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Users of chronic prescription opioids decrease in the first 12 months following bariatric surgery.

Enoch J Abbey1, Richard D Nudotor2, Banda A A Khalifa3

  • 1NYC Health + Hospitals/Harlem, Columbia University Medical Center, New York, New York, USA.

Obesity (Silver Spring, Md.)
|December 5, 2024
PubMed
Summary
This summary is machine-generated.

Bariatric surgery reduced chronic opioid use by nearly 25%, but some patients increased their opioid dosage post-surgery. Further research and pre-operative dose reduction are recommended.

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Area of Science:

  • Bariatric surgery
  • Pain management
  • Opioid use disorder

Background:

  • Obesity is a significant risk factor for chronic pain.
  • Opioids are commonly prescribed for chronic pain management.
  • Bariatric surgery is an effective weight-loss intervention.

Purpose of the Study:

  • To investigate the impact of Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG) on chronic opioid prescription use.
  • To compare opioid discontinuation and dosage changes after different bariatric procedures.

Main Methods:

  • Analysis of adult chronic opioid users from the IBM MarketScan database (2010-2017) who underwent bariatric surgery.
  • Measurement of opioid use in morphine milligram equivalents (MME) for 6-month periods pre- and post-surgery.
  • Comparison of MME changes between RYGB and VSG groups and against preoperative levels.

Main Results:

  • Nearly 25% of patients discontinued opioids within 12 months post-surgery, with similar rates for VSG and RYGB.
  • Preoperative opioid exposure did not predict discontinuation, but multiple prescription types were associated with lower cessation rates.
  • Among continuing users, average MME increased post-surgery for both RYGB and VSG patients.

Conclusions:

  • Bariatric surgery significantly reduces the number of chronic opioid users.
  • A subset of patients experiences increased opioid exposure post-surgery, necessitating long-term monitoring.
  • Healthcare providers should counsel patients on potential risks and consider pre-operative opioid dose reduction.