Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec;22(12):706-713.
doi: 10.1111/1751-2980.13064. Epub 2021 Nov 28.

Polysubstance use in inflammatory bowel disease

Kaleb Bogale  1 , Kent Vrana  2 , Wesley Raup- Konsavage  2 , Vonn Walter  3   4 , August Stuart  5 , Shannon Dalessio  5 , Walter Koltun  6 , Nana Bernasko  5 , Andrew Tinsley  5 , Emmanuelle Williams  5 , Kofi Clarke  5 , Matthew D Coates  2   5
Affiliations

Polysubstance use in inflammatory bowel disease

Kaleb Bogale et al. J Dig Dis. 2021 Dec.

Abstract

Objectives: We aimed to evaluate the incidence, predisposing factors and impacts of polysubstance use (PSU) (ie, the concurrent use or abuse of two or more drugs or substances) in inflammatory bowel disease (IBD).

Methods: Data of patients enrolled between 1 January 2015 and 31 August 2019 from a single tertiary care referral center were retrospectively collected. Patients' baseline and clinical characteristics and their antidepressant and/or anxiolytic medications were abstracted. Associations between PSU and patients' characteristics were analyzed. Multivariate logistic regression models were fit, incorporating significant clinical factors.

Results: Altogether 315 patients with IBD (166 women, 149 men; 214 with Crohn's disease and 101 ulcerative colitis) were enrolled. Of them, 66 (21.0%) exhibited PSU (CD 21.5%, UC 19.8%); 37.5% had moderate to severe disease activity, 34.3% with extraintestinal manifestations (EIM), 41.6% with an anxious or depressed state and 69.8% had used healthcare resources in the prior 12 months. Moreover, 71.2% used two substances, while 27.3% used three substances. In the total cohort, EIM (odds ratio [OR] 1.97, 95% confidence interval [CI] 1.14-3.34, P = 0.019) and antidepressant or anxiolytic use (OR 2.51, 95% CI 1.45-4.39, P < 0.001) were positively associated with PSU on multivariate analysis. PSU was associated with increased rate of IBD-associated imaging (57.6% vs 47.0%, P < 0.05).

Conclusions: PSU is common in IBD. EIM, antidepressant and/or anxiolytic use and imaging studies were independently associated with PSU. This study reinforces the importance of screening patients with IBD for substance use, particularly those with EIM and using antidepressants and/or anxiolytics.

Keywords: antidepressant and/or anxiolytic use; extraintestinal manifestation; healthcare resource utilization; inflammatory bowel disease; polysubstance use.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors of this manuscript have no relevant conflicts of interest or financial disclosures to report.

Figures

Figure 1.
Figure 1.
Polysubstance Use Patterns in Inflammatory Bowel Disease
Figure 2.
Figure 2.
Bivariable and Multivariable Analysis Outcomes
Figure 3.
Figure 3.
Polysubstance Use (PSU) and Healthcare Resource Utilization (HRU)
See this image and copyright information in PMC

References

    1. Kaplan MA, Korelitz BI. Narcotic dependence in inflammatory bowel disease. J Clin Gastroenterol. 1988;10(3):275–278. - PubMed
    1. Cross RK, Wilson KT, Binion DG. Narcotic use in patients with Crohn’s disease. Am J Gastroenterol. 2005;100(10):2225–2229. - PubMed
    1. Hanson KA, Loftus EV Jr, Harmsen WS, Diehl NN, Zinsmeister AR, Sandborn WJ. Clinical features and outcome of patients with inflammatory bowel disease who use narcotics: A case–control study. Inflamm Bowel Dis. 2009;15(5):772–777. - PubMed
    1. Moore RA, McQuay HJ. Prevalence of opioid adverse events in chronic non-malignant pain: systematic review of randomised trials of oral opioids. Arthritis Res Ther. 2005;7(5):R1046–1051. - PMC - PubMed
    1. Ravikoff Allegretti J, Courtwright A, Lucci M, Korzenik JR, Levine J. Marijuana use patterns among patients with inflammatory bowel disease. Inflamm Bowel Dis. 2013;19(13):2809–2814. - PMC - PubMed