The Growing Opioid Crisis in the Netherlands: Increase in Prescription and Misuse

These types of heavy painkillers are only available on prescription in the Netherlands. The drugs are often prescribed after, for example, knee or hip surgery, to combat acute pain. Public pharmacies provided a strong opioid to more than 1.12 million patients in 2023.

Hard to stop

“Fortunately, many people are doing well, says Marcel Bouvy, professor of Pharmaceutical Patient Care at Utrecht University. “But we know from practice that some find it difficult to stop.”

According to Bouvy, there are roughly two groups that misuse these heavy medications. “On the one hand, there is the group that cannot stop using it, but will not use it more and more,” he says. “They face side effects such as constipation, an increased risk of falling and emotional flattening.”

Valerie became addicted to oxycodone, and tells RTL News about it:

There is also a group of patients who are increasingly using the medicines, says the professor. “They try to get extra opioids through doctors and pharmacies, sometimes even forge prescriptions or order extra medication from unreliable illegal online stores. This group can no longer function normally and is addicted. They especially need help to stop.”

More and more needed

The fact that some people start using more and more of the drugs is because the medicines become less effective with long-term use. The drug is also too often prescribed to people with chronic pain complaints,” says Bouvy. “To a large extent, the opioids do not, or no longer, help against the pain, while patients do become physically dependent on them.”

Opioids work initially, but quickly become less effective. In addition, you become more sensitive to pain,” says the professor. “So if you stop, you feel even more pain and it is difficult to stop. Sometimes people start taking more and more for the same effect.”

This can lead to life-threatening situations. “The most dangerous is the situation in which people use too high a dose at once, then there is a strong slowdown in breathing that can lead to suffocation. Then we call it an overdose.”

The increase in the use of opioids has been going on for some time, but despite earlier warnings, more people continue to use the substances. Oxycodone in particular is often prescribed.

Increase in number of users

The use of these substances increased by 3 percent in the past year compared to 2022. This is evident from figures that RTL Nieuws requested from the Foundation for Pharmaceutical Characteristics. This is the third year in a row that use has increased. The number of people using the substances, in addition to oxycodone, mainly fentanyl and morphine, is now at the level of 2018, the year with the largest number of users so far.

“Part of this increase is due to a growing population and aging, but there is probably more going on,” says Ruud Coolen van Brakel of the Institute for Responsible Medicine Use. “We see it as a signal that calls for continued alertness among doctors, pharmacists and patients.”

It is not the first time that experts have sounded the alarm about the growing number of people using opioids. “With the ‘appropriate use of opioids’ task group, we have drawn a lot of attention between 2019 and 2022 to the importance of correct use: not too much, not too little and especially not longer than necessary,” says Coolen van Brakel.

More awareness

Despite previous concerns from experts, opioids are still too often prescribed for too long a period. If a patient uses the medication for a long time, longer than actually necessary, the risk of addiction increases significantly.

Michel Terheggen of the Association of Anesthesiologists also sees this. As a doctor, he specializes in pain management. “More awareness is needed among healthcare providers, so that they give really small amounts for a few days, explain to patients that longer use is not useful, and stop treatment in a timely manner,” says Terheggen. “The majority of doctors and pharmacists are already very critical, but some are still not enough.”

According to Coolen van Brakel, the new increase shows that attention to the theme continues to be necessary. However, he emphasizes that more research is needed: “It is not possible to indicate on the basis of user numbers to what extent this concerns overuse or use for a good reason. There is also a lack of data on the degree of risky use and the duration of use. Addition This data will help us to better assess the risks of the increasing number of users and take appropriate measures.”

Hesitant

What is especially important is that both doctors and patients are aware of the risks and use opioids with caution. “Doctors often still think that opioids are the best painkillers,” says Marcel Bouvy. “But paracetamol works just as well, especially when longer treatment is required, research shows.”

He advocates even more information about the risks: “I still see that there are many patients who are not aware of the risks. It is important that people realize that these drugs are intended for short-term use.”

2024-01-13 13:02:13


#Concerns #increasing #heavy #painkillers #aware #risks