Adjunctive Transcranial Stimulation to Reduce Impulsivity in Opiate Use Disorder

Inclusion Criteria: * Patients enrolled in the SMART Clinic at University of Kentucky * 18-60 years of age * Preferably right hand dominant * Currently self-report smoking 10 of more cigarettes per day or a score of \> 5 on the Fagerstrom Test for Nicotine * Willing and able to abstain from all drug use * Exhaled breath on day of study CO \< 10 ppm * Stabilized on maintenance buprenorphine if having comorbid opioid use disorder * Able to read and speak English * Able to provide informed consent to participate. Exclusion Criteria: * Pregnant, nursing, or becoming pregnant during the study. * History of traumatic brain injury or seizures which are contraindications for transcranial magnetic stimulation (TMS). * Increased risk of seizure for any reason, including prior diagnosis of epilepsy, seizure disorder, increased intracranial pressure, or history of significant head trauma with loss of consciousness for ≥ 5 minutes which are all contraindications for TMS. * Presence of intracranial implants (e.g. aneurysms clips, shunts, stimulators, cochlear implants, or electrodes), cardiac pacemakers, or vagus nerve stimulation device which are all contraindications for magnetic resonance imaging. * Neurological disorder including, but not limited to: space occupying brain lesion; any history of seizures, history of cerebrovascular accident; fainting, cerebral aneurysm, major neurocognitive disorder, Huntington chorea; multiple sclerosis which are all contraindications for TMS.