Bariatric Surgery Increases Risk of Alcohol, Substance Use in Some Patients
Individuals who undergo Roux-en-Y gastric bypass (RYGB) have a higher risk of alcohol use disorder, illicit drug use, and treatment for substance use disorder following surgery, compared with those who undergo laparoscopic adjustable gastric banding (LAGB), according to a recent study.
Existing evidence has indicated that RYGB increases the risk of developing alcohol use disorder. However, little data exists on the prevalence of substance use disorders following bariatric surgery.
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To better understand this relationship, the researchers assessed 2348 participants in the Longitudinal Assessment of Bariatric Surgery-2 study who underwent RYBG or LABG. Participants were a mean age of 47 years and had a median body mass index of 45.6 kg/m2. A total of 79.2% of participants were women.
At pre-surgery and annually post-surgery for up to 7 years through January 2015, participants self-reported symptoms of alcohol use disorder within the past year, based on the Alcohol Use Disorders Identification Test. Participants also self-reported illicit drug use, including any use of cocaine, hallucinogens, inhalants, phencyclidine, amphetamines, or marijuana; as well as any treatment for substance use disorder, including counseling or hospitalization for alcohol or drugs.
A total of 2003 participants had completed baseline and follow-up assessments. Results indicated that the cumulative incidence of the post-RYBG onset of alcohol use disorder symptoms at 5 years was 20.8%, compared with 7.5% for illicit drug use and 3.5% for treatment for substance use disorder. Following LAGB, the cumulative incidence of the onset of alcohol use disorder symptoms at 5 years was 11.3%, vs 4.9% for illicit drug use and 0.9% for treatment for substance use disorder.
“Undergoing RYGB versus LAGB was associated with twice the risk of incident [alcohol use disorder] symptoms,” the researchers concluded. “One-fifth of participants reported incident [alcohol use disorder] symptoms within 5 years post-RYGB. [Alcohol use disorder] education, screening, evaluation, and treatment referral should be incorporated in pre- and postoperative care.”
—Christina Vogt
Reference:
King WC, Chen JY, Courcoulas AP, et al. Alcohol and other substance use after bariatric surgery: prospective evidence from a U.S. multicenter cohort study. Surg Obes Related Dis. 2017;13(8):1392-1402. doi:10.1016/j.soard.2017.03.021.