R21 projects.

The practical value NIH highlights is that findings from these studies could improve identification of risk factors and inform clinical practice for older adults. The implication is not only better scientific understanding, but also clearer guidance for clinicians who are balancing legitimate therapeutic uses of these drugs (for example, pain management or anxiety treatment) against heightened older-age risks such as respiratory depression when combined with other sedatives, confusion, impaired balance, or cognitive side effects. By supporting exploratory work in this area, NIH is aiming to build a stronger foundation for future prevention strategies, screening approaches, prescribing practices, and tailored interventions that account for older adults unique physiology, comorbidities, and medication regimens.

From an administrative standpoint, this is a grant (Funding Instrument Type: Grant) in the education and health funding activity categories, associated with CFDA numbers 93.279 and 93.866. The listed award ceiling is $200,000, consistent with an R21-style exploratory mechanism that typically supports early or high-potential ideas rather than large multi-year definitive trials. The opportunity was created on 2017-11-03, and the provided original closing date is 2020-05-07.

Eligibility is expansive and includes a wide range of organizations that can credibly conduct or support research. Eligible applicants include state, county, city/township, and special district governments; independent school districts; public and state-controlled universities; private institutions of higher education; federally recognized Native American tribal governments; tribal organizations other than federally recognized governments; public housing authorities/Indian housing authorities; nonprofits with or without 501(c)(3) status (outside institutions of higher education); for-profit organizations (other than small businesses) as well as small businesses; and other categories. The FOA also explicitly calls out additional eligible applicant types such as Alaska Native and Native Hawaiian Serving Institutions, AANAPISI institutions, Hispanic-serving institutions, Historically Black Colleges and Universities (HBCUs), Tribally Controlled Colleges and Universities (TCCUs), faith-based or community-based organizations, eligible federal agencies, regional organizations, U.S. territories or possessions, and even non-U.S. entities (foreign organizations). That breadth suggests NIH is interested in encouraging diverse research settings and perspectives, including community-rooted and population-specific expertise that may be essential for studying older adults across different cultural, geographic, and health system contexts.

Overall, PA-18-079 is aimed at catalyzing innovative, cross-disciplinary research that clarifies why older adults use marijuana and certain prescription medications in potentially risky ways, how those patterns differ between lifelong users and late initiators, and what the neurological, behavioral, and public health impacts look like in an aging population. The intended payoff is actionable knowledge: better risk detection, better clinical decision-making, and a stronger evidence base to protect health and functioning as the U.S. population continues to age.

• The National Institutes of Health in the education, health sector is offering a public funding opportunity titled "Marijuana, Prescription Opioid, or Prescription Benzodiazepine Drug Use Among Older Adults (R21 Clinical Trial Optional)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.279, 93.866.
• This funding opportunity was created on 2017-11-03.
• Applicants must submit their applications by 2020-05-07. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Each selected applicant is eligible to receive up to $200,000.00 in funding.
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For-profit organizations other than small businesses, Small businesses, Others.

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