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. 2020 Sep 17;10(1):15309.
doi: 10.1038/s41598-020-72084-6.

Causes and consequences of the opioid epidemic in the Netherlands: a population-based cohort study

Ajda Bedene  1   2 , Eveline L A van Dorp  2 , Tariq Faquih  1 , Suzanna C Cannegieter  1   3 , Dennis O Mook-Kanamori  1   4 , Marieke Niesters  2 , Monique van Velzen  2 , Maaike G J Gademan  1   5 , Frits R Rosendaal  1 , Marcel L Bouvy  6 , Albert Dahan  2 , Willem M Lijfering  7
Affiliations

Causes and consequences of the opioid epidemic in the Netherlands: a population-based cohort study

Ajda Bedene et al. Sci Rep. .

Abstract

Over the past decade opioid use has risen globally. The causes and consequences of this increase, especially in Europe, are poorly understood. We conducted a population-based cohort study using national statistics on analgesics prescriptions, opioid poisoning hospital admissions and deaths in the Netherlands from 2013 to 2017. Pain prevalence and severity was determined by using results of 2014-2017 Health Interview Surveys. Between 2013 and 2017 the proportion of residents receiving opioid prescription rose from 4.9% to 6.0%, and the proportion of those receiving NSAIDs decreased from 15.5% to 13.7%. Self-reported pain prevalence and severity remained constant, as 44.7% of 5,119 respondents reported no pain-impeded activities-of-daily-living in 2014 (aRR, 1.00 [95% CI, 0.95-1.06] in 2017 vs 2014). Over the observation period, the incidence of opioid poisoning hospitalization and death increased from 8.6 to 12.9 per 100,000 inhabitants. The incidence of severe outcomes related to opioid use increased, as 3.9% of 1,343 hospitalized for opioid poisoning died in 2013 and 4.6% of 2,055 in 2017. We demonstrated that NSAIDs prescription decreased and opioid prescription increased in the Netherlands since 2013, without an increase in pain prevalence and severity. Consequently, the incidence of severe outcomes related to opioids increased.

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Conflict of interest statement

All authors have completed the Conflict of Interest Statement form and declare: no support from any organisation for the submitted work; AD has received research grants and personal fees from MSD, grants from Medasense, grants from Grunenthal, personal fees from Trevena, grants from AMO, grants from CHDR, outside the submitted work, DOMK has received personal fees from Metabolon, Inc., outside the submitted work; no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1
Opioid (overall and stratified by natural and synthetic), and NSAIDs prescription cases in the Netherlands, from 2013 to 2017. Abbreviations: NSAIDs, nonsteroidal anti-inflammatory drugs. Individuals, who reimbursed opioid prescriptions were selected by ATC code N02A (natural, N02AA; synthetic N02AZ), NSAIDs prescriptions by ATC code M01A.
Figure 2
Figure 2
Opioid and NSAIDs prescription cases (stratified by concomitant and single prescription) and those with neither of these analgesic prescriptions in the Netherlands, from 2013 to 2017. Abbreviations: NSAIDs, nonsteroidal anti-inflammatory drugs. Individuals, who reimbursed opioid prescriptions were selected by ATC code N02A (natural, N02AA; synthetic N02AZ), NSAIDs prescriptions by ATC code M01A. Prescription cases are presented as incidence rates per 100,000 inhabitants per observed calendar year. Primary axis presents incidence of analgesics prescription, and the secondary axis shows the incidence of those with neither of analgesics prescription.
See this image and copyright information in PMC

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