Chronic use of narcotics is common among children with inflammatory bowel disease (IBD)—particularly among those with anxiety and depression, researchers report in the February issue of Clinical Gastroenterology and Hepatology. Identifying and treating psychological disorders could reduce symptoms that lead to narcotic use and their complications in these patients.
Narcotics are prescribed to patients with IBD to provide temporary relief from pain during a flare or after surgery. However, long-term narcotic analgesia is not recommended for adults or children. In adults, use of narcotics increases mortality, serious infection, sleep disorders, pneumonia, and psychiatric disorders. In children, chronic treatment with narcotics can also lead to malnutrition, opportunistic infections, and hepatosplenic lymphoma, as well as reduce growth.
Although pain control is an important aspect of disease management in pediatric IBD, little is known about chronic narcotic use in children.
Jessie P. Buckley et al used data from a large insurance claims database, collected from 2010 through 2011, to compare the prescription narcotic use among children (younger than 18 years old) with and without IBD who were not undergoing surgery. Buckley et al also searched for factors associated with narcotic treatment of pediatric patients with IBD.
Of 4344 children with IBD during the study period, 63% had Crohn’s disease, and 37% had ulcerative colitis.
Buckley et al found that 5.6% of children with IBD vs 2.3% of children in the general population received chronic narcotic therapy. Associations between IBD and narcotic use revealed a particularly high burden among children with concomitant anxiety or depression.
Buckley et al say that psychiatric disorders have also been associated with increased risk of narcotic use among adults with IBD. The authors propose that increased awareness of psychological comorbidities, screening, and treatment could reduce IBD symptoms that lead to narcotic use, and complications that result from it.