Study: 1 in 5 surgical weight-loss patients take prescription opioids

The proportion of adults with severe obesity using prescription opioids initially declines right after bariatric surgery, researchers say.
By Amy Wallace   |   June 5, 2017 at 2:22 PM

June 5 (UPI) -- A study by the University of Pittsburgh found one in five surgical weight-loss patients take prescription opioids seven years after surgery.

Researchers at the University of Pittsburgh Graduate School of Public Health and the National Institutes of Health, or NIH, found that while the number of adults with severe obesity using prescription opioids initially declines in the months after bariatric surgery, it eventually increases to surpass pre-surgery rates.

"Almost half of patients reporting opioid use at the time of surgery reported no such use following surgery. However, among the much larger group of patients who did not report opioid use pre-surgery, opioid use gradually increased throughout seven years of follow-up," Wendy C. King, an associate professor of epidemiology at Pitt Public Health, said in a press release. "Thus, post-surgery initiation of opioid use explains this phenomenon."

The study found that the improvements in obesity-related pain gained through bariatric surgery are not enough to counter the need for pain relief in the years after the surgery.

Researchers followed more than 2,000 patients beginning in 2006 who participated in the NIH-funded Longitudinal Assessment of Bariatric Surgery-2, or LABS-2, of patients from one of 10 hospitals throughout the United States.

Approximately 70 percent of patients underwent Roux-en-Y gastric bypass, or RYGB, a procedure that significantly reduces the size of the stomach and changes the connections with the small intestine. The remaining patients had less invasive procedures including laparoscopic adjustable gastric banding where an adjustable band is inserted around the patient's stomach to lessen the amount of food that can be consumed.

Prior to surgery, 14.7 percent of patients reported taking prescription opioids. That number declined to 12.9 percent six months after surgery and then increased to 20.3 percent seven years after surgery.

Among those not taking prescription opioid pain medication before surgery, rates increased from 5.8 percent at six months and 14.2 percent at seven years, with hydrocodone being the most commonly reported opioid medication taken.

"Our nation is in an epidemic of opioid abuse, addiction and overdose. Recent reports have suggested that bariatric surgery patients are at elevated risk of chronic opioid use," said Dr. Anita P. Courcoulas, chief of minimally invasive bariatric and general surgery at UPMC. "Our study does not prove that bariatric surgery causes an increase in opioid use. However, it does demonstrate the widespread use of opioids among post-surgical patients, thereby highlighting the need for alternative pain management approaches in this population."

The study was published in Surgery for Obesity and Related Diseases.

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