Inclusion Criteria:  >= 18 years old Seeking treatment at APT Foundation Have high impact chronic pain (>= 3 months duration of pain occurring most days which limits life or work activities and/or leads to inability to work) Meet DSM-5 criteria for moderate to severe OUD Have an opioid-positive urine test Understand English Able to provide informed consent  Exclusion Criteria:  Have pending surgery or invasive pain management procedure Acutely psychotic, suicidal, or homicidal Have a contraindication to exercise (e.g. complete heart block) Have a pending or planned relocation or pending incarceration