The Six Building Blocks (6BBs) is a program to help primary care practices improve patient management for long-term opioid therapy for chronic pain. This mixed-method study seeks to assess practices’ use of the 6BBs implementation guide and the effectiveness of 6BBs implementation on opioid management care processes. Data collection is guided by the Consolidated Framework for Implementation Research, Proctor’s taxonomy of implementation outcomes, and the Centers for Disease Control and Prevention’s Guideline for Prescribing Opioids for Chronic Pain.