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[Colitis ulcerosa and opioid addiction].
W Häuser1, H Lachiheb, D Grandt
1Medizinische Klinik I, Klinikum Saarbrücken gGmbH, Saarbrücken, Germany. w.haeuser@klinikum-saarbruecken.de
Zeitschrift Fur Gastroenterologie
|May 23, 2002
Summary
Opioid addiction is rarely reported in inflammatory bowel disease (IBD) treatment. This case highlights the risk of opioid addiction during IBD pain and diarrhea management, emphasizing careful monitoring.
Area of Science:
- Gastroenterology
- Addiction Medicine
- Clinical Case Reports
Background:
- Inflammatory bowel disease (IBD), including ulcerative colitis, can cause chronic pain and diarrhea.
- Opioid therapy is sometimes used for refractory symptoms in IBD when other treatments fail.
- The risk of developing opioid addiction during such treatments is not well-documented.
Observation:
- A 36-year-old male with a 14-year history of ulcerative colitis developed opioid addiction.
- The addiction arose from using tincture of opium for abdominal pain and diarrhea, later progressing to buprenorphine.
- Diarrhea symptoms slightly worsened during buprenorphin withdrawal.
Findings:
- Opioid addiction can occur even when opioids are prescribed for pain and diarrhea in IBD.
- Detoxification was performed alongside ongoing ulcerative colitis treatment.
- Psychiatric comorbidity is identified as a significant risk factor for therapeutic opioid addiction.
Implications:
- Close monitoring of opioid therapy for side effects and abuse is crucial in IBD patients.
- Loperamide is recommended for refractory diarrhea due to its limited central nervous system effects.
- A seven-criterion checklist for opioid addiction during therapy is presented to aid clinical practice.