S842 Opioid Dependence and Over-Prescription of Opioids in Patients With Co-Existing IBD and IBS

Abstract

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). 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). Conclusion: 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. Table 1. - Opioid prescription and opioid dependence in patients with IBD+IBS and IBD alone 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