Distress Tolerance and Buprenorphine

Inclusion criteria

• initiating buprenorphine treatment (which requires meeting current criteria for a DSM-IV diagnosis of opioid dependence)
• plan to remain on buprenorphine for at least three months
• age between 18 and 65 years
• if female of childbearing potential -- must be using adequate contraception (an intrauterine device, oral contraceptive, depot contraceptive, a barrier method "every time," or hysterectomy) as assessed by the study physician
• has at least two persons they regularly contact and can provide contact information for them
• speaks English sufficiently to understand instructions and assessments.

Exclusion criteria

• current methadone maintenance treatment program participation
• medically necessary prescription opioid treatment (e.g., for chronic pain)
• current criteria for a DSM-IV diagnosis of substance dependence for sedative/hypnotic drugs, alcohol, stimulants, cocaine, inhalants, hallucinogens
• a diagnosis of organic brain disorder, bipolar disorder, schizophrenia, schizo-affective, schizophreniform, or paranoid disorder, or major depression (subjects who meet criteria for "substance-induced mood disorder," or dysthymia only will not be excluded)
• current suicidality on the Modified Scale for Suicidal Ideation
• use of daily psychotropic, antidepressant, or anxiolytic medication
• evidence of neuropsychological dysfunction as assessed by the study physician with confirmation with the Folstein Mini-Mental Status Examination
• anticipated major painful event (significant surgical procedure) in the coming 6 months
• probation/parole requirements that might interfere with protocol participation
• history of allergic reaction to buprenorphine or naloxone.