Chronic narcotic use in inflammatory bowel disease patients: Prevalence and clinical characteristics
Chronic narcotic use in inflammatory bowel disease patients: Prevalence and clinical characteristics
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DOI：
10.1046/j.1440-1746.2001.02468.x
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发表时间：
2001-11-01
影响因子：
4.1
通讯作者：
Florin, THJ
中科院分区：
文献类型：
--
作者：
Edwards, JT;Radford-Smith, GL;Florin, THJ
背景：麻醉成瘾可能是炎症性肠病(IBD)的一个重要问题。方法：在计算机布里斯班IBD研究组数据库(截至1999年1月1日，332名患者)中，确定了所有在没有明显器质性病变的情况下长期服用麻醉剂的患者。回顾这些患者的临床、精神和社会特征的个人病例记录，并将精神障碍的患病率与IBD患者的对照组进行比较。结果：确定了11名患者。9人有完整的数据集，8人患有克罗恩病(CD)，其中6人以前有狭窄的回肠疾病，1人患有溃疡性结肠炎，使得IBD患者和CD患者的患病率分别为2.7%和5.1%。吸毒者的精神障碍患病率为67%，显著高于对照组的8%(优势比22，95%可信区间3.24~177)。结论：非器质性病变的炎症性肠病患者中有相当一部分为慢性吸毒者。精神障碍在这一亚组中很常见，就像慢性功能性腹痛综合征一样。有人建议，通过认识到麻醉药物只对IBD患者是一种临时治疗，并意识到先前存在的社会和精神障碍，不仅影响临床疼痛表现，而且有助于确定有滥用麻醉药物风险的患者亚群，可以减少IBD患者的不适当麻醉药物使用。(C)2001年Blackwell Science Asia Pty.
Background: Narcotic addiction can be a significant problem in inflammatory bowel disease (IBD). However, there are few published reports about this problem.Methods: All patients prescribed narcotics chronically in the absence of demonstrable organic pathology were identified on the computerized Brisbane IBD Research Group database (n = 332 patients with informative data as of 1 January 1999). Individual case records were reviewed with regard to clinical, psychiatric and social characteristics of these patients, and the prevalence of psychiatric disorders were compared with a control group of IBD patients.Results: Eleven patients were identified. Nine had complete datasets, eight with Crohn's disease (CD), of which six had previous stricturing ileal disease, and one patient had ulcerative colitis, making a prevalence of 2.7% of IBD patients and 5.1% of CD patients. A 67% prevalence of a psychiatric disorder in narcotic users was significantly greater than the 8% prevalence in the control group of IBD patients (odds ratio 22, 95% CI 3.24-177).Conclusions: A significant proportion of IBD patients without demonstrable organic pathology were chronic narcotic users. Psychiatric disorders are common in this subgroup, as with chronic functional abdominal pain syndromes. It is suggested that inappropriate narcotic use in IBD patients can be reduced by appreciating that narcotics are a temporary therapy only for IBD patients, and awareness of pre-existing social and psychiatric disorders, which not only impact on clinical presentation of pain, but also help define the subgroup of patients who are at risk of narcotic misuse. (C) 2001 Blackwell Science Asia Pty.