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. 2023;2(6):747-754.
doi: 10.1016/j.gastha.2023.03.019. Epub 2023 Mar 17.

Substance Use Among Patients With Incident Crohn's Disease in the United States, 2010 to 2019: A Medicaid Observational Study

Po-Hung Chen  1 , Reeha Patel  2 , Steven D Miller  3 , Ryan Jasper  4 , Geetanjali Chander  5 , Susan Hutfless  1
Affiliations

Substance Use Among Patients With Incident Crohn's Disease in the United States, 2010 to 2019: A Medicaid Observational Study

Po-Hung Chen et al. Gastro Hep Adv. 2023.

Abstract

Background and aims: Substance use among persons with Crohn's disease (CD) is associated with symptomatic exacerbation and poorer quality of life. However, data on the prevalence of substance use among individuals with CD are limited. Therefore, our study aimed to estimate the burden of alcohol and drug use among individuals with incident CD in the United States. We also assessed the associations between CD-related interventions and substance use after CD diagnosis.

Methods: Our retrospective cohort study of the national Medicaid databases from 2010 to 2019 identified participants with newly diagnosed CD and defined substance use (ie, alcohol, opioids, cocaine, amphetamine, and cannabis) using diagnosis codes. Multivariable logistic regression models assessed the associations between CD-related interventions and substance use after CD diagnosis.

Results: Overall, 16.3% of Medicaid enrollees with incident CD had substance ever-use, most commonly alcohol or opioids (each 8.0%). Any substance use saw an absolute decrease of 3.8% after CD diagnosis, but changes were less than 1% in either direction for each substance. CD-related hospitalization was associated with increased alcohol or opioid use post-CD diagnosis. Surgery was associated with lower use post-CD of opioids but not alcohol. CD medications (except steroids) were generally associated with decreased post-CD alcohol or opioid use.

Conclusion: Among Medicaid enrollees with incident CD, alcohol and opioid use were more frequent than previously published estimates for the general US population (6% and 4%, respectively, in 2019). Consequently, medical communities must be more aware of substance use by patients with CD to provide quality patient-centered care.

Keywords: Alcohol; Crohn’s disease; Medicaid; Opioids; Substance use.

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Conflict of interest statement

Conflicts of Interest: Po-Hung Chen reports serving as a Medical Safety Officer for the NIH/NIDDK-sponsored Non-Alcoholic Steatohepatitis Clinical Research Network, a Steering Committee member for the Alcohol-associated Liver Disease Special Interest Group of the American Association for the Study of Liver Diseases (AASLD), and a Practice Guidelines Committee member of AASLD. The remaining authors disclose no conflicts.

Figures

Figure
Figure
Proportion of Medicaid participants with incident Crohn’s disease (CD) who used substance before or after CD diagnosis, from 2010 through 2019 (N = 37,323).
See this image and copyright information in PMC

Comment in

References

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