New Study Finds Higher Opioid Addiction Risk Among Weight-Loss Surgery Patients

by Chris Clancy

October 26, 2017

surgery

People recovering from weight-loss surgery present a higher risk of opioid dependence than those recovering from other general surgeries, according to new research presented earlier this month at a meeting of the American College of Surgeons in San Diego.

According to the study, “New Persistent Opioid Use After Bariatric Surgery,” nearly 9 percent of bariatric surgery patients who had never taken the powerful yet highly addictive pain medication until their weight-loss operation reported they were still using prescription opioids one year after their procedures.

“Patients undergoing bariatric surgery may be particularly vulnerable to opioid dependence, possibly because of chronic knee and back pain associated with morbid obesity,” said Dr. Ghaferi, an associate professor of surgery at the University of Michigan. “Surgeons must identify patients who may be at higher risk for addiction to opioids, so they can adjust prescribing for postoperative pain.”

How Opioid Dependence Can Happen After Bariatric Surgery

Ghaferi and his colleagues drew from more than 14,000 patients who underwent first-time bariatric surgical procedures—mostly minimally invasive, laparoscopic procedures—and then completed surveys about their use of prescription painkillers just before their operation and one year later.

Of this group, nearly three-quarters were found to be “opioid naïve” –that is, they had not taken any opioids in the year leading up to their surgery. Among this group, approximately nine percent were still on opioids one year after their surgery. This rate of what is known in medical circles as “new persistent opioid use,” was 46 percent higher than rates of similar opioid use among opioid naïve patients following general surgery.

“Given the known elevated risk of cross-addiction to alcohol and illicit drugs in bariatric surgical patients, providers should pay special attention to opioid use during the post-surgical period,” said Ghaferi, who also directs the Michigan Bariatric Surgery Collaborative (MBSC), a quality improvement program that supplied the data for the study.

Opioid painkillers like OxyContin, Percocet, and Vicodin are routinely prescribed to patients just before and immediately following bariatric surgery, to deal with the postoperative pain. While most patients stop using the drug within a couple of weeks, these new findings regarding opioid dependence and bariatric surgery patients may lead doctors to considering ways in which to reduce opioid dependence post-surgery, such as more effective screening tools for signs of substance abuse tendencies, like excessive alcohol use or a substance-prevalent family history. Increased use of local nerve blocks may likewise help minimize the need for opioids post-surgery.

“We don’t want our surgical patients to become addicted to opioids, but of course we don’t want them to be recovering at home in pain either,” Ghaferi said.

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