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Chronic opioid use emerging after bariatric surgery
Author(s) -
Raebel Marsha A.,
Newcomer Sophia R.,
Bayliss Elizabeth A.,
Boudreau Denise,
DeBar Lynn,
Elliott Thomas E.,
Ahmed Ameena T.,
Pawloski Pamala A.,
Fisher David,
Toh Sengwee,
Donahoo William Troy
Publication year - 2014
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.3625
Subject(s) - medicine , opioid , surgery , chronic pain , odds ratio , retrospective cohort study , narcotic , cohort , pharmacoepidemiology , anesthesia , physical therapy , medical prescription , receptor , pharmacology
ABSTRACT Purpose Little is known about opioid use after bariatric surgery among patients who did not use opioids chronically before surgery. Our purpose was to determine opioid use the year after bariatric surgery among patients who did not use opioids chronically pre‐surgery and to identify pre‐surgery characteristics associated with chronic opioid use after surgery. Methods This retrospective cohort study across nine US health systems included 10 643 patients aged 21 years or older who underwent bariatric surgery and who were not chronic opioid users pre‐surgery. The main outcome was chronic opioid use the post‐surgery year (excluding 30 post‐operative days) defined as ≥10 dispensings over ≥90 days or ≥120 total days' supply. Results Overall, 4.0% ( n = 421) of patients became chronic opioid users the post‐surgery year. Pre‐surgery opioid total days' supply was strongly associated with chronic use post‐surgery (1–29 days adjusted odds ratio [OR] 1.89 [95%CI, 1.24–2.88]; 90–119 days OR, 14.29 [95%CI, 6.94–29.42] compared with no days). Other factors associated with increased likelihood of post‐surgery chronic use included pre‐surgery use of non‐narcotic analgesics (OR, 2.22 [95%CI, 1.39–3.54]), antianxiety agents (OR, 1.67 [95%CI, 1.12–2.50]), and tobacco (OR, 1.44 [95%CI, 1.03–2.02]). Older age (OR, 0.84 [95%CI, 0.73–0.97] each decade) and a laparoscopic band procedure (OR, 0.42 [95%CI, 0.25–0.70] vs. laparoscopic bypass) were associated with decreased likelihood of chronic opioid use post‐surgery. Conclusions Most patients who became chronic opioid users the year after bariatric surgery used opioids intermittently before surgery. Copyright © 2014 John Wiley & Sons, Ltd.