Cessation of Long-term Opioid Therapy in Chronic Pain Patients

Inclusion Criteria: * Male or Female, age above 18. * Chronic non-cancer pain (pain for 6 or more months, current pain not attributed to a cancerous disease). * Referrals to the Massachusetts General Hospital (MGH) Center for Pain Medicine for opioid taper. * Chronic (more than 3 months) prescription of morphine, oxycodone, hydrocodone, hydromorphone, codeine or any formulation of these medications. * Morphine dose equivalent of 60 mg or above. * Opioid treatment has to be stable (plus or minus20%) over the last 3 months. * Meeting Substance Abuse and Mental Health Services Administration (SAMHSA) criteria for exit from chronic opioid therapy * Willingness to taper and participate in treatment as randomized (including cognitive workshop sessions), able to meet the protocol follow-up schedule and activities * Agreement to undergo random urine toxicology assays, which will be recommended to prescribing physician during study. * Agreement to sign an opioid contract, as recommended to prescribing physician. * Informed consent to study (IRB approved informed Consent form). * English Language Literacy. Exclusion Criteria: * Methadone, suboxone or fentanyl patch: the tapering with these opioids would not be comparable to the other patients. As enrolment will be open during about 12 months, if a patient was motivated to participate in the study, they could be referred to the pain clinic for advice on a switch to a medication that could allow inclusion. They would, 3 months after this switch, become eligible for the study. * Pregnancy. * History of epilepsy and drug-induced seizures. * Proof of current diversion of drugs or recent substance related legal problems (e.g. buying/selling on the streets). * Concurrent use of illicit drugs and narcotics (urine toxicology), active diagnosis of substance abuse or dependence disorder within last 3 months. * Absence of the prescribed drug in the urine toxicology * Refusal of taper or dose reduction trial. * Preference for suboxone or related treatments. * Severe psychiatric condition and/or cognitive deficits limiting patient's ability to participate * Involved in concurrent opioid management for an acute pain condition. * Current suicidal ideation. * Severe and unstable medical illness including cardiovascular, hepatic, renal, respiratory, endocrine, neurological or hematological disease. * General conditions that would impede participation in a group intervention, as assessed by evaluating physician (e.g. cognitive impairment, tendencies towards physical aggression).