Opioid use decreases in first year after bariatric surgery

Bariatric surgery has reduced the number of patients using opioids by nearly 25 percent, but those with multiple opioid prescriptions are less likely to stop its use after the procedure, according to a study.

The authors examined adult chronic opioid users who underwent bariatric surgery using the IBM MarketScan database from 2010 through 2017. Opioid use was measured in morphine milligram equivalents (MME) for 6 months before and after surgery. Changes in MME for each 6-month interval were compared with preoperative exposure and across different bariatric surgery types.

A total of 2,197 patients were included in the analysis, of whom 29 percent stopped using opioids 6 months after surgery. This further declined to 23.4 percent at 12 months. There was no significant difference in discontinuation rates between vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB).

Preoperative exposure to opioids was not predictive of discontinuation after surgery. However, patients with several opioid prescription types showed a lower likelihood of cessation.

Among patients who continued using opioids, the average MME rose at 6 months following the procedure when compared with 6 months prior to surgery in both groups (VSG: mean 74.9; RYGB: mean 49.4).

“Further research to track long-term opioid use should be conducted, and providers should inform patients of these risks and attempt opioid dose reductions before surgery,” the authors said. 

“Obesity is an independent risk factor for chronic pain frequently treated with opioids,” they noted.