text: Several years ago, a community-based patch-for-patch exchange protocol was created in North Bay, Ontario. Completely voluntary. Part of launching the protocol was information & education for physicians & pharmacists in the community. Almost all signed on. Fentanyl-related deaths stopped. The protocol was adapted & adopted by many other Ontario communities, & is now law in the province (sadly, the regulations implementing the law are toothless--nevertheless, the volunteer initiatives continue).
  
  My point is this: education & information for prescribers and dispensers stopped patch-related deaths cold. What does that say about the level of education and information that existed previously, especially in prescribers?
  
  We  have known for decades that physicians receive essentially no education, initially or thereafter, in appropriate prescribing of mind- & mood-altering substances.
  
  Until this root cause is addressed, & such training is mandatory, there will be little substantive change