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Open Access 12-03-2025 | Bariatric Surgery | Original Contribution

Alcohol and Other Substance Screening in Bariatric Surgery Candidates: Utility of Self-Report and Toxicology Tests, Including Ethyl-Glucoronide

Authors: Silvia Cañizares, Laura Nuño, Pablo Barrio, Mireia Forner-Puntonet, Carolina Gavotti, Miquel Monràs, Patricia Gavín, Ricard Navinés, Lilliam Flores, Maite Barrios, Alba Andreu, Judit Molero, Amanda Jimenez, Josep Vidal, Anna Lligoña

Published in: Obesity Surgery

Abstract

Following bariatric surgery (BS) patients have an increased risk of alcohol misuse.

Purpose

This 1-year cross-sectional study in potential BS candidates had several objectives: (a) assess the prevalence of risky drinking, alcohol use disorder (AUD), and other substance use/disorder; (b) compare the prevalence of these behaviors to that of the general Spanish population; (c) determine the proportion of patients with positive results in toxicology tests; and (d) study the predictive factors of risky drinking. Setting: tertiary university hospital.

Materials and Methods

Alcohol and other substance use were evaluated with the AUDIT-C and ASSIST questionnaires. Urine tests analyzed several markers (ethyl-glucoronide [EtG] ≥ 500 ng/ml, amphetamine, benzodiazepine, cannabinoid, cocaine, and opioid). The Mini-International-Neuropsychiatric-Interview (5.0.0) was employed to assess psychiatric diagnoses.

Results

Among 308 candidates for BS, 196 were accepted to participate (69% women; mean age 46.7 ± 10.9 years; mean body mass index 45.6 ± 5.9). AUDIT-C and ASSIST identified 7% and 5% of risky drinkers, respectively. Men were more frequently risky drinkers compared to women (18% vs. 2%) and compared to the general population (18% vs. 8%). Six percent of individuals had AUD, being men the most affected, and 2% met criteria for other substance disorder. Fifteen percent of the sample presented risky tobacco use. Cannabis was self-reported only by males (3%). EtG ≥ 500 ng/ml was present in 15% of the sample, being a risk factor for risky drinking together with the male sex.

Conclusion

Identification of candidates at risk for risky drinking can help to prevent any alcohol misuse after BS. The combination of subjective and objective measures improves the validity of the assessment of substance use.

Graphical Abstract

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Title: Alcohol and Other Substance Screening in Bariatric Surgery Candidates: Utility of Self-Report and Toxicology Tests, Including Ethyl-Glucoronide
Authors: Silvia Cañizares
Laura Nuño
Pablo Barrio
Mireia Forner-Puntonet
Carolina Gavotti
Miquel Monràs
Patricia Gavín
Ricard Navinés
Lilliam Flores
Maite Barrios
Alba Andreu
Judit Molero
Amanda Jimenez
Josep Vidal
Anna Lligoña
Publication date: 12-03-2025
Publisher: Springer US
Keywords: Bariatric Surgery
Bariatric Surgery
Benzodiazepine
Opioids
Opioids
Obesity
Obesity
Published in: Obesity Surgery
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-025-07774-z

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Alcohol and Other Substance Screening in Bariatric Surgery Candidates: Utility of Self-Report and Toxicology Tests, Including Ethyl-Glucoronide

Abstract

Purpose

Materials and Methods

Results

Conclusion

Graphical Abstract

Mastering chronic pancreatitis pain: A multidisciplinary approach and practical solutions

Podcast | Sexual health in older age

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Abstract

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Materials and Methods

Results

Conclusion

Graphical Abstract

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Mastering chronic pancreatitis pain: A multidisciplinary approach and practical solutions