Inclusion Criteria:  Women requesting medication abortion up to 10 weeks gestation Fluent English speaking Able and willing to receive and send text messages and receive phone calls Opioid naive Healthy patients with no significant comorbidities  Exclusion Criteria:  Any history of drug or alcohol use, opioid use in last 30 days, chronic use of pain medications, or use of benzodiazepines. Any chronic disease including renal, liver, respiratory or cardiac disease Any known allergies to mifepristone, misoprostol, nonsteroidal anti-inflammatory drugs (such as ibuprofen) and methadone. Known history of QT prolongation