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Chronic narcotic use common among pediatric IBD patients
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Chronic narcotic use is prevalent among children with inflammatory bowel disease, especially those with anxiety and depression, according to new research data.
In order to determine the prevalence of chronic narcotic use in children with IBD compared with those without IBD, and also to determine the variables associated with narcotic therapy among pediatric IBD patients, Jessie P. Buckley, MPH, from the department of epidemiology at University of North Carolina, Chapel Hill, and colleagues performed a cross-sectional study that included 4,911,286 children younger than 18 years with continuous health plan enrollment from 2010 through 2011 identified using a large administrative claims database. They identified 4,344 children with IBD (63% Crohn’s, 37% ulcerative colitis) using diagnosis codes and pharmacy claims for IBD medications, and matched them based on age, sex and region with five children without IBD (n = 21,720). Narcotic analgesic use was determined using dispensed prescription drug claims, and chronic users were defined as having at least three claims through the study period.
Jessie P. Buckley
They found that 5.6% of the pediatric IBD patients were chronic narcotic users compared with 2.3% in the general population (OR = 2.59; 95% CI, 2.21-3.04). Relative to the general population, chronic narcotic use was higher among pediatric IBD patients who also had psychological impairment (OR = 6.75; 95% CI, 4.29-10.62) compared with those who did not (OR = 2.27; 95% CI, 1.91-2.7). Older age, living outside of the Northeast, acute sinusitis/headache, fracture, joint pain, psychological impairment and increased health care utilization were all associated with narcotic use in pediatric IBD patients.
“Our findings are important for pediatric IBD treatment given that long-term narcotic use is contraindicated for patients with IBD, and for children in particular,” Buckley told Healio Gastroenterology. “Of the factors we studied, anxiety and depression were most strongly related to chronic narcotic use among children with IBD and may be important treatable risk factors.” – by Adam Leitenberger
Disclosure: Buckley reports having received funding through a research assistantship at GlaxoSmithKline. Other researchers report various financial ties with AbbVie, Cubist, GlaxoSmithKline and Janssen Biotech.
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