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Increased drug use

Bariatric patients at risk of substance abuse post-surgery

Roux-en-Y patients are particularly at risk of alcohol abuse.
Survey finds significantly increased use of alcohol, tobacco and drugs after surgery
Roux-en-Y patients most likely to practice increased alcohol use

Bariatric patients may be at risk of increased drug, alcohol and tobacco use following surgery, according to a new report published in the Archives of Surgery.

The paper, by Alexis Conason of the New York Obesity Nutrition Research Center, and colleagues, analysed questionnaire responses from a survey issued at an information session at a bariatric surgery centre. It found that following an immediate decrease in reported substance use post-surgery, average use tended to increase up to the 24-month follow-up point.

The paper suggests that the patients may be increasing their drug, alcohol and tobacco use to replace neurological responses that they used to experience through food eating, citing studies that found that drug and alcohol use trigger similar responses in the brain to binge-eating.

Those in the study who underwent Roux-en-Y gastric bypass surgery were particularly at risk of increased alcohol use post-surgery.

"Based on the present study, undergoing Roux-en-Y gastric bypass surgery appears to increase the risk for alcohol use following weight loss surgery," the authors write. "Risks and benefits should be weighted when recommending Roux-en-Y gastric bypass surgery to patients who may be at increased risk of developing problems with alcohol after weight loss surgery, such as those with a personal or family history of alcohol abuse or dependence.

The survey assessed responses from 155 patients (132 women and 23 men) at one, three, six, 12, and 24 months after surgery. One hundred patients had Roux-en-Y gastric bypass, and 55 underwent gastric band surgery.

The authors found a significant increase in the frequency of all substance use from baseline to 24 months after surgery (p=.02), as well as significant increases from one month, three months, and six months to 24 months after surgery (all p≤.002). The increase in alcohol use from baseline to 24 months after laparoscopic Roux-en-Y gastric bypass surgery was significant at P = .011.

The study claims to be among the first to document significant increases in substance use following weight loss surgery using longitudinal data.

The results reinforce a study published in the Journal of the American Medical Association earlier this year, which found increased levels of alcohol abuse among bariatric patients post-surgery.

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