Excessive use of opioids

PublicationNr. 10 - 31 oktober 2017
AuthorProf. dr F.M. Helmerhorst

In late December 2016, the US Surgeon General wrote a paper for all physicians, called ‘Ending the opioid epidemic, a call to action’.6 Results of scientific research can answer many of the unresolved questions that remain due to the scarce and insufficiently detailed data available in the Netherlands so far, such as the precise indication for which these drugs are used, the level of abuse and addiction, and the causes of increased or decreased use of opioids. Should such research show that there is an epidemic of opioid use or abuse in the Netherlands, the next question is whether the American recommendations to reduce the prescription of opioids could be applied in the Dutch situation. According to the authors of the article reviewed here, these recommendations include effective communication towards patients, teaching medical students adequately about this topic, standardised prescription protocols in guidelines, and having expert teams treat chronic pain. Another option could be to check whether the current continuing education programmes for doctors and pharmacists are sufficient with regard to these problems. In addition, the funding of patient and professional associations by third parties with conflicts of interest could be prohibited.


  1. https://ppsg.medicine.wisc.edu/
  2. Helmerhorst GTT, et al. An epidemic of the use, misuse and overdose of opioids and deaths due to overdose, in the United States and Canada: is Europe next? Bone Joint J 2017; 99: 856-864.
  3. https://www.sfk.nl/publicaties/PW/2016/aantal-oxycodon-gebruikers-in-drie-jaar-tijd-verdubbeld
  4. Warlé-van Herwaarden MF, et al, Dutch H-WTF. Targeting outpatient drug safety: recommendations of the Dutch HARM-Wrestling Task Force. Drug Saf. 2012; 35(3): 245-259. En via: https://www.rijksoverheid.nl/documenten/rapporten/2008/02/25/rapport-expertgroep-medicatieveiligheid.
  5. Porter J, et al. Addiction rare in patients treated with Narcotics. N Engl J Med 1980; 302: 123. Via: http://www.nejm.org/doi/10.1056/NEJM198001103020221
  6. Murthy VH. Ending the Opioid Epidemic – A Call to Action. N Engl J Med. 2016; 375: 2413-2415.

*The literature refers to the Dutch text