In response to the opioid overdose crisis, the Centers for Disease Control and Prevention (CDC) released the Guideline for Prescribing Opioids for Chronic Pain (CDC Guideline) in 2016, which included recommendations to initiate opioids carefully and only when expected benefits outweigh risks.1 Although opioid prescriptions have decreased in recent years,2 an estimated 9.4 million people misused opioids in 2020.3 Little is known about how prescriptions dispensed to opioid-naive individuals (i.e., those new to opioid therapy) have changed in recent years; previous research focused on commercially insured individuals from 2012 to 2017.