⚠️ Warning still current (Trimbos, April 2026): counterfeit oxycodone containing nitazenes is still circulating.
Read the warning →Two Zembla documentaries about chronic pain, oxycodone and the black market. Below are the moments that matter, with timestamps so you can look them up. Plus what we could and could not verify against primary sources.
What is remarkable about this documentary is not that patients appear in it. It is that doctors, pharmacists and professors acknowledge on camera that things went wrong, and why. All quotations below carry a timestamp so you can look them up.
We used to make crude jokes about it: you get a kind of goodie bag with oxycodone plus repeat prescriptions.Michel ter Hegge, anaesthesiologist and pain specialist16:53 ⓘ translated from Dutch Asked whether in hindsight he thinks too much oxycodone was handed out, he answers: "Absolutely. Absolutely. Far too much."
Most people who start prescribing opioids do not know how to do it, but far worse: they do not know how to stop it.Prof. Kris Vissers, professor of pain and palliative medicine, Radboudumc24:04 ⓘ translated from Dutch He continues: "Stopping an opioid is ten times harder than starting it." That is the sentence most often quoted, and this is where it comes from.
It is easy, isn't it. You prescribe it and you are rid of the patient quickly, I am putting that completely wrongly now, but it is the reality.Prof. Kris Vissers30:46 ⓘ translated from Dutch Note the self-correction in the middle of the sentence. He knows it sounds harsh and says it anyway.
We were not at fault, because back then we did not know any better. But now that we do know, and you carry on with a policy you know is not good for the patient, then you are at fault.Janneke Pelser, general practitioner29:29 ⓘ translated from Dutch She says she prescribed too many opioids for years, and now works in a regional collaboration trying to turn the tide.
Sometimes the GP simply says: I am not your dealer. Or: enough is enough, you are behaving like a junkie.Carol Vlucht, manager of opiatenafbouwen.nl26:43 ⓘ translated from Dutch For someone who has become dependent on prescribed medication, that does not feel like care. That feels like a kick while you are down.
A few years ago I had a young woman who bought extra oxycodone on the black market because she felt her own oxycodone was not enough. And she died of an overdose.Prof. Kris Vissers26:54 ⓘ translated from Dutch Here the two halves of this dossier meet: the prescription and the black market. That is exactly the pattern this site describes.
I had become a junkie. Yes, but I am really not the only one. There are thousands of people like me.A patient in the documentary27:44 ⓘ translated from Dutch Her first painkillers were prescribed by her rheumatologist. We do not name her here: she spoke out in a documentary, not to end up in search results.
This is where the documentary and the official records diverge. We had it checked against primary sources and set out both sides below. Judge for yourself.
Health insurers also scored hospitals on how people experienced their pain. They did that with those little faces, red to green. And really they only wanted smiling faces.Angelique van der Geest, pharmacistⓘ translated from Dutch
She saw more and more prescriptions for oxycodone coming across her counter, and in the same documentary describes "an enormous explosion of painkillers".
No, that is not correct. The score indicates whether hospitals carry out a pain measurement.Minister for Medical Care, answer to parliamentary questionsⓘ translated from Dutch
The question asked literally whether hospitals get a better score if patients experience less pain, and whether that creates an incentive to prescribe stronger painkillers.
This is not a question of who is lying. The pharmacist describes how it worked out at her counter. The minister describes how the indicator was intended on paper. Both can be true at the same time, and it is precisely that gap between paper and practice where people get stuck.
What we were able to establish from primary sources:
Demonstrable: "pain after surgery" was a quality indicator in the Health Inspectorate's basic set from 2003. Hospitals had to report what percentage of patients received a pain measurement, and what percentage had a pain score above 7 in the first 72 hours after surgery. The target was less than 5 per cent. The indicator was replaced in 2018 and later converted into a voluntary improvement goal.
Not demonstrated: that health insurers settled accounts with hospitals on this basis. No purchasing document or contract confirming that has been found, and a 2017 study by the Dutch Healthcare Authority concludes that insurers barely use this type of process indicator in care purchasing.
True in the United States, however: there, patient questions about pain relief were part of the Medicare programme until payment year 2018, where higher scores meant higher payments. Out of concern about over-prescription that link was severed. The regulator CMS itself noted it had no scientific evidence for that effect, but wanted to remove even the appearance of financial pressure.
Following the documentary, Zembla put four questions to the Dutch Minister of Health. The answers came on 27 January 2026. They are remarkably consistent: the problem is partly acknowledged, but every requested measure is rejected with the same argument.
"In recent years a great deal of attention has been paid to the appropriate use of opioids. Much material has already been developed and structures are available that could be used more intensively."
"A great deal of knowledge is already available to further improve care for people with pain. What matters above all is that the existing effective materials and collaborative structures are used optimally."
According to the minister the figures point instead to "increased expertise and awareness". Long-term use remains a point of attention, "but this does not indicate a lack of basic knowledge".
The minister writes that there is no lack of basic knowledge. Professor Vissers says in the same period that most prescribers do not know how to stop an opioid.
The minister calls long-term use "a point of attention" and cites the figure himself: around 35 per cent use for longer than three months. For a medicine which, in the same document, he acknowledges causes tolerance and dependence.
We do not draw that conclusion for you. We set it side by side and cite the source, so you can weigh for yourself whether "much is already available" is an answer to what practitioners describe.
Source: answers of the Dutch Minister of Health to questions from Zembla, 27 January 2026, translated from Dutch. In the same answers the minister acknowledges that opioids carry risks, that tolerance can develop and that tapering off is therefore often difficult. He also points to a positive trend: 72.1 per cent of new users of strong opioids now receive a long-acting preparation, in line with the GP guideline.
Perhaps the most interesting thing about the documentary is not the problem, but the proof that it can be done differently. Without a national programme, without extra money.
We see that what has been dispensed in the pharmacies shows a fall of 87 per cent among GPs and a good 70 per cent among specialists.Janneke Pelser, general practitioner, Arnhem region30:10 ⓘ translated from Dutch Figures as stated in the documentary, for the participating practices in this region. We have not been able to verify them separately against a primary source.
An addiction physician, a pharmacist, a GP and an anaesthetist in the Arnhem region made agreements together: for new prescriptions a maximum of one week, only the long-acting form, at a low dose, and without repeats on the prescription.
That is not complicated policy. It is four people agreeing among themselves how they do it. And according to Pelser use will never reach zero, because there are always people who genuinely need these medicines.
Meanwhile national use is barely falling. That contrast, between what works regionally and what happens nationally, is the heart of this dossier.
The total number of direct drug deaths tripled between 2014 and 2024. Deaths from opioids quadrupled over the same period, with the highest year in 2023. Hover over a point for the exact number.
This is what makes it a care trap rather than a scandal. Every step is defensible in isolation. The sum of them is not.
The prescription is justified. The relief is real. Nobody is doing anything wrong at this point.
Chronic pain requires time, examination and often a multidisciplinary approach. A prescription takes two minutes.
The prescriber assumes the GP will pick it up. The GP assumes the specialist arranged it. Duration of use grows in that gap.
A body that has adapted does not stop with the treatment. What comes next happens out of sight of everyone who wrote the prescription.
Partly. That pain after surgery was a compulsory quality indicator of the Health Inspectorate from 2003 is demonstrably true. That health insurers settled accounts with hospitals on that basis cannot be supported by sources: no purchasing document has been found confirming it, a 2017 study by the Dutch Healthcare Authority points the other way, and the minister explicitly denied the incentive in 2018. In the United States such a link with hospital payments did exist; it was severed in 2018.
On 27 January 2026 the Dutch Minister of Health answered four questions from Zembla. He acknowledges that opioids carry risks, that tolerance can develop and that tapering off is therefore difficult. But he rejects a new Opioid Action Plan, rejects a National Pain Programme, and states that there is no lack of expertise among prescribers. His argument each time is that sufficient material and collaborative structures are already available and could be used more intensively.
No. For acute pain, after surgery and in palliative care it is effective and often indispensable. The problem is not the substance but the chain around it: prescribing without an end date, repeat prescriptions without evaluation, and tapering that nobody owns.
Because it shows that the pattern is not an individual failing. Doctors, pharmacists and professors say on camera that it went wrong and why. That shifts the question from "why did that person not stop" to "how is it that a whole chain lets this happen".
Both broadcasts are available through Zembla (BNNVARA). The timestamps on this page refer to the original Dutch-language broadcast, so you can look up each quotation.
Zorgfuik collects experiences to show that this is a pattern and not isolated bad luck. And the help page lists who you can call today.