Neuromodulation in Substance Use Disorders

Inclusion Criteria: * Aged 22 - 60 years at time of enrollment. * Fulfill current DSM-5 diagnostic criteria for OUD and/or other SUDs with at least a 2-year history. * Currently receiving outpatient treatment from the WVU Comprehensive Opioid Addiction * Treatment Program (COAT), Intensive Outpatient Program (IOP) or any other program which implements the COAT model; or receiving outpatient/inpatient/residential treatment from similar SUD treatment programs. * Currently are under the care of a licensed psychiatrist or other mental health care provider, or a licensed addiction medicine specialist and agrees to promptly inform the investigator or the study staff of any change in these providers. * Agrees to allow any and all forms of communication between the investigators/study staff and any healthcare provider who currently provides and/or has provided service to the patient/subject within at least two years of study enrollment for the purposes of eligibility confirmation or in case of a safety event. Exclusion Criteria: * Unable to undergo MR-imaging because of non-MR compatible implants or if candidates are uncomfortable in small spaces (have claustrophobia). * History of any clinically significant neurological disorder. * History of stroke or brain lesion with observable structural abnormalities in the targeted brain region. * Clinically significant MRI abnormality indicative of a neurological condition or abnormality that may jeopardize the participant's safety, study conduct, or confound the participant's diagnostic assessments. * An abnormal screening result that is considered clinically significant by a medically qualified research team member (i.e., laboratory tests, imaging findings). * More than 30% of the skull area traversed by the sonication pathway is covered by scars, scalp disorders (e.g., eczema), or atrophy of the scalp. * Past or present diagnosis of schizophrenia or psychotic disorder (assessed via SCID- * History of medically verified suicide attempt within the past year. * Meet the criteria for Cluster A or B Personality Disorders (assessed via SCID-5-PD). * Current substance use treatment mandated by court of law. * Subject who is currently participating in another clinical investigation with an active * treatment arm. * Subject is considered to be a poor surgical or study candidate, which may include, but is not limited to the following: any medical, social, or psychological problem that could complicate the required procedures and evaluations of the study in the judgment of the investigator