Olalekan Akanbi, MD, MPH1, Adeyinka C. Adejumo, MD, MS2, Quazim A. Alayo, MD, MSc, MMSc3, Nishant Tripathi, MD1, Pradeep Yarra, MD1, Praneeth Kudaravalli, MD1
1University of Kentucky College of Medicine, Lexington, KY; 2North Shore Medical Center, Salem, MA; 3St. Luke's Hospital, Chesterfield, MO
Introduction: Opioids are a mainstay of chronic pain management however their continued use has become a public-health crisis with potential for abuse and associated adverse outcomes. Patients with Chronic Pancreatitis (CP) suffer from recurrent debilitating pain and are thus susceptible to opioid abuse. We aimed to determine the prevalence, trends and determinants of Opioid Use Disorder (OUD) among hospitalized patients with CP.
Methods: Patients with OUD were identified in the Healthcare Cost and Utilization Project – Nationwide Inpatient Sample (HCUP-NIS), 2007-2014 and the temporal trend of OUD was analyzed and compared among patients with and without CP. We then extracted patients with a discharge diagnosis of CP from HCUP-NIS 2012-2014 and identified the characteristics of OUD in these patients. Predictors of OUD was evaluated using multivariate logistic regression models (SAS 9.4).
Results: 87,068 patients with a primary diagnosis of CP were identified, of which 3,008 (3.45%) had concomitant OUD. With an average annual increase of 29.4 cases per 10,000 hospitalizations vs. 10.6 cases per 10,000 hospitalizations, the rate of OUD in CP patients is increasing at a steeper rate than patients without CP. Predictors of OUD were young age, females, Medicare or Medicaid insurance, mental health disorders, non-opioid substance abuse and comorbid conditions such as arthritis, back pain and headache. The northeast region, urban and large bed size hospitals also have higher odds of OUD.
Discussion: OUD affects a significant proportion of patients with CP and occurs at an increasing rate; almost 3 times the rate of those without CP. A better recognition of predisposing pre-existing demographic and clinical variables among at-risk individuals may help guide the utilization of opioids in this patient group, slowing and potentially reversing the rates of OUD.
Citation: Olalekan Akanbi, MD, MPH; Adeyinka C. Adejumo, MD, MS; Quazim A. Alayo, MD, MSc, MMSc; Nishant Tripathi, MD; Pradeep Yarra, MD; Praneeth Kudaravalli, MD. P0919 - PREVALENCE, TREND, AND PREDICTORS OF OPIOID ABUSE AMONG PATIENTS WITH CHRONIC PANCREATITIS. Program No. P0919. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.