Abstract
Background
Crohn’s disease (CD) is an inflammatory disease of the gut with multiple psychosocial comorbidities, including lost wages, stress on loved ones, and psychiatric illnesses, all of which are associated with substance use disorders. While approximately 7.5% of individuals aged 12 or older in the United States have a substance use disorder, we know little about this issue among patients with CD. Using a nationally representative dataset, we examined the burden of alcohol, tobacco, and illicit drug use among patients with CD in the United States.
Methods
We queried the national Medicaid claims data from 2010 through 2014 using ICD-9-CM codes for CD and use of alcohol, tobacco, opioids, cocaine, amphetamine, and cannabis. We defined CD as having two or more CD diagnostic codes; all included individuals must have at least one continuous year of Medicaid eligibility. The primary outcomes of interest were the total and the substance-specific prevalence of use in patients with CD.
Results
During our five-year study period, there were 51,091 individuals with CD. Among them, 7.4% had at least one code to suggest substance use, and 1.3% had codes for two or more substance types. Non-users were 65% female, 39-years old at the first CD diagnosis, and had 1.7 years of median follow-up after the said diagnosis. Users were 62% female, 40-years old at the first CD diagnosis, and had 1.8 years of median follow-up after diagnosis. The frequencies of substance use codes by CD patients were tobacco (3.9%), opioids (2.2%), alcohol (1.6%), cannabis (0.4%), cocaine (0.3%) and psychostimulants (0.3%).
Conclusion
At least 1 in 13 patients with CD in the US Medicaid cohort noted substance use from 2010 through 2014. Our finding was comparable to the reported prevalence of substance use disorders in the general US population.
Risk and Protective Factors for Adolescent Substance Use in Washington State, the United States and Victoria, Australia: A Longitudinal Study
