Substance Use Among Patients With Incident Crohn's Disease in the United States, 2010 to 2019: A Medicaid Observational Study.
Alcohol
Crohn’s disease
Medicaid
Opioids
Substance use
Journal
Gastro hep advances
ISSN: 2772-5723
Titre abrégé: Gastro Hep Adv
Pays: Netherlands
ID NLM: 9918350485906676
Informations de publication
Date de publication:
2023
2023
Historique:
medline:
15
9
2023
pubmed:
15
9
2023
entrez:
15
9
2023
Statut:
ppublish
Résumé
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. 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. 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. 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.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
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
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
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
CONCLUSIONS
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.
Identifiants
pubmed: 37712010
doi: 10.1016/j.gastha.2023.03.019
pmc: PMC10500958
mid: NIHMS1928581
doi:
Types de publication
Journal Article
Langues
eng
Pagination
747-754Subventions
Organisme : NIAAA NIH HHS
ID : K23 AA028297
Pays : United States
Organisme : NIAAA NIH HHS
ID : K24 AA027483
Pays : United States
Déclaration de conflit d'intérêts
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.
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