Buprenorphine Prescribing Trends and Practice Environment Associations with Clinician Adoption

Overview

Efforts to expand buprenorphine treatment for opioid use disorder often focus on individual clinicians’ training and prescribing authority. We examine the organizational setting in which clinicians work: whether moving into a group practice with greater peer buprenorphine prescribing is associated with changes in their own prescribing.

We link national pharmacy dispensing data to clinicians’ group-practice affiliations and specialty information from 2013–2024. Propensity-score-weighted event studies compare clinicians moving from low-prescribing practices into high-prescribing practices with those moving between low-prescribing practices. The analysis accounts for clinician characteristics that do not change over time and local trends through clinician and ZIP-by-year fixed effects.

Findings

Joining a high-prescribing practice is associated with a 2.48 percentage point increase in the probability of prescribing any buprenorphine. The positive association appears in the move year and persists through the displayed follow-up period. The findings are consistent with organizational context being relevant to clinicians’ participation in treatment, alongside individual training and regulatory reforms.

Clinicians choose their destinations, and the event study shows significant pre-move differences. These features limit a causal interpretation. The study also does not distinguish peer influence from shared workflows, organizational support, or patient referral patterns, and its outcome measures prescribing participation rather than patient treatment outcomes.