S67 Prevalence and Patterns of Opioid Use Disorder in Patients With Chronic Pancreatitis: A Systematic Review and Meta-Analysis

Introduction: Patients with chronic pancreatitis (CP) may be particularly vulnerable to opioid use disorder (OUD) due to the chronic nature of their pain and frequent healthcare interactions. Small sample sizes have limited previous evidence on the burden of OUD in patients with CP. This systematic review and meta-analysis investigated the prevalence and demographic patterns of OUD in patients with chronic pancreatitis. Methods: Following the PRISMA guidelines, we conducted a comprehensive search on MEDLINE, Embase, Scopus, Web of Science and PsycINFO for articles published in English from inception of the databases to March 13, 2025. Random-effects meta-analytic models were used to calculate pooled log-transformed odds ratios (ORs) and their variances to evaluate the determinants of OUD in patients with CP. Heterogeneity across studies was assessed using the I² statistic and Cochran’s Q test. Results: We included 6 studies with a total sample of 606,678 participants. All studies were conducted retrospectively and were published in the USA, between 2019 and 2024. The polled prevalence of OUD in CP was 9% (95% CI: 6%-14%) and the mean age of participants with both OUD and CP was 45.46 (±11.67) years. Most cases of OUP in CP patients were reported in the Southern region of the USA (35.48%), followed by the West, Midwest, and Northeast regions (21.98%, 21.55%, and 20.97%, respectively). About two-thirds of patients were on Medicaid or Medicare (29.75% and 30.6% respectively), with only a third on private insurance or self-pay (21.86% and 9.6% respectively). The majority of patients were white (67.2%), meanwhile Black/African American and Hispanic populations accounted for 21% and 7% respectively. We found no statistically significant difference in the risk of OUD among Blacks/African Americans (OR 0.79, 95% CI: 0.58–1.08) or Hispanics (OR 0.78, 95% CI: 0.57–1.07) with OUD, compared to white patients. Similarly, there was no significant association between gender and OUD in CP patients (OR 0.89, 95% CI: 0.63–1.26). Conclusion: Our study indicates that the burden of opioid use disorder is high in patients with chronic pancreatitis, especially in the southern United States population and socioeconomically underprivileged groups. However, we found no significant disparities in OUD risk related to race and gender. These insights underscore the importance of more comprehensive, regionally-tailored pain management strategies, especially opioid prescribing practices in patients with chronic pancreatitis.