Premature Death Linked to Heavy Opiate Use in IBD Patients

Heavy use of opiates among patients with inflammatory bowel diseases (IBD) is tied to increased risk of premature all-cause death, according to a study published in the April issue of Clinical Gastroenterology and Hepatology. Nicholas E. Burr, MD, from the University of Leeds in the United Kingdom, and colleagues retrospectively reviewed de-identified clinical and administrative information from the health records of 3517 individuals with Crohn's disease (CD) and 5349 with ulcerative colitis (UC). Trends in opiate prescriptions and associations between opiates and all-cause mortality were examined.

The researchers found a statistically significant increase in the prescription of opiate medications, with 10% of patients receiving an opiate prescription from 1990 through 1993 versus 30% of patients from 2010 through 2013. There was a significant association between the prescription of strong opiates and increased premature mortality of patients with CD (heavy use) or UC (moderate or heavy use). In addition, in patients with UC, there was a significant association between heavy use of any opiate or codeine alone and premature mortality. In patients with CD and UC, use of tramadol alone or in combination with codeine was not associated with premature mortality.

"Heavy use of strong opiates among patients with IBD associates with increased all-cause premature mortality," the authors write.

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