ArticleDrug and alcohol dependence reports2026
High-volume buprenorphine prescribers: Examining state policy contexts.
Article in Drug and alcohol dependence reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
Background: Most patients prescribed buprenorphine depend on a small number of high-volume prescribers. However, little is known about how state policies may affect high-volume prescribing. Methods: We used 2009-2018 IQVIA Real World Data - Longitudinal Prescriptions (a national dataset capturing approximately 90 % of U.S. retail pharmacy transactions) to examine associations between four state policies and high-volume buprenorphine prescribing (i.e., clinicians averaging ≥30 active buprenorphine patients/month). Using multivariable event-time linear probability models, we estimated the percentage-point changes in the share of prescribers qualifying as high-volume in the three years following the implementation of: (1) mandatory behavioral health counseling when prescribing buprenorphine, (2) mandatory substance use disorder-related continuing medical education (CME) for licensure, (3) Affordable Care Act (ACA) Medicaid expansion, and (4) mandatory prescription drug monitoring program (PDMP) laws. Results: Of 109,218 clinicians who prescribed buprenorphine, 8.8 % were classified as high-volume prescribers for at least one year. Both high- and low-volume prescribers increased substantially over the study period, with total prescribers rising nearly 70 %. Policies mandating behavioral health counseling were consistently significantly associated with an increase in the share of high-volume prescribers post-implementation (Y1: +3.4 %age points; Y2: +5.1 %age points; Y3: +3.2 %age points). Conversely, mandatory PDMP laws were correlated with a decreased share of high-volume prescribers (Y1: -1.6 %age points; Y2: -3.2 %age points; Y3: -4.1 %age points). No significant associations were found for mandatory CME or ACA Medicaid expansion. Conclusions: The proportion of buprenorphine prescribers who are high-volume increased during 2009-2018, reflecting faster growth among high-volume prescribers. Our findings indicate that state policies coincided with differential patterns of growth.
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