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Updated: Jan 29, 2026

Evaluation of Synaptic Multiplicity Using Whole-cell Patch-clamp Electrophysiology
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Evaluation of the fentanyl patch-for-patch program in Ontario, Canada.

Mina Tadrous1, Simon Greaves2, Diana Martins2

  • 1Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada; Institute for Clinical Evaluative Sciences, Toronto, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.

The International Journal on Drug Policy
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The Patch-for-Patch (P4P) program reduced fentanyl dispensing by 30.5% but did not impact opioid-related hospitalizations or deaths. This opioid strategy shows promise for controlling high-potency fentanyl use.

Keywords:
Drug and narcotic controlFentanylGovernment programsHealth policyOpioids

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Area of Science:

  • Public Health
  • Pharmacology
  • Health Policy

Background:

  • Rising prescription opioid use, particularly potent fentanyl, poses a global mortality risk.
  • The Patch-for-Patch (P4P) program was implemented in Ontario (2012-2015) to reduce fentanyl misuse and diversion.
  • P4P mandates returning used fentanyl patches before new ones are dispensed.

Purpose of the Study:

  • To assess the P4P program's effect on fentanyl and non-fentanyl opioid dispensing.
  • To evaluate the program's impact on opioid-related hospitalizations and mortality.

Main Methods:

  • A time-series analysis was conducted in Ontario counties using administrative claims data.
  • Interventional autoregressive integrated moving average (ARIMA) models analyzed outcomes pre- and post-P4P implementation.
  • Outcomes included monthly dispensing rates, hospital/ED visits for opioid toxicity, and opioid-related deaths.

Main Results:

  • A 30.5% decrease in fentanyl patch dispensing was observed 24 months post-P4P implementation (p=0.04).
  • No significant changes were found in non-fentanyl opioid dispensing (p=0.32).
  • Opioid toxicity hospitalizations (p=0.4) and deaths (p=0.96) showed no significant change within 12 months.

Conclusions:

  • The P4P program effectively reduced fentanyl patch dispensing without increasing other opioid use.
  • The program did not demonstrate a measurable impact on opioid toxicity hospital visits or deaths.
  • P4P programs can be a valuable component of broader opioid control strategies.