SIOUX FALLS, S.D. (KELO) — A popular weight loss surgery can have an unexpected downside, one that can even be deadly.

Most patients who undergo the surgery are prescribed some kind of opioid to cope with the pain. But several new studies show that gastric bypass patients may be most at risk of developing an opioid addiction.  That was the case for a Sioux Falls woman who underwent the surgery in 2011. Jessica Pfau had what’s known as addiction transfer — from food to painkillers — and she was hooked.

In our KELOLAND News Investigation, we bring you Jessica’s journey from years of struggling with addiction to legal troubles to surviving a near-fatal overdose and now a prison sentence.

“I wanted a child my entire life. We tried throughout my first marriage and it never happened,” Jessica said.

But at 36-years-old, after that marriage had ended, Jessica, who thought she couldn’t have children, was pregnant.

“At the time I found out I was pregnant, I had a scram bracelet on and was doing three UAs a week at 24/7,” Jessica said.

To understand how Jessica found herself pregnant and in DUI court, you have to go back to 2011. Her weight had been an issue since she was 16.

“Throughout the years, it just got out of control and I got to the point where I weighed close to 400 pounds,” Jessica said.

Jessica underwent gastric bypass surgery and was prescribed opioid painkillers.

Traded my food for pain pills after that; I was depressed. I had liquid meals. I was used to eating whatever I wanted to and when I wanted to. I took the pain med and realized it made me feel warm and fuzzy and I got a little of that comfort feeling back.

Jessica Pfau

She says she was desperate for the pills and started doctor shopping; eventually she was caught and her supply cut off.

In 2013, she turned to the streets to buy her opioid pills.

Angela Kennecke: Do you blame the doctors?
Jessica: I don’t know that I blame the doctors. What I wish is that people would be more educated before having a surgery like that–gastric bypass. What I have learned during research is a large percentage, 60 to 70 percent, of people do become addicted to alcohol or other drugs after gastric bypass surgery.

Bariatric Surgeon Dr. Veronica Guerrero did not perform Jessica’s surgery, but confirms that gastric bypass patients are up to three times more likely to abuse alcohol or drugs. It’s called addiction transfer.

“With bariatric surgery their diet is so restricted, and that’s a good thing, that’s how it works. But then unfortunately they might find other tendencies to replace that void to take something in and feel different,” Guerrero said.

Dr. Guerrero says today, patients are being prescribed fewer opioids after surgery.

In Jessica’s case, she got fired from her job for falling asleep repeatedly at her desk while on opioids. A few months later, she sought treatment at the methadone clinic. But she missed getting her doses over a long weekend and went into withdrawal.

“I thought I was dying. I was crawling out of my own skin; my legs would tremble so badly.  I mean I went through childbirth and I can’t even compare the two. Withdrawals are something… I think that’s what scares a lot of people from quitting. It’s what scared me for a long time,” Jessica said.

That’s when Jessica turned to alcohol, which is more rapidly absorbed by gastric bypass patients. They also have a more intense and longer-lasting response to the effects of alcohol. Whiskey was Jessica’s drink of choice.

“You drink just a little bit and you’re blacked out and down,” Jessica said.

Several attempts at treatment were unsuccessful and Jessica racked up drunken driving charges.

“I’m not sure I thought much of myself, because I was drunk all the time. I just didn’t care anymore, about anything,” Jessica said.

What made it even worse was the judgment of others as her world fell apart.

Kennecke: Your intention was not to become an addict?
Jessica: No. Never, never to hurt my family in the way that I have and to hurt myself in the way that I have. No, I wouldn’t wish it on anybody.

After failing the 24/7 program, she was required to wear a SCRAM ankle bracelet.

Jessica: With that bracelet on, I went back to the pills.
Kennecke: Because it didn’t detect…
Jessica: It doesn’t detect pills, just alcohol.

Then she crossed a line.

“My whole life, I said there are two things I would never do; one was prostitution and two was shoot up drugs. And there is still one I haven’t done,” Jessica said.

She couldn’t get the pills from her dealer.

But he said, ‘I can keep you out of withdrawal–I have something else you can try.’ And he came over with heroin. That’s the day it switched to heroin being the love of my life.

Jessica Pfau

Jessica explains the insatiable craving for heroin.

Jessica: It steals your soul and just takes off with it.
Kennecke: It steals your soul?
Jessica: Yes, that’s your number one love. Nothing matters like that. All I wanted was that feeling. You’d chase it. And it was never the same as it was in the beginning and it takes more of it. You’re married to your drug.  

But Jessica had also gotten remarried to Greg Pfau, who she met in drug court when she was pregnant during a longer period of sobriety.

“I’ve got 30-plus years of using. I’ve had enough,” Greg said.

But fate wasn’t on Jessica’s side. She had a perforated ulcer and required surgery. Despite her history with substance use disorder, especially with opioids, she was given hydromorphone.

“I literally almost died; he made the decision that he would take the chance to do that–the doctor did,” Jessica said.

Jessica says after that she constantly craved the drug and hid her use from Greg.

“I assumed since we were both the same kind of people that it wouldn’t be a big deal to say, ‘Hey, I’m having trouble. Can you help me here?’ And I got none of that,” Greg said.

“I didn’t choose to be an addict. But at the same time, what do you do with an addict that won’t quit?” Jessica said.

What do you do with an addict that won’t quit? You’ll want to watch the second part of “Jessica’s Journey” Thursday night to find out what happened when she repeatedly failed in DUI court and eventually overdosed.

80 percent of the women in South Dakota’s prisons are struggling with addiction. Are they getting the treatment they need? We’ll look into it Thursday.

Visit our Opioid Crisis Special Coverage page for resources and information on addiction.