title: Chronic opioid use emerging after bariatric surgery.
abstract: OBJECTIVE
  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.
authors.affiliation: Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA; University of Colorado Skaggs, School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA.
authors.forename: Marsha A
authors.initials: MA
authors.lastname: Raebel
authors.forename: Sophia R
authors.initials: SR
authors.lastname: Newcomer
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Bayliss
authors.forename: Denise
authors.initials: D
authors.lastname: Boudreau
authors.forename: Lynn
authors.initials: L
authors.lastname: DeBar
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Elliott
authors.forename: Ameena T
authors.initials: AT
authors.lastname: Ahmed
authors.forename: Pamala A
authors.initials: PA
authors.lastname: Pawloski
authors.forename: David
authors.initials: D
authors.lastname: Fisher
authors.forename: Sengwee
authors.initials: S
authors.lastname: Toh
authors.forename: William Troy
authors.initials: WT
authors.lastname: Donahoo
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D050110:Bariatric Surgery / Q000009:adverse effects / Q000639:trends*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D009293:Opioid-Related Disorders / Q000209:etiology*; D010146:Pain / Q000188:drug therapy*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000701:Analgesics, Opioid
keywords: bariatric surgery; chronic opioid use; chronic pain; obesity; opiate; opioid; pharmacoepidemiology