Publications // 2021
Carney H, Marrie RA, Bolton JM, Patten SB, Graff LA, Bernstein CN, Kowalec K. Prevalence and Risk Factors of Substance Use Disorder in Inflammatory Bowel Disease. Inflammatory Bowel Diseases 2021; 27: 58–64.
Substance use disorders impose a substantial individual and societal burden; however, the prevalence and associated factors in persons with inflammatory bowel disease (IBD) are largely unknown. We evaluated the prevalence and risk factors of substance use disorders in an IBD cohort. Inflammatory bowel disease participants (n = 247) were recruited via hospital- and community-based gastroenterology clinics, a population-based IBD research registry, and primary care providers as part of a larger cohort study of psychiatric comorbidity in immune-mediated inflammatory diseases. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders IV was administered to participants to identify lifetime substance use disorders, anxiety disorders, and major depressive disorders. Additional questionnaires regarding participants' sociodemographic and clinical characteristics were also completed. We examined demographic and clinical factors associated with lifetime substance use disorders using unadjusted and adjusted logistic regression modeling. Forty-one (16.6%) IBD participants met the criteria for a lifetime diagnosis of a substance use disorder. Factors associated with elevated odds of substance use disorders were ever smoking (adjusted odds ratio [aOR], 2.96; 95% confidence interval [CI], 1.17-7.50), male sex (aOR, 2.44; 95% CI, 1.11-5.36), lifetime anxiety disorder (aOR, 2.41; 95% CI, 1.08-5.37), and higher pain impact (aOR, 1.08; 95% CI, 1.01-1.16).
We concluded that one in six persons with IBD experienced a substance use disorder, suggesting that clinicians should maintain high index of suspicion regarding possible substance use disorders, and inquiries about substance use should be a part of care for IBD patients, particularly for men, smokers, and patients with anxiety disorders