• Age ≥ 18yrs;

• English-speaking;

• On LTOT, defined as taking daily prescription opioid therapy for 90 days or more;

• Past week average morphine equivalent dose (MED) ≥50;

• Willing and able to complete written informed consent;

• Willing and able to use a mobile/cell phone;

• Have at least one additional risk for opioid toxicity or overdose from the following list:

• Taking benzodiazepines with opioids

• Substance Use Disorder diagnosis \[non-tobacco; Opioid Risk Tool\]

• Having ever experienced an overdose

• Current major medical problem \[e.g. mod-severe liver disease, pancreatitis, chronic pulmonary disease, untreated sleep apnea, hospitalized for an acute medical issue in the past 6 months\]

• Response to Brief Pain Iinventory Item 8 \<30%, suggesting less than moderately clinically meaningful response to pain treatment

• Co-morbid psychiatric diagnosis \[Opioid Risk Tool\]

• Signs of opioid misuse \[any score \>0 on the following COMM Items: 3, 4, 5, 9, 10, 11, 14, 15, 16\]

• Opioid Risk Tool \>3 or Current Opioid Misuse Measure ≥ 9

• Struggling with the following side effects from opioids \[self-report\]: Dizziness and/or falls Difficult-to-manage stomach pain, nausea, constipation or GI issues, Fatigue or low energy, Sleepiness or sedation, Trouble with memory or thinking clearly \[COMM Item 1\>0\], Other troublesome side effect \[open answer\]