Opioid use and misuse in ulcerative colitis

Area of Science:

• Gastroenterology
• Pharmacology
• Public Health

Background:

• Opioid use presents risks like intestinal dysmotility and addiction in ulcerative colitis (UC) patients.
• Limited research exists on narcotic use and misuse rates within the UC population.
• Functional gastrointestinal disorders (FGID) are common in UC and may elevate narcotic use/misuse risk.

Purpose of the Study:

• To determine the prevalence of chronic opioid use and misuse among patients diagnosed with UC.
• To investigate the association between FGID and opioid use/misuse in UC patients.

Main Methods:

• Retrospective chart review of 497 UC patients from 2006-2011.
• Data collected included demographics, medical history, and medication records.
• Opioid filling histories accessed via electronic prescription monitoring program; misuse defined by multiple prescribers/pharmacies.

Main Results:

• Patients with UC and FGID showed significantly higher rates of chronic opioid use (36% vs. 9%) and misuse (12.8% vs. 1.3%).
• FGID was independently associated with a 4.5-fold increased risk of chronic opioid use and a 5-fold increased risk of misuse.
• Tobacco use and anxiety also correlated with increased chronic opioid use.

Conclusions:

• Functional gastrointestinal disorders are strongly linked to increased chronic opioid use in ulcerative colitis patients.
• FGID significantly elevates the risk of prescription opioid misuse in this patient group.
• Identifying FGID in UC patients may help mitigate risks associated with opioid therapy.