Among 2.5 million IBD hospitalizations over 11 years, substance use disorders increased from 24% to 28% in Crohn's and 14% to 19% in ulcerative colitis, with cannabis use disorder showing significant growth.
Gastroenterologists, IBD specialists, addiction medicine professionals, and IBD patients considering cannabis for symptom management.
What the researchers found
SUD prevalence increased significantly in both Crohn's disease (23.8% to 27.9%) and ulcerative colitis (14.2% to 19.4%) from 2010-2020. The predominant substances shifted from alcohol to opioids and cannabis. Male sex, Medicaid insurance, and lower income were associated with higher SUD rates.
Why it matters
IBD patients increasingly have co-occurring substance use disorders, affecting disease management and outcomes. The shift toward cannabis and opioid use disorders requires adapted treatment approaches.
The numbers in context
2,532,450 IBD hospitalizations. CD: SUD increased 23.8% to 27.9%. UC: 14.2% to 19.4%. Male OR: 1.26-1.34. Medicaid vs. Medicare OR: 1.59-1.84. Lowest vs. highest income: OR 1.54-1.56.
How the study worked
Retrospective analysis of 2,532,450 patients hospitalized with IBD from 2010-2020 using the Nationwide Readmissions Database, with multivariable logistic regression for demographic associations.
What this study cannot tell us
Administrative data cannot determine causation or distinguish therapeutic cannabis use from recreational. Hospitalized patients may not represent all IBD patients. Coding practices for SUD may have changed over the study period.
How to read the evidence
Very large national database with 11-year trend analysis — strong evidence for the trend, though administrative data has inherent limitations.
When this study was published
Covers 2010-2020, capturing the period of both opioid crisis expansion and cannabis legalization across many states.
The bigger picture
Cannabis is commonly used by IBD patients for symptom relief, but the rising rate of cannabis use disorder among hospitalized IBD patients suggests a subset develops problematic use patterns that complicate their care.
Questions still open
- Is cannabis use disorder in IBD patients driven by self-medication for GI symptoms? Should IBD treatment programs routinely screen for substance use disorders?
Common questions
Do IBD patients have higher rates of substance use?
Is cannabis use disorder increasing in IBD patients?
Read the original research
Trends in Substance Use Disorder Among Hospitalized Patients With Inflammatory Bowel Disease: An 11-Year Nationwide Study.
Journal of clinical gastroenterology
Citation
Zheng, Melanie; DeDecker, Lauren; Chen, Po-Hung; Limketkai, Berkeley N. (2025). Trends in Substance Use Disorder Among Hospitalized Patients With Inflammatory Bowel Disease: An 11-Year Nationwide Study.. Journal of clinical gastroenterology. https://doi.org/10.1097/MCG.0000000000002205
Explore the wider topic
- CBD Oil Quality Guide: How to Avoid Snake Oil
- Anxiety After Quitting Weed: When to Consider Medication
- Cannabis for Chemotherapy Nausea: What the Evidence Actually Shows
- Cannabis for Chronic Pain: What the Research Actually Supports
- Cannabis and Epilepsy: The Epidiolex Story and What It Means
- Does CBD Actually Work for Anxiety? What the Evidence Shows
- Does CBD Help with Weed Withdrawal? What Studies Show
- CBD vs THC: The Differences That Actually Matter
- The Proven Medical Benefits of Cannabis: What Research Supports
- Quitting Weed Before Surgery
- Weed and Medications: What Changes When You Quit
- Quitting Weed During Pregnancy: What You Need to Know
- Quitting Weed While Pregnant: What You Need to Know
- Cannabis and Older Adults: Risks Seniors Should Know
- Cannabis and Breastfeeding: THC in Breast Milk
- Cannabis and IBS: Gut Health, Inflammation, and Symptom Relief
- Cannabis and Crohn's Disease: What Gastroenterology Research Shows