Drug overdose is the leading cause of accidental death in the U.S. More than half of overdose deaths involve an opioid; about half of opioid deaths involve a prescription opioid; and more than half of opioid prescriptions are written in primary care. This study addresses the need for a comprehensive and effective implementation strategy to improve opioid prescribing practices. Specifically, the proposed study evaluates a sequence and combination of implementation strategies that is tailored to the needs of stakeholders at different levels (health system, clinic, and prescriber) with the ultimate goal of reducing the average morphine milligram equivalent dose prescribed.