Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

The Prevalence and Predictors of Opioid Use in Inflammatory Bowel Disease: A Population-Based Analysis

Targownik, Laura E MD, MSHS1, 2; Nugent, Zoann PhD1, 3; Singh, Harminder MD, MPH1, 2; Bugden, Shawn PharmD4; Bernstein, Charles N MD1, 2

American Journal of Gastroenterology: October 2014 - Volume 109 - Issue 10 - p 1613–1620
doi: 10.1038/ajg.2014.230
Inflammatory Bowel Disease
Buy
SDC

OBJECTIVES: Opioids are commonly used in the treatment of pain and associated symptoms of inflammatory bowel disease (IBD). The continuous use of opioids has been associated with adverse outcomes, including death. The prevalence and the risk factors for opioid use in IBD are poorly characterized.

METHODS: We used the population-based Manitoba IBD Epidemiology Database to identify all individuals in Manitoba with IBD who were prescribed opioids both before and following diagnosis. We determined the point prevalence of any opioid use, as well as the risk of becoming a heavy opioid user (defined as continuous use for 30 days at a dose exceeding 50 mg morphine/day or equivalent). Logistic regression and Cox proportional hazards models were generated to assess whether IBD was an independent risk factor for opioid use, the risk factors for opioid use in individuals with IBD, and to determine whether opioid use was associated with excess mortality in IBD.

RESULTS: Within 10 years of diagnosis, 5% of individuals with IBD had become heavy opioid users. Moderate use of opioids before diagnosis was strongly predictive of future heavy use. Individuals with IBD were significantly more likely to become heavy opioid users than their matched controls (odds ratio (OR) 2.91, 95% confidence interval (CI) 2.19–3.85). Heavy opioid use was strongly associated with mortality (OR 2.82, 95% CI 1.58–5.02).

CONCLUSIONS: IBD is an independent risk factor for becoming a heavy opioid user, and heavy opioid use is associated with excess mortality in IBD patients. Clinicians should recognize risk factors for future heavy opioid use among their patients with IBD.

1 Section of Gastroenterology, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada

2 University of Manitoba IBD Clinical and Research Centre, Winnipeg, Manitoba, Canada

3 CancerCare Manitoba, Winnipeg, Manitoba, Canada

4 Faculty of Pharmacy, University of Manitoba, Winnipeg, Manitoba, Canada

Correspondence: Laura Targownik, MD, MSHS, Section of Gastroenterology, Department of Internal Medicine, University of Manitoba, 805G-715 McDermot Avenue, Winnipeg, Manitoba R3E 3P4, Canada. E-mail: targowni@cc.umanitoba.ca

SUPPLEMENTARY MATERIAL accompanies this paper at http://links.lww.com/AJG/B17, http://links.lww.com/AJG/B18, http://links.lww.com/AJG/B19

Received 4 November 2013; accepted 17 June 2014

published online 2 September 2014

© The American College of Gastroenterology 2014. All Rights Reserved.
You currently do not have access to this article

To access this article:

Note: If your society membership provides full-access, you may need to login on your society website