{"doi":"10.1016/j.dadr.2025.100406","title":"High-volume buprenorphine prescribers: Examining state policy contexts","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.","journal":"Drug and Alcohol Dependence Reports","year":2025,"id":586365,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.902,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":526752,"name":"Flora Sheng","orcid":"0000-0003-1511-6754","position":1,"is_corresponding":false},{"id":345885,"name":"Brendan Saloner","orcid":"0000-0001-9013-3023","position":2,"is_corresponding":false},{"id":367509,"name":"Adam J. Gordon","orcid":"0000-0002-2453-8871","position":3,"is_corresponding":false},{"id":184665,"name":"Bradley D. Stein","orcid":null,"position":4,"is_corresponding":false},{"id":478451,"name":"Megan S. Schuler","orcid":"0000-0002-6009-8367","position":0,"is_corresponding":true}],"reference_count":32,"raw_metadata":null,"created_at":"2026-07-19T02:59:28.666390Z","pmid":"41550418","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}