Long-term Narcotic Use in Juvenile IBD May Be Harmful

Long-term Narcotic Use in Juvenile IBD May Be Harmful
Jessie Buckley

A research team from the Department of Epidemiology at the University of North Carolina studied the effect of the chronic use of narcotics in children with inflammatory bowel disease (IBD), an inflammatory condition in the colon and small intestine. The study, supported by GlaxoSmithKline, was published in the journal Clinical Gastroenterology and Hepatology entitled Prevalence of Chronic Narcotic Use Among Children With Inflammatory Bowel Disease.

Narcotic analgesics are prescribed to IBD patients for temporary pain relief. However, long-term narcotic use increases mortality in adult patients, and the risk of developing comorbidities such as infections, sleep and psychiatric disorders. In children, chronic treatment with narcotics may lead to gastrointestinal side effects, disease complications, and potential for dependency.

This study compared the chronic use of narcotics among children with IBD with the general population and investigated factors associated with narcotic use in the pediatric IBD population. 4,344 children with IBD (63% Crohn’s, 37% ulcerative colitis) were identified from a large administrative claims database of 4,911,286 children younger than 18 years with continuous health plan enrollment from 2010 through 2011.

The authors found that 5.6% of pediatric IBD patients were chronic narcotic users compared with 2.3% among the general population. Anxiety and depression were associated with greater burden of narcotic use among children with IBD, even after adjusting for factors such as age, healthcare utilization, and other comorbidities. Therefore, increased awareness, screening, and treatment of these psychological symptoms may help reduce narcotic use and related disease complications.

“Our findings are important for pediatric IBD treatment given that long-term narcotic use is contraindicated for patients with IBD, and for children in particular,” said Jessie Buckley, the corresponding author. “Of the factors we studied, anxiety and depression were most strongly related to chronic narcotic use among children with IBD and may be important treatable risk factors.”

In other related developments, in response to the steadily growing number of children and teenagers suffering with inflammatory bowel disease (IBD) in the United States — which has now reached an estimated 1.6 million people, 10 percent of whom are under the age of 18 — the Crohn’s & Colitis Foundation of America (CCFA) and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) together launched a new website dedicated to children and teenagers with the disease. “Just Like Me” is specially designed for young patients with ulcerative colitis and Crohn’s Disease.

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