(Foto: GeoTrinity, Wikimedia).
Three researchers from the LUMC write in an article published today in Scientific Reports that there is a problem in the Netherlands with pain relief by powerful painkillers such as oxycodone. General practitioners are increasingly prescribing opiates, which is associated with an increase in serious complications such as poisoning. According to the LUMC researchers, the guideline for the prescription of opiates urgently needs to be adjusted.
The researchers, Albert Dahan (anesthetist), Willem Lijfersing and Frits Rosendaal (both clinical epidemiologists) searched for the cause of the increasing use of analgesic opiates in the Netherlands. “We found no indications of an increase in pain in the population,” says L figureing. “A growth in illegal use also explained the increase insufficiently.” The researchers did see a clear link between the decrease in NSAID painkillers (eg ibuprofen) and an increase in opiate use.
L figureing explains: “In our article we show that the opiate epidemic in the Netherlands is most likely a direct result of changes to the ‘Postoperative pain’ guideline from 2013, which advises doctors to prescribe opiates more quickly. This is at the expense of NSAID painkillers. ”
Opiate poisoning
The opioid epidemic is different in the Netherlands than in other countries. In the US, it is caused by an increase in pain in the general population. And in the UK, illegal use is responsible. “The increase in opiate use in our country led to more than a million people using an opiate in 2017. The result was an increase in opiate poisoning with 2,200 hospital admissions in 2017, ”said L figureing.
Call for change
Since the pain guideline appears to be the main cause of the opiate epidemic, a change of the guideline is warranted, the three LUMC researchers believe. This amended guideline should advise doctors to prescribe an opiate less often. This is in line with the position of former minister Bruins (Medical Care). If nothing changes, the number of serious complications from opiate use is unlikely to decrease, the researchers conclude in their paper.
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