Care insurers Netherlands (ZN) did research into the use of heavy painkillers and noted a considerable increase. The number of patients that such opioids are taking, rose from 650,000 in 2010 to more than a million in 2017. What is going on?
More than 200,000 of these patients used in 2017 for a longer period very heavy painkillers. In 2010 this was still 135.000 patients. ZN based the research on declaratiegegevens of health insurers.
Gerben Klein Nulent, chairman of apothekersorganisatie KNMP, has a few possible explanations for the increase. “Patients seem to be nowadays less pain to want to accept. In addition, it seems faster a heavy drug is prescribed.”
Also the fact that hospitals will be assessed on the basis of a so-called pijnscore, plays according to the KNMP chairman may have a role. The quality of care in a hospital is measured on the basis of the pain that a patient has.
For example, a hospital, the purpose of a patient pain-free. The pijnscore is repeatedly administered to patients. “We want to be in the Netherlands, so no patients with pain, because the hospital is poorly reflected in the figures.”
More than 200,000 patients last year, very heavy painkillers ().
Difficult to map
It is difficult to get figures about the use to compare, says Monique Verduijn, senior scientific employee at the Dutch general Practitioners Society (NHG).
“In several studies to other types of pain medication looked, making it difficult to get a clear image,” says Verduijn.
In the study of ZN is also the weak acting opioid tramadol taken. “The 200,000 users are people who are strong-acting pain medication such as oxycodone and make it less strong tramadol swallow.”
Four types of pain medication
There are four categories of pain medications in the so-called pijnladder, explains Small Nulent. “Paracetamol is category 1. In category 2, also called NSAID’s, ibuprofen, naproxen, and diclofenac. When this pain killers is there a chance for maagbloedingen, but with a good maagbescherming can this be prevented.”
Tramadol falls into category 3. The opioids such as oxycodone are the heaviest category, which is category 4.
In accordance with the KNMP chairman is category 2 may have to be quickly skipped because of the side effects. “By this category, someone comes sometimes with heavier painkillers than necessary.”
“Because of the acetaminophen in the drug store to purchase, gives the people receiving the idea that the less strong.”
Gerben Klein Nulent, chairman of the KNMP
The fact that acetaminophen at the drug store to purchase, gives people the idea that it is less work or less strong. But that is not so, stresses Small Nulent.
General practitioners prescribe pain medication for
From the study of ZN shows that women are more often heavy painkillers swallow (60 percent) than men (40 percent). The opioids, including the weak-acting tramadol, are primarily prescribed by general practitioners. This happened in 82 percent of the cases.
Especially the heavy-duty painkiller oxycontin is more often prescribed. Where the share in 2010 was 2.8 percent, this percentage in 2017 increased to 14.2 percent. Medical specialists, surgeons, and internists prescribe this pain killer for after a treatment or surgery.
The use of strong painkillers is all of of years followed. The numbers are according to Small Nulent so no surprise. “We do think that it has something to put into perspective is by looking at the figures of 2018, which have not yet been included in this study of ZN.”
In the new report about the use of oxycodone will see the apothekersorganisatie that the number of users in 2018 remained the same. The years before there was a substantial increase in the use. It’s still about two million benefits of the drug. “That is quite a lot,” said the KNMP chairman.
Where you used to sometimes days in the hospital after a surgery, a patient now, sometimes all on the same day, with painkillers. “It is important that there is a good transfer of the doctor in the hospital to the general practitioner, for example, with the help of a treatment plan. Then someone gets unnecessarily long a heavy painkiller,” says Verduijn.
According to her, is to find the right balance, and if there is pain. “If the pain is violent, a heavy-duty painkiller and then you quite drowsy. It is smarter to work with the doctor to see how the balance can be found. Then you get pain relief, but also allows you to clear thinking.”
The apothekersorganisatie find that pain medication from the second category only available at the pharmacy. ().
Available at the pharmacy
The apothekersorganisatie would like to see, pain medication from the second category is only available at the pharmacy. “That way, this information can be added to the medical history of the patient and there is more visibility on the situation.”
Possible, patients should more often reflect on the fact that a bit of a pain sometimes associated with it, thus Small Nulent.
Get someone to temporarily take a heavy painkiller, preferably as short as possible and with as little as possible herhaalrecepten, to find both the organizations. So can addiction be prevented.
People who seek out more information about the use of painkillers, it is best to visit thuisarts.nl and apotheek.nl where to find more about the different types and about the proper use.