Balancing care and caution: Examining opioid prescribing in the Netherlands

The aim of this thesis was to 1) investigate the magnitude of prescription opioid use and misuse in the Netherlands, 2) provide an overview of different definitions of opioid use and types of opioid-related harm, and give an analysis of possible drivers for prescription opioid use and related harm, 3) find targets for quality improvement in pain management by investigating practice variation in opioid prescribing, and 4) investigate possible psychiatric risk factors for chronic high-dose opioid prescribing.
Although the Netherlands remains shielded from high levels of opioid-related harm compared to the US, the increase in prescription opioid use cannot be ignored. The variation in opioid prescribing in primary care suggests inconsistent healthcare quality regarding pain management, and the relationship between psychiatric disorders and chronic high-dose opioid use underscores the need for a multidimensional approach to pain, especially in patients with psychiatric comorbidities.
Going forward, it is imperative to develop pain guidelines that steer away from opioids as much as possible in situations where they have no benefit. At the same time, we must ensure that those who benefit from them retain access while preventing misuse.