Chronic opioid use emerging after bariatric surgery.

Area of Science:

• Bariatric Surgery Outcomes
• Pain Management
• Opioid Use Disorder

Background:

• Limited understanding of post-bariatric surgery opioid use in non-chronic pre-surgery users.
• Need to identify predictors of chronic opioid use after bariatric procedures.

Purpose of the Study:

• Determine the incidence of chronic opioid use in the year following bariatric surgery among opioid-naïve patients.
• Identify pre-surgery characteristics associated with chronic opioid use post-surgery.

Main Methods:

• Retrospective cohort study of 10,643 patients aged 21+ across nine US health systems.
• Defined chronic opioid use as ≥10 dispensings over ≥90 days or ≥120 total days' supply in the post-surgery year (excluding the first 30 days).

Main Results:

• 4.0% of patients developed chronic opioid use post-surgery.
• Pre-surgery opioid supply (1-29 days: OR 1.89; 90-119 days: OR 14.29) was strongly associated with post-surgery chronic use.
• Pre-surgery use of non-narcotic analgesics, antianxiety agents, and tobacco increased likelihood; older age and laparoscopic band procedures decreased likelihood.

Conclusions:

• The majority of patients who transitioned to chronic opioid use post-bariatric surgery had a history of intermittent pre-surgery opioid use.
• Pre-surgery intermittent opioid use is a significant risk factor for developing chronic opioid dependence after bariatric surgery.