Abstract
Opioid abuse has reached epidemic proportions with over 12 million reporting a history of opioid misuse. Patients with inflammatory bowel disease (IBD) suffer from chronic relapsing-remitting pain and are at risk for opioid abuse and dependence. We aim to determine the prevalence and trend of opioid abuse amongst admitted IBD patients.
A retrospective cross-sectional study was performed using Nationwide Inpatient Sample data from 2005–2014, which is a nationally representative all-payer dataset provided through the Healthcare Cost and Utilization Project and the Agency for Healthcare Research and Quality. IBD hospital visits were identified by ICD9 billing code and associated opioid-related diagnoses were identified using a previously published schema. A multivariable logistic regression was performed controlling for variables associated with an opioid-related discharge with a p <0.05 on univariable analysis.
2,507,604 weighted adult discharges with any diagnosis of IBD were identified. 2.2% of inpatient discharges for IBD carried an opioid-related diagnosis, with a rise in opioid-related IBD inpatient discharges over time (p <0.001). On multivariable analysis, Crohn’s disease, public payer, white race, urban setting, and mood disorder predicted opioid abuse (Table 1). Opioid-related diagnoses were also associated with increased length of stay (regression coefficient 1.42; 95% confidence interval [CI] 1.28, 1.56) and increased total charge (regression coefficient 3883.58; 95% CI 2816.13, 4951.04). For IBD-related surgical discharges, an opioid-related diagnosis was also associated with increased length of stay and pneumonia (Table 2).
Opioid-related discharges are more common amongst IBD patients than the overall population and are associated with increased healthcare utilization. With a rising prevalence, it is important to target opioid misuse in IBD to improve outcomes.
