Opioid Use Increases Significantly 7 Years After Bariatric Surgery

A recent study found that 1 in 5 bariatric surgery patients continue taking prescription opioids 7 years after having weight-loss surgery, despite an initial decrease in use in the months following surgery.

The Longitudinal Assessment of Bariatric Surgery-2, an observational cohort study, included 2258 participants at baseline and 2218 at follow-up from 10 hospitals in the United States. The majority of participants was female and had undergone a Roux-en-Y gastric bypass surgery. Participants had a median body mass index of 46.
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For the study, the researchers assessed opioid use pre-surgery, at 6 months post-surgery, and annually post-surgery for up to 7 years. Opioid use—defined as a prescribed opioid analgesic—was self-reported as daily, weekly, or “as needed.”

Results of the analysis after final follow-up showed that, although patients’ opioid use decreased from 14.7% at baseline to 12.9% at 6 months, it had reached 20.3% by year 7.

For patients not prescribed opioids at baseline, opioid use post-surgery increased from 5.8% at 6 months to 14.2% at year 7.

The researchers linked several factors to a higher risk of initiating opioid use after surgery, including public vs private health insurance, higher pain levels prior to surgery, undergoing subsequent surgeries, worsening pain, less improvement in pain, and starting or continuing non-opioid analgesics following surgery.

“After bariatric surgery, prevalence of prescribed opioid analgesic use initially decreased but then increased to surpass baseline prevalence, suggesting the need for alternative methods of pain management in this population,” the researchers concluded.

—Christina Vogt

Reference:

King WC, Chen JY, Belle SH, et al. Use of prescribed opioids before and after bariatric surgery: prospective evidence from a U.S. multicenter cohort study. Surg Obes Related Dis. In press. doi:10.1016/j.soard.2017.04.003.