Bariatric surgery can be an effective treatment for musculoskeletal and nonspecific pain linked to obesity. But postoperative pain treatment may increase the risk for chronic opioid use, researchers find.
New data on long-term, post-surgery drug use supports the case that opioids are a problem for bariatric surgery patients. For some surgery patients, long-term use of opioids increased steadily for the seven years of the study.
The research from the University of Pittsburgh Graduate School of Public Health was published in the journal Surgery for Obesity and Related Diseases.
The researchers looked at data from more than 2,000 patients. Before surgery, 14.7% of the participants reported regularly taking a prescription opioid. That dropped to 12.9% after surgery, but rebounded to 20.3 % seven years after surgery.
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Another group of subjects who were not taking opioids at the time of surgery, later began using them. Opioid use rates for that group rose from 5.8 % six months after surgery, to 14.2 % at the end of the study.
The type of surgery and and amount of weight loss were not associated with risk of post-surgery opioid use, but severity of pain was.
Longer Initial Opioid Prescription Ups Risk of Chronic Use
The data was collected as part of the Longitudinal Assessment of Bariatric Surgery. A group of six clinical centers worked with the National Institutes of Health to coordinate bariatric surgery research.
Bariatric surgery can be an effective treatment for musculoskeletal and nonspecific pain linked to obesity. But postoperative pain treatment may increase the risk for chronic opioid use.
Hydrocodone was the most commonly reported opioid medication, followed by Tramadol and Oxycodone. Nonsteroidal anti-inflammatory drugs (NSAIDs) are not allowed due to a risk of marginal ulcers after bariatric surgery, leaving fewer nonopioid options.
"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," said study co-author Anita P. Courcoulas, MD, MPH, chief of minimally invasive bariatric and general surgery at UPMC in a statement.
Tinker Ready is a contributing writer at HealthLeaders Media.