New persistent opioid use after bariatric surgery.
Mohanty S, Lee J, Ross R, Stricklen A, Carlin A, Ghaferi A. New persistent opioid use after bariatric surgery.. J Am Coll Surg 2017; 225(4):S123.
J Am Coll Surg
INTRODUCTION: Patients undergoing bariatric surgery may be particularly vulnerable to opioid dependence due to chronic knee and back pain associated with morbid obesity. Recent work noted post-bariatric surgery patients are at increased risk risk of self-harm and have significant potential for cross-addiction to alcohol and illicit drugs. We sought to understand the prevalence of persistent opioid use after bariatric surgery. METHODS: Using data from the Michigan Bariatric Surgery Collaborative (MBSC), we identified patients undergoing primary, nonrevisional bariatric surgery who had baseline and 1-year follow-up data (n = 14, 063). We ascertained opioid use using a patient-reported survey methodology previously validated within MBSC. Patients were asked whether they used “prescription pain killers, “ with a list of commonly prescribed opioid medications. RESULTS: In this cohort, 76% (n = 10, 697) of patients denied opioid use preoperatively (Table). Nearly 10% of these opioid näive patients reported new persistent opioid use 1 year after surgery. This represents a 60% increase compared with general surgical patients (9.7% vs 6.0%). Among patients who reported preoperative opioid use (n = 3, 366), 39.7% no longer reported opioid use at 1 year after surgery. Overall, 27% of post-bariatric surgery patients report opioid use 1 year after bariatric surgery. CONCLUSIONS: Opioid näive patients undergoing bariatric surgery develop much higher rates of new persistent opioid use compared with other general surgical patients. Furthermore, those with baseline opioid use have a small rate of remission. Given the elevated risk of cross-addiction in these patients, providers should pay special attention to opioid use during the post-surgical period.