The use of opioids nine months after surgery for Crohn's disease – a nationwide cohort study

Abstract

SummaryBackgroundThe risk of chronic opioid use after surgery for Crohn's disease (CD) is not known.AimThe aim of this study is to examine the chronic opioid use after surgery according to age at time of surgery and to opioid use prior to surgery.MethodsThis nationwide cohort study included patients with a first surgery for CD (January 1, 1996 through 2021). We examined prescribed opioids 9 months after surgery and estimated adjusted odds ratios (OR) for chronic opioid use in elderly (≥60 years), adults (≥40 and <60 years), and young adults (≥18 and <40 years) according to opioid use prior to surgery. Chronic opioid use was defined as prescriptions in at least two of three consecutive quarters.ResultsA total of 797 patients had surgery as elderly, 1603 as adults, and 2786 as young adults. Across all age groups, 18%–38% received opioid prescriptions throughout 9 months after surgery, if opioids were prescribed prior to surgery. If opioids were not prescribed prior to surgery, the corresponding proportions were 2%–5%. If patients were prescribed opioids (≥1) prior to surgery, the adjusted ORs (95% CIs) for their chronic use after surgery in elderly, adults, and young adults were 10.37 (6.77–15.88), 10.48 (7.74–14.19), and 6.55 (4.93–8.72), respectively.ConclusionClinicians should be aware that in patients with a need for opioids before surgery, the surgery may not change the need for opioids. Future research should examine effective analgesic strategies that help minimise opioid use in this population.