Pain Management Teams Using Whole Health to Optimize Function and Safety in Veterans: The TEAMWORK Trial

Inclusion Criteria:

1. High-impact chronic pain (defined using the Graded Chronic Pain Scale - Revised).
2. Active prescription for long-term opioid therapy (LTOT; including full agonist and buprenorphine) (\>90 days continuous prescription).
3. Exhibit evidence of at least ONE opioid safety concern (\*indicators of opioid safety concerns described below).

   * Opioid safety concerns for inclusion purposes include:

     1. moderate-to-high dose opioid prescription (morphine equivalent daily dose \>60mg)
     2. comorbid conditions that increase the risk of full-agonist opioids including chronic pulmonary disease (e.g., emphysema, chronic bronchitis, asthma, or other breathing problems), sleep apnea, chronic kidney disease, chronic hepatitis or cirrhosis
     3. active high-risk co-prescriptions, including long-term benzodiazepine prescription, gabapentin or pregabalin, nonbenzodiazepine hypnotic agents or sedative hypnotics, or skeletal muscle relaxants
     4. a positive TAPS or AUDIT-C score
     5. reported score of \>8 as measured by the Prescribed Opioids Difficulties Scale (PODS).

Exclusion Criteria:

1. Moderate to severe cognitive impairment as measured by the Blessed Orientation Memory Concentration (BOMC) screening tool.
2. Inability to read or understand English.
3. Severely impaired hearing or speech that would preclude participation in telephone interviews or appointments with the Whole Health Coach.
4. Terminal illness/disease with a prognosis of \<12 months.
5. Planned move/relocation outside of the treatment areas of the participating enrolling study sites.
6. Participants actively working with a Whole Health Coach or who have worked with a Whole Health Coach in the 6-months prior to enrollment.
7. Major surgical procedure planned during the study treatment or follow-up period.
8. a recent suicide attempt, defined as documented and/or reported suicide attempt within 90 days of the screening date.