Programs like the VA Opioid Safety Initiative should be actively spread by prescribing clinicians. The primary reason to implement systematic opioid safety programs is to benefit patients. Such programs could also have the important benefit of restoring trust in medicine if physicians actively, willingly, and universally implement such efforts themselves rather than waiting until an outside regulator loses patience and imposes controls which may or may not be sensible. Many prescribers have already made steps in this direction, but these should be expanded throughout the health care system.