Opioid Resource Center

Opioid Resource Center

November 16, 2018
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Depression, COPD increase risk for persistent opioid use in patients with IBD

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New persistent opioid use is becoming increasingly common among patients with inflammatory bowel disease, particularly for patients with mental health disorders and chronic obstructive pulmonary disease, according to research published in Alimentary Pharmacology & Therapeutics.

Mohamed Noureldin, MD, of the division of gastroenterology and hepatology at Michigan Medicine, and colleagues wrote, that previous studies have identified IBD itself as a risk factor for higher doses of opioids, and they wanted to assess patient factors for persistent use among opioid-naive patients.

“New persistent opioid use has been associated with different patient factors including behavioral and pain disorders,” they wrote. “Appreciating the dangers of prescribing narcotics for patients with IBD is an important step in the prevention of narcotic misuse.”

Researchers identified 15,119 patients with IBD from a national insurance claim data set who received opioids around the time of a corticosteroid-treated IBD flare.

They grouped patients based on their prior opioid use; naive, intermittent users, and chronic users.

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Depression, COPD and other factors contribute to new persistent opioid use among patients with inflammatory bowel disease.
Source: Shutterstock.

Investigators found that out of 5,411 patients designated as opioid-naive, 35% developed persistent opioid use after their flare. They identified history of depression (HR = 1.29; 95% CI, 1.13–1.47), substance abuse (HR = 1.36; 95% CI, 1.2–1.54), COPD (HR = 1.17, 95% CI, 1.04–1.3), Crohn’s disease (HR = 1.26, 95% CI, 1.14–1.4) and indeterminate colitis (HR = 1.6, 95% CI, 1.36–1.88) as factors associated with new persistent opioid use.

Noureldin and colleagues wrote that these findings could spur the development of new strategies to manage chronic pain among patients with IBD.

“These findings can be helpful in riskstratifying patients when choosing an acute pain therapy and guiding counseling of patients before prescribing opioids to opioidnaive patients experiencing an IBD flare,” they wrote. “Further studies are warranted to investigate the physicianlevel and healthsystem level risk factors associated with new persistent opioid use.” – by Alex Young

Disclosures: Noureldin reports no relevant financial disclosures. Please see the full study for all other authors’ relevant financial disclosures.