Chronic opioid use among adolescent and young adult patients with inflammatory bowel disease has become increasingly common, according to research published in Inflammatory Bowel Diseases.
Anava A. Wren, PhD, of the Stanford Children’s Hospital Bowel Disease Center, and colleagues wrote that with the rise of the opioid epidemic, understanding the trends in opioid use among these younger patients with IBD has become more important.
“Adolescents and young adults with IBD are a particularly vulnerable population given their complex disease phenotype, and transition from pediatric to adult care,” they wrote. “These factors may increase adolescents’ and young adults’ risk for uncontrolled disease activity and associated pain, and treatment with opioids.”
Wren and colleagues analyzed data from patients taken from the Truven MarketScan Database between 2007 and 2015. They included patients aged 15 to 29 years with at least two IBD diagnoses and identified opioid use with prescription claims.
They found that of 93,668 total patients, 18.2% received chronic opioid therapy at some point during the study period. Patients receiving chronic opioid therapy had a greater use of biologics (36.8% vs. 26.2%) and corticosteroids (75.2% vs. 46.1%). These patients also had higher rates of comorbid pain, arthritis, anxiety, depression and substance diagnoses compared with nonchronic opioid therapy patients (P < .01).
The annual prevalence of chronic opioid use among young adults and adolescents with IBD rose from 9.3% in 2007 to 12.2% in 2011 before decreasing to 10.8% in 2015.
In a group of 2,503 patients who received chronic opioid therapy and were followed longitudinally, 30.5% were maintained on chronic opioid therapy for 2 years, and 5.3% remained on it for 4 years.
Investigators also found that patients who were maintained on chronic opioid therapy for 4 years had more visits to the emergency department, more hospitalizations and higher health care costs compared with patients who were in a 1–3-year group, as well as patients who received no chronic opioid therapy.
Wren and colleagues wrote that health care providers who treat patients with IBD need to be aware of the risk for opioid dependence among young adults and adolescents.
“Overall, health care providers should be mindful of the potential long-term effects of starting adolescents and young adults with IBD on opioids and, when prescribed, utilize multidisciplinary pain managements strategies to support timely weaning,” they wrote. – by Alex Young
Disclosures: Wren reports no relevant financial disclosures. Please see the full study for all other authors’ relevant financial disclosures.