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People who have had surgery are at increased risk for addiction transfer (also called cross addiction). This means trading one compulsive behavior for another one. Addiction can take many forms, such as alcohol, opioids or other pain management medications, and other substances or behaviors. It’s important to understand the risk factors and signs and symptoms of addiction and know how to get help.

Factors that increase the risk for addiction transfer:

  • History of eating disorders, food addiction, or compulsive eating
  • Family history of substance abuse
  • Regular alcohol use before surgery
  • History of chronic pain or overuse of narcotics for pain management
  • History of trauma, especially childhood sexual abuse
  • History of depression and other mood or anxiety disorders
  • Lack of adequate support or feeling isolated
  • Avoidance of emotions and experiences
  • History of engaging in self-sabotaging behaviors (binge eating)

Signs and symptoms of addiction may include:

  • Needing more of the substance or behavior to get the same effect
  • Doing a behavior or using a substance longer or in higher amounts than planned
  • Not being able to cut down, even when you want to
  • An increase in negative consequences caused by the use or behavior (issues with self, family, friends, work, and/or legal problems)
  • Others have suggested that you stop or cut down
  • An increase in hiding or covering up the behavior or use
  • An increase in feelings of guilt and shame
  • Craving or having a strong desire or urge for the substance or behavior
  • Withdrawing from important social, job-related, or recreational activities because of substance use

A Special Note on Alcohol

After surgery, the way the body tolerates alcohol changes for many reasons.

Faster alcohol absorption Your stomach is smaller and/or bypassed, so you will absorb alcohol much faster.
Alcohol takes longer to process For many reasons, alcohol may take longer to be processed by your liver and clear your system.
No eating while drinking Because the diet after surgery recommends that you do not eat and drink at the same time, alcohol will be absorbed faster because there is no food to slow it down in your digestive system.
Chemical/hormonal changes from surgery The chemical/hormonal changes that result from surgery can affect the way your body and brain process and respond to alcohol.

Alcohol is not recommended after surgery. It’s important to get help if you’re struggling with any substance abuse before or after surgery. Learn more about resources to support your health at Kaiser Permanente.

There are many resources at Kaiser Permanente and elsewhere that can support you and help you get back on track. You are not alone.

Learn more about cross addiction and bariatric surgery.

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