Opioids are commonly prescribed for temporary pain relief among individuals with inflammatory bowel disease (IBD); however, the efficacy of opioids for managing chronic pain is limited and risk of adverse effects is high. Emerging evidence demonstrates that a subset of individuals with IBD receive chronic opioid therapy (COT), and that adolescents and young adults (AYAs) are at particular risk of continued opioid use. The aim of this study was to evaluate persistence of COT and associated healthcare utilization among AYAs with IBD in the United States.