Inflammatory Bowel Disease May Lead to Heavy Opioid Use in Some
the MPR take:
There is limited data on the effectiveness of opioid analgesics in relieving symptoms such as abdominal pain and diarrhea associated with inflammatory bowel disease (IBD), as well as the effects of these drugs over the long-term course of IBD. A newly published study in the American Journal of Gastroenterology evaluated data on 4,217 IBD patients who were followed for a median of 6.5 years regarding prescription medications dispensed in outpatient settings. Five percent of patients became heavy opioid users (defined as a period of use exceeding 50mg morphine/day, or equivalent, for a 30-day period) within 10 years of IBD diagnosis. Compared to matched controls, the IBD patients were nearly four times more likely to become heavy opioid users; women with IBD also had a higher prevalence of opioid use five years prior to confirmed diagnosis. Heavy opioid use was also a strong predictor of nonmalignancy-related mortality in the IBD group. Clinicians should closely monitor the use of these medications in IBD treatment plans to reduce the risk of heavy subsequent use and identify patients at a higher risk for mortality.
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.