Higher Prescribed Opioid Use Among Adults With Crohn's Disease Than General Population: A Nationwide Cohort Study in Sweden 2006-2021.

BACKGROUND AND AIMS

Population-based data on prescribed opioid use among adults with Crohn's disease (CD) remain limited.

METHODS

This nationwide register-based study included individuals ≥ 18 years with incident (2008-2019) or prevalent (2008-2021) CD and up to 10 individually matched reference individuals without inflammatory bowel disease. We categorised opioid dispensations as weak (e.g., tramadol) or strong (e.g., oxycodone). We calculated the prevalence of ≥ 1 dispensation and mean daily doses (MDD) of opioids per 6 month period from 2 years before until 5 years following CD diagnosis (for incident cohort) and annual dispensation and MDD of opioids (for prevalent cohort).

RESULTS

Among 10,527 patients with incident CD and 96,123 references, opioid dispensations were two-fold among patients 2 years before diagnosis (26.2% vs. 12.6%) and remained high 13-36 months after diagnosis (26.5% vs. 11.7%). In the prevalent cohort (32,306 patients and 289,516 reference individuals), there was a declining trend in the use of dispensed opioids. During observation, the use of weak opioids decreased substantially among individuals with CD (16.0% vs. 6.0%) and reference individuals (8.0% vs. 3.0%). However, opioid MDD only decreased substantially among those with CD between 2008 and 2021.

CONCLUSION

Adults with incident CD had a two-fold higher use of dispensed opioids than references 2 years before diagnosis, which peaked at three- and four-fold higher use around diagnosis and remained high for 3-5 years. The decreased use of weak opioids might explain the recent decline in opioid consumption among patients with CD.