Treating Chronic Pain in Buprenorphine Patients in Primary Care Settings

Inclusion Criteria: * Chronic Pain, defined as pain duration for at least six months with a mean score of 5 or higher on the BPI Pain Interference Scale; * Pain severity of 40 or higher on a Visual Analog Scale (0-100) indicating "worst pain in the last week"; * Previous attempt at initial steps of PCP guideline pain care: must have had at least one trial of recommended medication (i.e. acetaminophen, NSAIDS, skeletal muscle relaxants) judged through interviews with patients and PCPs; * QIDS score of ≥ 10 (depression severity) * If using an antidepressant, the dose must be stable for the previous 2 months; * Age 18 or older * Has received buprenorphine/naloxone (Suboxone)for at least the last 3 months; * Plan to continue buprenorphine/naloxone (Suboxone)for at least 3 months. Exclusion Criteria: * Lifetime DSM-IV diagnosis of bipolar disorder, schizophrenia, or other chronic psychotic condition; * Current DSM-IV diagnosis of substance dependence for sedative/hypnotic drugs, alcohol, stimulants, or cocaine; * Suicidal ideation or behavior requiring immediate attention; * In psychotherapy or in a multidisciplinary pain management program at baseline; * Anticipate having surgery in the next 6 months; * Pain thought to be due to cancer, infection, inflammatory arthritis, or associated with severe or progressive neurological deficits; * SSDI or SSI claim pending; * Pregnancy.