Substance Use Disorders Are Rising Among Hospitalized IBD Patients

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.

Zheng, Melanie et al.·Journal of clinical gastroenterology·2025·Strong Evidenceretrospective-analysis
RTHC-08042Retrospective AnalysisStrong Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
retrospective-analysis
Evidence
Strong Evidence
Sample
N=2,532,450

What This Study 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.

Key Numbers

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 They Did This

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.

Why This Research 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 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.

What This Study Doesn't 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.

Questions This Raises

  • ?Is cannabis use disorder in IBD patients driven by self-medication for GI symptoms?
  • ?Should IBD treatment programs routinely screen for substance use disorders?

Trust & Context

Key Stat:
Evidence Grade:
Very large national database with 11-year trend analysis — strong evidence for the trend, though administrative data has inherent limitations.
Study Age:
Covers 2010-2020, capturing the period of both opioid crisis expansion and cannabis legalization across many states.
Original Title:
Trends in Substance Use Disorder Among Hospitalized Patients With Inflammatory Bowel Disease: An 11-Year Nationwide Study.
Published In:
Journal of clinical gastroenterology (2025)
Database ID:
RTHC-08042

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study
What do these levels mean? →

Frequently Asked Questions

Do IBD patients have higher rates of substance use?

Yes — about 1 in 4 Crohn's patients and 1 in 5 UC patients hospitalized had a co-occurring substance use disorder, and rates are rising.

Is cannabis use disorder increasing in IBD patients?

Yes — cannabis use disorder showed significant growth alongside opioid use disorder, while the overall substance pattern shifted away from alcohol dominance.

Read More on RethinkTHC

Cite This Study

RTHC-08042·https://rethinkthc.com/research/RTHC-08042

APA

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

MLA

Zheng, Melanie, et al. "Trends in Substance Use Disorder Among Hospitalized Patients With Inflammatory Bowel Disease: An 11-Year Nationwide Study.." Journal of clinical gastroenterology, 2025. https://doi.org/10.1097/MCG.0000000000002205

RethinkTHC

RethinkTHC Research Database. "Trends in Substance Use Disorder Among Hospitalized Patients..." RTHC-08042. Retrieved from https://rethinkthc.com/research/zheng-2025-trends-in-substance-use

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.