title: Pilot evaluation of a substance abuse prevention group intervention for at-risk bariatric surgery candidates.
abstract: BACKGROUND
  Concerns have been raised about an increased incidence of substance abuse after bariatric surgery. Alcohol use after surgery may be particularly problematic because of changes in pharmacokinetics leading to greater intoxication. The present study evaluated a substance abuse prevention group pilot intervention for at-risk bariatric surgery candidates.
  
  
  METHODS
  Patients with a history of substance abuse/dependence or at-risk substance use applying for weight loss surgery (WLS; N = 86) were referred to a single-session 90-minute intervention (67.4% female; 65.1% Caucasian; mean age 46.2 years; mean body mass index 48.77 kg/m(2)). The session included education about the health effects of alcohol/substances on WLS outcomes, developing alternative coping strategies, identifying warning signs of misuse, and providing treatment resources. Patients completed a preintervention and postintervention questionnaire measuring knowledge of substance use health effects, the Alcohol Use Disorders Identification Test-Consumption Items, and items on motivation for abstinence.
  
  
  RESULTS
  Patients reported a significant increase in knowledge regarding the negative effects of substance abuse after surgery (t = 42.34; P<.001). Patients also reported more healthy alternative coping strategies after the intervention (t = 18.96; P<.001). In addition, a significant number of patients reported a lower intention of consuming alcohol after surgery (χ(2) = 16.18; P<.001) and were more likely to report health reasons as motivation to abstain (χ(2) = 102.89; P< .001).
  
  
  CONCLUSIONS
  At-risk patients applying for weight loss surgery may benefit from a substance abuse prevention intervention. More research will be needed to see if such benefits can be sustained over time and if interventions affect postsurgical behaviors.
authors.affiliation: Cleveland Clinic Bariatric and Metabolic Institute, Cleveland, OH 44195 , USA. ashtonk@ccf.org
authors.forename: Kathleen
authors.initials: K
authors.lastname: Ashton
authors.forename: Leslie
authors.initials: L
authors.lastname: Heinberg
authors.forename: Julie
authors.initials: J
authors.lastname: Merrell
authors.forename: Megan
authors.initials: M
authors.lastname: Lavery
authors.forename: Amy
authors.initials: A
authors.lastname: Windover
authors.forename: Kathleen
authors.initials: K
authors.lastname: Alcorn
mesh_terms: D000223:Adaptation, Psychological; D000428:Alcohol Drinking / Q000517:prevention & control; D050110:Bariatric Surgery / Q000009:adverse effects / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009767:Obesity, Morbid / Q000523:psychology* / Q000601:surgery; D010353:Patient Education as Topic / Q000379:methods; D010865:Pilot Projects; D019966:Substance-Related Disorders / Q000517:prevention & control*