Pain prescription trends and opioid disorder risk in chronic pancreatitis: A real-world data analysis from 2015 to 2024.

Authors

Yanna Cai, Jianing Li, Niwen Kong, Walter G Park, Yan Bi, Stephen Pandol, Yi Jiang

Published in

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]. Aug 24, 2026. Epub Aug 24, 2026.

Abstract

Pain in chronic pancreatitis (CP) negatively impacts quality of life and healthcare utilization. This study characterized longitudinal analgesic prescribing trends, demographic differences, treatment pathways, and factors associated with opioid-related outcomes among patients with CP.
Using TriNetX, we identified adults with CP and assessed annual incidence and annual period prevalence of documented prescriptions from 2015 to 2024 for: NSAIDs/acetaminophen, opioids, benzodiazepines, neuropathic agents, and muscle relaxants. Treatment pathways and opioid-related outcomes were analyzed using Cox regression models adjusting for 39 covariates.
Among 142,650 CP patients, the annual period prevalence of pain medication prescription increased from 41.24% to 58.80%, substantially exceeding the general population. NSAIDs/acetaminophen and opioid prescription prevalence showed the highest increases. Females exhibited higher use across all medication classes. Younger patients demonstrated higher initiation rates. Initial treatments mostly involved NSAIDs/acetaminophen and opioids, with frequent polypharmacy observed. 10% of patients developed opioid-related conditions, with significantly higher hazards among those with alcohol-related CP (opioid-related disorders: HR = 1.23, 95% CI 1.18-1.29, P < 0.001; opioid dependence: HR = 1.21, 95% CI 1.14-1.27, P < 0.001; opioid abuse: HR = 1.09, 95% CI: 1.02-1.18, p = 0.018) and those undergoing pancreatic surgery (opioid-related disorders: HR = 1.81, 95% CI 1.66-1.96, P < 0.001; opioid dependence: HR = 2.07, 95% CI: 1.89-2.27, p < 0.001).
This large-scale analysis highlights substantial and increasing analgesic use in CP, marked by increasing opioid prescription burden, polypharmacy, and higher hazards of opioid-related disorders among patients with alcohol-related etiology or pancreatic surgery. These findings emphasize the need for more guideline-concordant, multimodal, and individualized pain management with careful monitoring of high-risk groups.

PMID:
42648912
Bibliographic data and abstract were imported from PubMed on 27 Aug 2026.

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