Weight loss surgery patients abuse opioids in long term

By: Dr. Victor Marchione | General Health | Wednesday, June 07, 2017 - 08:00 AM

weight loss surgeryWeight loss can be extremely difficult for some, which is why there are so many obese people today. These morbidly obese individuals are at very high risk for a multitude of life-threatening health conditions, often leading to premature death. However, there are surgical procedures available that can aid in weight loss. They are effective, but unfortunately, one in five of those who go through this surgery get addicted to opioids.

Obesity leading to opioid use

Weight loss surgery—bariatric surgery—includes a variety of procedures that help obese people lose weight. This is achieved by reducing the size of the stomach with a gastric band or through the removal of a portion of the stomach. Another procedure involves resecting and rerouting the small intestine to a smaller stomach pouch, called gastric bypass.

These surgeries are designed to decrease the amount eaten and metabolized by the body. Over time, this reduced calorie intake results in significant weight loss.

Not all obese people can get this type of surgery, as the U.S. National Institute of Health recommends a body mass index (BMI) of at least 40, or 35 for people with a serious medical condition.

Painkillers are commonly prescribed to obese individuals due to their predisposition to conditions such as arthritis, back pain, and depression. The fact that use is continued after weight loss surgery is troubling, considering how prevalent opioid abuse is in the U.S.

“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,” said study co-author Dr. Anita Courcoulas.

Following post-surgical patients

The study in question followed more than 2,000 patients, 14.7 percent of which said they regularly used prescription opioids before their surgery. This rate fell to 13 percent six months after surgery but rose to 20.3 percent after seven years.

Of those who weren’t taking opioids before surgery, 5.8 began taking them six months later. After seven years, 14 percent were on opioids.

“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,” said lead study author Wendy King, an associate professor of epidemiology at the University of Pittsburgh.

The results of the study suggest that while weight loss surgery does ease obesity-related pain, it does not eliminate it. So, patients seek relief in the form of painkillers. However, opioids have a high risk of addiction and should not be used to manage chronic pain.

“Our nation is in an epidemic of opioid abuse, addiction, and overdose. Recent reports have suggested that bariatric [weight-loss] surgery patients are at elevated risk of chronic opioid use,” said Dr. Courcoulas.


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Weight loss surgery may increase risk of alcohol abuse: Study

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Sources:

http://www.upmc.com/media/NewsReleases/2017/Pages/opioid-weight-loss.aspx

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