According to an editorial, these findings highlight that in Ontario, as elsewhere, fatalities involving drugs that are prescribed—and often diverted—remain a critical component of the broader overdose crisis. It notes Canada is second only to the US internationally in per capita opioid prescribing, and among 42,249 US opioid related deaths from overdose in 2016, 40% included a potentially prescribed opioid, and one third of these also included heroin or fentanyl. It adds that as uncritical opioid prescribing is understood to have spurred this crisis, policy makers have embraced interventions to reduce prescribing, including clinical guidelines, quality metrics, prescription drug monitoring programmes, payment barriers, opioid dose and duration limits, and the development of crush resistant opioid formulations. Whether these interventions have had the desired effect is unclear. It warns that policies focused heavily on curbing prescriptions—when not accompanied by comprehensive approaches to tackle both addiction and pain—invite multiple deleterious consequences.