Key result
Among Medicaid enrollees with incident Crohn's disease, 16.3% had a history of substance use, with any substance use decreasing by an absolute 3.8% after diagnosis.
Why the study?
Substance use among persons with Crohn's disease is associated with symptomatic exacerbation and poorer quality of life, but data on its prevalence are limited.
Are CD-related interventions associated with substance use after CD diagnosis in Medicaid enrollees with incident Crohn's disease?
Cohort
Yes
Are CD-related interventions associated with substance use after CD diagnosis in Medicaid enrollees with incident Crohn's disease?
Substance use, particularly alcohol and opioids, is highly prevalent among Medicaid enrollees with incident Crohn's disease, and its trajectory is influenced by CD-related interventions.
Substance use warrants attention in new Crohn's disease among Medicaid enrollees; leaves open whether interventions influence post-diagnosis trajectories.
BACKGROUND AND AIMS: Substance use among persons with Crohn's disease (CD) is associated with symptomatic exacerbation and poorer quality of life. However, data on the prevalence of substance use among individuals with CD are limited. Therefore, our study aimed to estimate the burden of alcohol and drug use among individuals with incident CD in the United States. We also assessed the associations between CD-related interventions and substance use after CD diagnosis. METHODS: Our retrospective cohort study of the national Medicaid databases from 2010 to 2019 identified participants with newly diagnosed CD and defined substance use (ie, alcohol, opioids, cocaine, amphetamine, and cannabis) using diagnosis codes. Multivariable logistic regression models assessed the associations between CD-related interventions and substance use after CD diagnosis. RESULTS: Overall, 16.3% of Medicaid enrollees with incident CD had substance ever-use, most commonly alcohol or opioids (each 8.0%). Any substance use saw an absolute decrease of 3.8% after CD diagnosis, but changes were less than 1% in either direction for each substance. CD-related hospitalization was associated with increased alcohol or opioid use post-CD diagnosis. Surgery was associated with lower use post-CD of opioids but not alcohol. CD medications (except steroids) were generally associated with decreased post-CD alcohol or opioid use. CONCLUSION: Among Medicaid enrollees with incident CD, alcohol and opioid use were more frequent than previously published estimates for the general US population (6% and 4%, respectively, in 2019). Consequently, medical communities must be more aware of substance use by patients with CD to provide quality patient-centered care.
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Chen et al. (2023) conducted a cohort in Incident Crohn's disease. Incident Crohn's disease was evaluated on Substance ever-use (alcohol, opioids, cocaine, amphetamine, and cannabis). Among Medicaid enrollees with incident Crohn's disease, 16.3% had a history of substance use, with any substance use decreasing by an absolute 3.8% after diagnosis.
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