How a Surge in Opiate Misuse in the Netherlands Compares to the American Opiate Epidemic

Netherlands tulip fields

The Netherlands is known for its beautiful tulip fields and for having one of the highest happiness ratings in the world, the Netherlands often seems like a dream place to live. Add to it cities built for bicycles and not cars, green energy advancements, and public health at the forefront of the nation’s many missions, and what could possibly be unpleasant about the Netherlands?

Sadly, a drug problem has cropped up in the Netherlands. And much in the same way as in the U.S., the problem has not just been one of illicit street drugs. In fact, the real focal point of the drug crisis in the Netherlands revolves almost entirely around prescription opioids.

How did this problem come about? What is the Netherlands doing to address the problem? And why is their problem so similar to the addiction struggles currently facing the U.S.?

The Beginning of a Health Crisis in One of the World’s Healthiest Countries

The Netherlands has one of the highest life expectancies in the world, with its residents living a little more than two years longer than the average American. The small, European nation also has a low infant mortality rate, as well as a low rate of preventable deaths.

While the Netherlands has accomplished much in the way of improving the health and well being of its citizenry, those accomplishments teeter on a knife-edge. The country has experienced an increase in opioid misuse since 2009. And much like the U.S., this problem began with an increase in painkiller prescribing.

The drug addiction crisis in the Netherlands has followed much of the same parallel as the progression of the opiate epidemic in the United States. But while the opiate epidemic kicked off in the U.S. in 1999, the problem in the Netherlands did not really begin until about ten years later.

Woman taking a painkiller

At this time, the vast majority of opiate abuse in the Netherlands revolves around prescription painkillers. Millions of people are addicted to prescription painkillers in the United States, too. Though separated by time and space, these problems seem to contain many similarities among the two countries. What might have started these problems? And what might be done to correct them?

Overprescribing Often Leads to Addiction

Between 2008 and 2017, the total number of prescription opioid users in the Netherlands nearly doubled, from 4,109 users per 100,000 residents to 7,489 users per 100,000. But did pain symptoms in the Netherlands double? Certainly not.

And take a look at this. Examining the misuse of just one drug, the number of oxycodone users more than quadrupled from 574 users per 100,000 residents to 2,568 users per 100,000. That means roughly 2.5 percent of the population of the Netherlands was using just one type of opiate painkiller.

During that same period, the number of opioid-related hospital admissions in the Netherlands tripled, from about 2.5 admissions per 100,000 residents to 7.8 admissions per 100,000.

The statistics went up for the numbers of Dutch men and women seeking treatment for opiate addiction as well. In 2008, about 3.1 people for every 100,000 residents sought treatment for opiate addiction. By 2017, 5.6 people for every 100,000 residents were seeking care.

And last but not least, opiate deaths have also gone up in the Netherlands. The increase is not on the same level as what the United States experienced, but fatalities have increased nonetheless. In 2014, for example, about one Dutch person died from opiate-related causes for every 500,000 people living there. But by 2017, nearly three Dutch were dying for every 500,000 residents. It’s still a low death rate, but a three-fold increase in deaths is concerning, especially in just three years.

Conservative Prescribing — Following the CDC’s Recommendations

Netherlands doctor with a patient

What is the source of the opiate crisis in the Netherlands? Well, it comes down to several factors, but one of them stands out among the rest.

Like in the United States, the medical community in the Netherlands increased its prescribing of opiate painkillers. Doing so led to an increase in the number of addictions nationwide, which also led to even more consumption of opiates (and more deaths too).

One of the critical steps towards reducing addiction statistics in the Netherlands will be getting the medical community to reduce prescribing rates. That is crucial.

The United States saw the negative effects over a decade ago, and is continuing to see the consequences today. Overprescribing became so bad in the U.S. that the Centers for Disease Control and Prevention released detailed guidelines on opiate prescribing, cautioning doctors to reign in their tendency to dole out potentially dangerous drugs into the hands of the American people.

The Netherlands could certainly implement conservative prescribing policies into its medical community as well. That would be a monumental step forward in reducing the drug problem in that country.

Addiction Treatment — When a Loved One Falls Prey to Opioid Abuse

Efforts have been made to address the drug problem in the Netherlands. Historical data does indicate that the country experienced positive results with therapeutic communities (TCs). But unfortunately, the Netherlands has also attempted to use methadone as a drug treatment method (using methadone to replace other addictive drugs). Studies suggest that methadone treatments have not been effective at curbing drug problems in the Netherlands.

From observing countries like the U.S. and Netherlands, one lesson to learn is that even legal, accessible, and recommended drugs can be harmful. When people fall prey to addictions to their medications, they need to seek help. Such drugs can be lethal. Thankfully, residential drug treatment exists as a comprehensive, effective pathway to drug-free living.

If someone you care about struggles with a drug crisis, no matter where they live or what country they live in, help them get into a drug treatment program as soon as possible. It doesn’t matter if they are using legal or illegal substances. Addiction is a life or death problem.


Reviewed by Claire Pinelli, ICAADC, CCS, LADC, RAS, MCAP



After working in addiction treatment for several years, Ren now travels the country, studying drug trends and writing about addiction in our society. Ren is focused on using his skill as an author and counselor to promote recovery and effective solutions to the drug crisis. Connect with Ren on LinkedIn.