Key PointsQuestionWhat is the association between selected state policies and buprenorphine dispensing?FindingsIn this cross-sectional study using US county-level pharmacy claims data, educational requirements for buprenorphine prescribers beyond those required to obtain a waiver were associated with increased buprenorphine dispensing, as was continuing medical education related to substance misuse and addiction. Prescription drug monitoring programs, pain management clinic laws, and Medicaid policies had no association with buprenorphine dispensing.MeaningThese findings suggest that meaningful changes in access to buprenorphine may be achieved through greater attention to professional education and clinician knowledge.