B0389 - Opioid Dependence and Over-Prescription of Opioids in Patients With Co-Existing IBD and IBS

Monday, October 24, 2022

10:00 AM – 12:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Yuhan Fu, DO

MetroHealth Medical Center/Case Western Reserve University
Cleveland, OH

Yuhan Fu, DO, Michael Kurin, MD, Marc Landsman, MD, Gengqing Song, MD
MetroHealth Medical Center/Case Western Reserve University, Cleveland, OH

Introduction: Opioids are commonly prescribed to control pain for patients with Inflammatory bowel disease (IBD). However, the wide use of narcotics raised concerns for possible opioid dependence and related mortality. IBD patients with co-existing irritable bowel syndrome (IBS) are more likely to complain about abdominal pain. The goal of the study was to determine the prevalence of opioid prescription and opioid dependence in patients with coexisting IBD and IBS, and to compare with IBD patients without IBS.

Methods: A retrospective cohort analysis was performed using IBM Explorys (1999-2022), which contained deidentified patient information from more than 300 hospitals in the US. We selected patients with a diagnosis with IBD and IBS (IBD+IBS). The control group consist of patients with IBD without IBS (IBD). We collected information regarding opioid prescriptions and diagnosis of opioid dependence. Categorical data was presented as number of patients and percentage. Odd ratios (OR) with 95% confidence interval were used to compare the cohorts.

Results: We identified a total of 38,650 patients with co-existing IBD and IBS and 327,770 patients with IBD without IBS (Table 1). 83.2% of patients in the IBD+IBS group and 62.6% of patients in the control group have been prescribed opioids (OR [2.87-3.03], p< 0.0001). Opioids were more commonly prescribed in the IBD+IBS cohort including morphine (48.5 vs 29.1%), Hydromorphone (44.7 vs 24.8%), Oxycodone (46.0 vs 27.2%) and Hydrocodone (58.4 vs 35.7%). Opioid dependence was also more common in the IBD+IBS group (4.8% vs 1.6%, OR [2.99-3.33], p< 0.0001).

Discussion: Patients with overlapping IBD and IBS are prescribed opiates more often than patients with IBD alone, and the former are more likely to be diagnosed with opioid dependence. Appropriate use of therapies approved for IBS, in conjunction with treatment of IBD may help reduce opiate use in this population.

	IBD+IBS (N=38650)	%	IBD alone (N=327770)	%	OR	95% CI	P
Opioid dependence	1840	4.8%	5110	1.6%	3.16	2.99-3.33	< 0.0001
Opiate	32140	83.2%	205290	62.6%	2.95	2.87-3.03	< 0.0001
Morphine	18760	48.5%	95410	29.1%	2.30	2.25-2.35	< 0.0001
Hydromorphone	17260	44.7%	81420	24.8%	2.44	2.39-2.49	< 0.0001
Oxycodone	17780	46.0%	89210	27.2%	2.28	2.23-2.33	< 0.0001
Hydrocodone	22590	58.4%	117110	35.7%	2.53	2.48-2.59	< 0.0001

Table: Table 1 Opioid prescription and opioid dependence in patients with IBD+IBS and IBD alone

Disclosures:

Yuhan Fu indicated no relevant financial relationships.

Michael Kurin indicated no relevant financial relationships.

Marc Landsman indicated no relevant financial relationships.

Gengqing Song indicated no relevant financial relationships.

Yuhan Fu, DO, Michael Kurin, MD, Marc Landsman, MD, Gengqing Song, MD. B0389 - Opioid Dependence and Over-Prescription of Opioids in Patients With Co-Existing IBD and IBS, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.