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. 2025 May 1;16(5):e00807.
doi: 10.14309/ctg.0000000000000807.

Prevalence and Patterns of Opioid Use in Chronic Pancreatitis

Anna Evans Phillips  1 , Darwin L Conwell  2 , Shuang Li  3 , Jami L Saloman  1 , Phil A Hart  4 , Evan L Fogel  5 , Santhi Swaroop Vege  6 , Dana K Andersen  7 , William E Fisher  8 , Christopher E Forsmark  9 , Stephen Pandol  10 , Walter G Park  11 , Mark D Topazian  6 , Stephen K Van Den Eeden  12 , Jose Serrano  7 , Liang Li  3 , Dhiraj Yadav  1 ; Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer (CPDPC)
Affiliations

Prevalence and Patterns of Opioid Use in Chronic Pancreatitis

Anna Evans Phillips et al. Clin Transl Gastroenterol. .

Abstract

Introduction: Opioids are used to treat pain in chronic pancreatitis (CP), but little is known about current use patterns. The aim of this study was to characterize the utilization of opioids and associations with clinical characteristics in adult patients with CP.

Methods: This cross-sectional analysis used baseline data from participants with definite CP enrolled in a cohort study in the United States (PROspective Evaluation of CP for EpidEmiologic and Translational StuDies). Data on demographics, pain medication use, healthcare utilization, disability, and pain patterns were systematically collected in case report forms while quality of life was assessed with patient-reported outcome instruments. Opioid use was classified according to strength (weak or strong) and frequency (scheduled or as-needed).

Results: A total of 681 participants (n = 364, 53% male) were included: 299 (44%) were current opioid users (22% only weak opioids and 22% at least 1 strong opioid). Increasing frequency and severity of pain was associated with increase of weak, strong, as-needed, or scheduled opioids. Neuromodulators were used by ∼40% of participants; increasing use was associated with increasing frequency and severity of pain. On multivariate analysis, independent predictors associated with strength and frequency of current opioid use were pain patterns (odds ratios [ORs] 1.84-8.32 and ORs 1.92-8.52, respectively, P < 0.001) and prior celiac plexus block (OR 3.54, 95% confidence intervals 1.82-6.87 and OR 3.42, 95% confidence intervals 1.76-6.64, respectively). Participants using opioids had higher prevalence of disability, healthcare utilization, and poorer quality of life.

Discussion: Opioid use in CP is common and associated with increased pain severity and constancy. These data provide foundational estimates for future trials that can elucidate the complex interactions between patient factors, pain, and interventions.

Keywords: chronic pain; chronic pancreatitis; neuromodulator; opioid.

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Conflict of interest statement

Guarantor of the article: Anna Evans Phillips, MD, MS.

Specific author contributions: A.E.P.: drafting of manuscript, critical review of manuscript. D.L.C.: critical review of manuscript. S.L.: Statistical analysis and review of manuscript. J.L.S.: critical review of manuscript. P.A.H.: data interpretation, critical review of manuscript. E.L.F.: critical review of manuscript. S.S.V.: data interpretation, critical review of manuscript. W.E.F.: critical review of manuscript. C.F.: critical review of manuscript. S.P.: critical review of manuscript. W.G.P.: critical review of manuscript. M.D.T.: critical review of manuscript. S.K.V: critical review of manuscript. J.S.: data interpretation, critical review of manuscript. L.L.: Statistical analysis, review of manuscript. D.Y.: Study design and conception, data interpretation, revision and critical review of manuscript.

Financial support: Research reported in this publication was supported by National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under award number(s) related to the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer (CPDPC) U01 DK108328 (University of Texas - MD Anderson), U01 DK 108288 (Mayo Clinic), U01 DK 108300 (Stanford University), U01DK108306 (University of Pittsburgh), U01 DK108314 (Cedars-Sinai Medical Center), U01DK108320 (University of Florida), U01 DK108323 (Indiana University), U01DK 108326 (Baylor College of Medicine), U01DK108327 (The Ohio State University), U01DK108332 (Kaiser Foundation Research Institute). The content of this work is solely the responsibility of the authors and does not necessarily represent the official view of the National Institutes of Health.

Potential competing interests: A.E.P.: Board Member, National Pancreas Foundation. W.G.P.: Consultant, Arctx Medical, Capsovision, Olympus, Advisory Board, Nestle, Horizon Therapeutics, Pfizer, Research Grant, Abbvie. D.Y.: Consultant, Pfizer; Research Support from Abbvie, Inc.. All other authors declare no conflicts of interest.

Figures

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Graphical abstract
Figure 1.
Figure 1.
Patterns of opioid usage in 681 adults with chronic pancreatitis according to the specific opioid (a), opioid potency by pain severity (b), and opioid frequency by pain severity (c).
Figure 2.
Figure 2.
Radar chart of Patient-Reported Outcomes Measurement Information Systems from 29.0 quality-of-life domains in 681 adults with chronic pancreatitis according to opioid potency (a) and opioid dosing frequency (b). A higher number represents a less favorable outcome for all domains with the exception of physical function and social roles.
See this image and copyright information in PMC

References

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