Trends in Substance Use Disorder Among Hospitalized Patients With Inflammatory Bowel Disease: An 11-Year Nationwide Study.

Goals: We described the temporal trend of substance use disorder (SUD) and SUD subtypes among patients hospitalized with inflammatory bowel disease (IBD), accounting for readmissions within the calendar year.

Background: One in six patients with IBD is estimated to have a concomitant SUD. SUD has had mounting morbidity and mortality rates since 2010 and has been shown to adversely affect IBD activity.

Study: We performed a retrospective analysis of patients hospitalized at least once with IBD from 2010 through 2020 using the Nationwide Readmissions Database. Multivariable logistic regression analysis evaluated associations between SUD and age, sex, insurance type, income for the ZIP Code, and geographic region.

Results: Of 2,532,450 patients hospitalized with IBD, 26.5% and 17.0% involved SUD in Crohn's disease (CD) and ulcerative colitis (UC), respectively. Between 2010 and 2020, the prevalence of patients with SUD increased from 23.8% to 27.9% in CD (Ptrend<0.001) and 14.2% to 19.4% in UC (Ptrend<0.001). Rates of alcohol, opioid, and cannabis use disorders increased (Ptrend<0.001 for all). Patients with SUD were more likely to be male [CD: OR: 1.26; 95% CI: 1.24-1.27; UC: 1.34, (1.31-1.36)], have Medicaid insurance compared with Medicare [CD: 1.59, (1.55-1.63); UC: 1.84, (1.78-1.90)], and be in a lower income quartile [lowest to highest quartile, CD: 1.54, (1.51-1.58); UC: 1.56, (1.52-1.61)].

Conclusions: SUD among IBD patients continued to increase over time, with the predominant substances used shifting from alcohol to opioids and cannabis. Rates of SUD among patients hospitalized with CD were consistently higher than those with UC or with non-IBD-related hospitalizations.