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

Osooli, Mehdi LU orcid ; Voghera, Siri ; Bruze, Gustaf ; Nordenvall, Caroline ; Khalili, Hamed ; Hedin, Charlotte ; Myrelid, Pär ; Everhov, Åsa H. ; Ludvigsson, Jonas F. and Olén, Ola (2025) In Alimentary Pharmacology and Therapeutics p.1-13
Abstract

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... (More)

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.

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author
; ; ; ; ; ; ; ; and
contributor
Olsson, Malin ; Myrelid, Pär ; Jäghult, Susanna ; Rejler, Martin ; LU ; Fagerberg, Ulrika L. and Halfvarson, Jonas
author collaboration
publishing date
type
Contribution to journal
publication status
epub
keywords
Crohn's disease, incidence, opioid use, time trend
in
Alimentary Pharmacology and Therapeutics
pages
1 - 13
publisher
John Wiley & Sons Inc.
external identifiers
  • scopus:105007102591
  • pmid:40450700
ISSN
0269-2813
DOI
10.1111/apt.70203
language
English
LU publication?
no
additional info
Publisher Copyright: © 2025 The Author(s). Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.
id
6a703d01-dab4-4e92-963c-43270d63b122
date added to LUP
2025-06-18 16:04:55
date last changed
2025-07-02 18:15:06
@article{6a703d01-dab4-4e92-963c-43270d63b122,
  abstract     = {{<p>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.</p>}},
  author       = {{Osooli, Mehdi and Voghera, Siri and Bruze, Gustaf and Nordenvall, Caroline and Khalili, Hamed and Hedin, Charlotte and Myrelid, Pär and Everhov, Åsa H. and Ludvigsson, Jonas F. and Olén, Ola}},
  issn         = {{0269-2813}},
  keywords     = {{Crohn's disease; incidence; opioid use; time trend}},
  language     = {{eng}},
  pages        = {{1--13}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Alimentary Pharmacology and Therapeutics}},
  title        = {{Higher Prescribed Opioid Use Among Adults With Crohn's Disease Than General Population : A Nationwide Cohort Study in Sweden 2006–2021}},
  url          = {{http://dx.doi.org/10.1111/apt.70203}},
  doi          = {{10.1111/apt.70203}},
  year         = {{2025}},
}