Abstract

Background Individuals with inflammatory bowel disease (IBD) often experience pain, mood disturbances, and sleep disruption, which may lead to greater use of pain‐relieving and sedative medications compared with the general population. These are associated with increased mortality, paradoxical worsening of pain, and inappropriate IBD treatment discontinuation. Chronic prescribing and co‐prescribing increase the risk of respiratory depression, dependence, and overdose. Methods Using Clinical Practice Research Datalink, a large nationally representative dataset, we examined the annual prevalence of total, chronic (> 90 days opioids; > 28 days sedatives), and co‐prescribed opioids, gabapentinoids and sedatives in adults with incident IBD from January 2010 to December 2019. Multivariable regression identified predictors of chronic or co‐prescribing. Results Among 17,388 individuals, over 20% were prescribed a pain or sedative medication each year. Annual prevalence for opioids and gabapentinoids increased (13.6%–14% and 2.5%–5.6%, respectively) while sedative prevalence remained stable (8.4%). Chronic prescribing increased for strong opioids (3.6%–4.6%), weak opioids (3.6%–3.7%) and sedatives (4.2%–4.4%). Between 4.2% and 6.9% of individuals per year were co‐prescribed opioids, gabapentinoids, and/or sedatives. Female sex, smoking, older age at diagnosis, Crohn's disease, and a diagnosis of inflammatory arthropathy, irritable bowel syndrome, fibromyalgia, or anxiety/depression were significantly associated with chronic and/or co‐prescriptions of opioids or sedatives. Conclusion A substantial proportion of individuals with IBD are prescribed pain and sedative medications, including long‐term and co‐prescriptions. Identifying high‐risk patients is essential to ensure they are prioritised for limited resources, such as psychological therapies, as alternatives to harmful prescriptions.