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In an effort to prevent circumstances contributing to the Opiate Epidemic, the state of Ohio is launching a large-scale increase of the PAX Good Behavior Game in Ohio schools. This intervention teaches self-regulation in young people with dramatic effects on behavior, academics, and even long-term outcomes such as preventing mental health and addiction disorders.

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PAX has been in Canada for eight years. In response to concerns over growing mental, emotional and behavioural health issues, Healthy Child Manitoba identified PAX GBG as an evidence-based approach for schools to address these concerns. During the 2010/11 school year the Seine River School Division in Manitoba piloted the implementation of PAX in its schools. Within ten weeks, problematic behaviours dropped by 45%.