12 June 2019

Opiate epidemics part of National Science Agenda

A new consortium of scientists, care institutions and pharmaceutical companies is going to investigate the use of addictive pain killers in the Netherlands. The project was taken up by the National Science Agenda and has received funding from NWO, as the science fund announced today. Research leader Marcel Bouvy from Utrecht University: “Over the past few years, the use of opiates has gotten completely out of hand.”

Man in pain at the gp
Image: Unsplash / Jesper Aggergaard

Opiates are morphine-like pain killers such as oxycodone. Its use in the Netherlands has risen strongly in recent years, and the numbers worry Marcel Bouvy, professor of Pharmaceutical Patient Care at Utrecht University (UU). “Over the past decade, the use of these remedies has grown five-fold. In 2018, about 600,000 people were prescribed an opiate. We are not talking about pain killing in hospital, right after surgery, but about medicine that patients collect at the pharmacist themselves. It has really got out of hand.”

We know that about five percent of the people is sensitive to opiate addiction.
Marcel Bouvy
Research leader prof. Marcel Bouvy

TAPTOE

Bouvy is the research leader of a new consortium in which the universities of Utrecht, Leiden, and Nijmegen cooperate closely with anaesthesiologists, pharmacists, general practitioners and addiction specialists from organisations throughout the country. The project was given the name TAPTOE: Tackling And Preventing The Opioid Epidemic, and has received a grant of 1.8 million euros of funding from NWO for a period of five years. The research is one of 17 proposals that have been awarded in the first round of the National Science Agenda.

Bouvy: “We know that about five percent of the people are sensitive to opiate addiction. That is why it is important to determine how long patients have been using the medicine and which group of patients has a higher risk of getting addicted.”

Prevent an opiate problem like in the US

The purpose of the consortium is to prevent an opiate problem similar to the one in the United States from arising in the Netherlands. “One out of every thirty Dutch people was prescribed an opiate during the past year, but in the US, this number is four to five times as high”, says Bouvy. “Twenty years ago, the numbers began to rise strongly there. At the time, pharmaceutical companies and others claimed that the medicines were not addictive when used as a pain killer. They have been used more and more in the Netherlands over the past decade, too. But by now we know that also opiates can indeed be addictive as a pain killer.”

There was a time when opiates were used exclusively in case of severe pain, but over the past few years they have been prescribed more and more for relatively mild pain, such as after tonsillitis surgery or removing wisdom teeth.

Fifteen subprojects

Four PhD candidates will carry out the TAPTOE projects. Bouvy elaborates on their work: “With 15 subprojects, the research will focus on the whole trajectory of prescription of opiates to its long-term use. Based on the data provided by various country-wide databases, we will map the problematic use of pain killers. Furthermore, instruments will be developed to better predict the risk of this problematic use.”

The project will also pay attention to the interaction between the medical and illegal circuit, and to private purchases through channels such as the dark web. “In the US, we can see that some of the patients who had once received an opiate via prescription, subsequently bought it through the illegal circuit.” It is unknown how often that happens in the Netherlands.

Cooperating parties

The TAPTOE consortium is cooperating with a large number of social partners, including policy makers (CBG and ZIN), research institutes (SIR, NIVEL and the Trimbos Institute), hospitals (CWZ, Maartenskliniek and UMCs), professional associations (KNMP and NHG) and patients’ federations (Zorgbelang and het Zwarte Gat). In so doing, scientific results can be brought into practice already during the research period 2019-2024.