October 15, 2014
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IBD increased risk for heavy opioid use

Having inflammatory bowel disease was found to increase an individual’s risk for becoming a heavy opioid user, which subsequently increased the risk for mortality, according to new research data.

Researchers from Manitoba, Canada, performed a large population-based study to determine the risk factors for opioid use among patients with IBD, whether IBD was an independent risk factor for opioid use, and whether opioid use was associated with a higher risk for death in patients with IBD. Using data from the Manitoba IBD Epidemiology Database, they identified 4,217 patients with IBD diagnosed from April 1996 to March 2010 who were prescribed opioids before and after diagnosis and compared them to matched controls identified using the Drug Prescribing Information Network.

Opioid use among patients with IBD peaked in the first month after diagnosis and was higher in females compared with males (11.9% vs. 9.9%; P=.038) and for Crohn’s disease compared with ulcerative colitis (13.4% vs. 8.9%; P<.0001), a pattern which persisted throughout the study period. Within 10 years after IBD diagnosis, 5% of patients became heavy opioid users. Patients with IBD were more likely to use opioids 5 years before diagnosis compared with controls (OR=1.36; 95% CI, 1.21-1.53) and had increased risk for becoming heavy opioid users compared with controls (OR=2.91; 95% CI, 2.19-3.85), especially those diagnosed before age 25 years (HR=5.99; 95% CI, 2.63-13.6). Furthermore, heavy opioid use was strongly predictive of mortality among patients with IBD (OR=2.82; 95% CI, 1.58-5.02).

“Heavy opioid use is associated with a significant risk of mortality in IBD,” the researchers concluded. “Strategies directed at limiting and closely monitoring the use of opioids in IBD patients may serve to reduce the risk of subsequent heavy opioid use and for identifying IBD patients at higher risk for mortality.”

Disclosure: See the study for a full list of relevant financial disclosures.