Low-Intensity Focused Ultrasound and the Complex Patient

This study explores whether low-intensity focused ultrasound (a non-invasive brain treatment using sound waves) can help people who have chronic back pain, opioid use disorder, and an anxiety disorder — a challenging combination of conditions that often overlap. **You may be eligible if...** - You are 18–65 years old with chronic back pain lasting at least 3 months - You have been diagnosed with opioid use disorder and are currently in treatment (using buprenorphine or methadone) - You also have an anxiety disorder (such as generalized anxiety, PTSD, or social anxiety) - You show signs of widespread pain sensitivity on a standardized questionnaire **You may NOT be eligible if...** - You have neuropathic pain (nerve-based pain) or had previous spine surgery - You have another substance use disorder (other than opioids or tobacco) - You have schizophrenia or schizoaffective disorder - You have chronic pain conditions beyond just back pain - You are pregnant or breastfeeding - You have a history of stroke, brain surgery, seizures, multiple sclerosis, or other neurological disease Talk to your doctor to see if this trial is right for you.