Increased Rates of Opioid Use Disorder Observed Among Patients With Chronic Pancreatitis

Patients with chronic pancreatitis (CP) were associated with higher rates of opioid use disorder (OUD). These findings were published in the Annals of Gastroenterology.

Information on hospital admissions and discharges of patients with CP included in the National Inpatient Sample (NIS) collected in the United States between 2012 and 2014 were included in this retrospective, cross-sectional study. Patients (N=87,068) were assessed for clinical outcomes on the basis of OUD. Trends of OUD and its interactions with CP from NIS 2007-2014 were then charted. 

According to the data from 2007-2014, OUD has been increasing steadily by an average rate of 11.41 cases per 10,000. Stratified by CP, OUD has historically been 2.8 times greater among patients with CP and the slope of increased OUD rates has been nearly 2.7 times steeper than that of patients without CP.

A total of 4.99% of patients with CP had OUD. Patients with and without OUD were of mean age 46.90±11.73 and 52.63±14.72 years (P <.001), 54.20% and 55.04% were men, 67.26% and 64.90% were White (P =.0157), 46.29% and 28.11% had a mental health disorder (P <.001), 13.06% and 9.05% had chronic back pain (P <.001), and 60.57% and 46.56% had alcohol-related CP (P <.001), respectively.

OUD was associated with the following: use of other substances besides alcohol, tobacco, or opioids (adjusted odds ratio [aOR], 4.77; 95% CI, 4.52-5.03; P <.001), a mental health disorder (aOR, 1.66; 95% CI, 1.58-1.74; P <.001), back pain (aOR, 1.46; 95% CI, 1.35-1.57; P <.001), urban teaching (aOR, 1.46; 95% CI, 1.33-1.60) or non-teaching (aOR, 1.37; 95% CI, 1.25-1.51) hospitals (P <.001), Medicaid (aOR, 1.36; 95% CI, 1.27-1.45) or Medicare (aOR, 1.29; 95% CI, 1.20-1.38) insurance (P <.001), alcoholic CP (aOR, 1.31; 95% CI, 1.11-1.54; P =.0011), and among women (aOR, 1.06; 95% CI, 1.01-1.11; P =.0163).

Risk for OUD was decreased among older patients (per 10-year increments: aOR, 0.79; 95% CI, 0.77-0.80; P <.001), non-idiopathic or alcoholic CP (aOR, 0.80; 95% CI, 0.71-0.90; P <.001), and Black (aOR, 0.95; 95% CI, 0.89-1.01), Hispanic (aOR, 0.84; 95% CI, 0.77-0.93), or other non-White (aOR, 0.90; 95% CI, 0.79-1.01) ethnicities (P =.0013).

OUD was associated with increased length of hospital stay (aOR, 1.05; 95% CI, 1.02-1.09; P =.0015) but did not associate with increased mortality (aOR, 0.70; 95% CI, 0.49-1.00; P =.0506) or hospital charges (aOR, 0.96; 95% CI, 0.92-1.00; P =.0598).

This study was limited by its access to complete data and cross-sectional design. It remains unclear why patients with certain characteristics were at increased risk for OUD.

These data indicated a subset of patients with CP were at increased risk for OUD and that compared with the general hospital population, risk for OUD was elevated and has been increasing more quickly over time. Clinicians should be aware of risk factors and offer non-opioid options for patients at high risk for OUD.

Reference

Adejumo AC, Akanbi O, Alayo Q, et al. Predictors, rates, and trends of opioid use disorder among patients hospitalized with chronic pancreatitis. Ann Gastroenterol. 2021;34(2):262-272. doi:10.20524/aog.2021.0579.

This article originally appeared on Gastroenterology Advisor