In the last decade, the number of opioid users in the Netherlands is sharply increasing. Opioids are the cornerstone of postoperative pain management. The postoperative period is therefore an important period to be aware of needless and possible persistent opioid use. Identification of patients at risk for persistent opioid use, limitation of opioid prescriptions and clear guidelines and communication about the follow-up of postoperative pain will be necessary to prevent opioid misuse. Awareness of the above-mentioned measures will hopefully help to stop further growth of opioid use, and thereby avert an American scenario.