Narcotics Commonly Dispensed for Children with IBD

Narcotics are not recommended for managing chronic pain in children with inflammatory bowel disease (IBD), due to gastrointestinal side effects and potential dependence. Nevertheless, researchers from the University of North Carolina at Chapel Hill have uncovered that long-term narcotic use is more than twice as prevalent in pediatric IBD patients compared with the general population.

“Although narcotic use appears to be less common among children than adults with IBD, any prolonged non-surgery narcotic use in children is controversial because of current practice guidelines,” the researchers wrote. “…Describing the characteristics of children with IBD using long-term narcotics is important to define the magnitude of this problem in the pediatric population and to identify potential strategies or interventions to reduce narcotic use.”

For the cross-sectional study, which was published in the February 2015 edition of Clinical Gastroenterology and Hepatology, researchers compared chronic use of narcotics among 4344 children with either Crohn’s disease or ulcerative colitis and 21,270 matched peers without IBD. During the 2-year study period, 5.6% of the pediatric IBD patients had at least 3 prescriptions filled for a narcotic analgesic, compared with 2.3% of those without IBD.

The findings aligned with the authors’ previous research on 104,582 IBD patients of all ages, which reported that 48.1% of IBD patients had at least 1 narcotic prescription, and 19.5% had at least 3 prescriptions for the same narcotic.

In the current study, the investigators also determined that chronic narcotic use was significantly higher among pediatric IBD patients with psychological impairment, greater health care utilization, and fracture, as well as those who were older. Psychological comorbidity was common among the IBD subjects, as 18.7% had a psychological impairment compared with 10.8% of the general population.

“Although narcotic analgesic use in IBD has been associated with increased mortality, disease complications, and other comorbidities, prolonged use of narcotic analgesics in the nonsurgical setting is not uncommon among children with IBD,” the authors concluded. “…Increased awareness of psychological comorbidity, screening, and treatment may reduce symptoms leading to narcotic use and disease complications that are due to narcotic use.”