What Are the Outcomes of Short- and Long-Term Opioid Use in IBD?

Short-term and long-term opioid use are associated with an increased risk for emergency department (ED) visits and corticosteroid use among outpatients with inflammatory bowel disease (IBD) compared with outpatients with IBD who did not use opioids, according to study results presented at Digestive Disease Week (DDW), held from May 6 to 9, 2023 in Chicago, Illinois, and virtually.

The retrospective cohort analysis used data from the TriNetX database from 2015 to 2018 for all outpatients aged 18 to 70 years with an established IBD diagnosis (Crohn disease or ulcerative colitis) for at least 6 months.

Participants were stratified into 3 groups according to their length of opioid use: long-term opioid users (prescribed opioids for >6 weeks, n=1390); short-term opioid users (prescribed opioids for <6 weeks, n=40,567); or nonopioid users (did not receive an opioid prescription after IBD diagnosis, n=283,506).

Propensity score matching 1:1 was used to match each group. RxNorm codes were used to identify opioid analgesics prescriptions, including meperidine, morphine, oxycodone, fentanyl, hydrocodone, and hydromorphone.

The primary outcomes were death, ED visits, IBD-related surgeries, and corticosteroid use in nonopioid users, short-term opioid users, and long-term opioid users. Risk ratios (RR) were calculated for all outcomes.

After propensity score-matching, the following comparative group sizes were used for each analysis: short-term opioid users vs nonopioid users (n=40,359 in each cohort); long-term opioid users vs nonopioid users (n=1380 patients in each cohort); and long-term opioid users vs short-term opioid users (n=1385 in each cohort).

The patients with IBD and short-term opioid use and long-term opioid use had an increased risk for ED visits compared with patients with IBD who did not use opioids (RR, 1.32; 95% CI, 1.27-1.36; P <.0001; and RR, 2.08; 95% CI, 1.81-2.39; P <.0001, respectively). The patients with short-term opioid use and long-term opioid use also had an increased risk for corticosteroid use compared with patients with IBD who did not use opioids (RR, 2.52; 95% CI, 2.44-2.60; P <.0001; and RR, 2.38; 95% CI, 2.0-2.84; P <.0001, respectively).

No association was observed among short-term and long-term opioid users regarding death or IBD-related surgery. Long-term opioid users had a greater risk for ED visits vs short-term opioid users (RR, 1.57; 95% CI, 1.39-1.78; P <.0001).

“Opioids, independent of the length of use, are associated with negative health outcomes in outpatients with IBD,” the study authors wrote. “Certain risks appear to vary depending on length of exposure to opioids. These findings reinforce the importance of avoiding opioid use in this setting, even on a short-term basis.”

This article originally appeared on Gastroenterology Advisor