and a 50% increase in runs for suspected opioid overdoses with deaths at the scene. Individuals with opioid overdose may refuse transportation to the hospital for many reasons, including fear of exposure to COVID-19 (Slavova et al., 2020). Efforts are needed to treat individuals with OUD without an initial in person evaluation. Primary care providers try to adapt their practice for individuals with OST (stopping face-to-face visit, avoiding the requirement of urine drug screen, shifting to telemedicine) (Wilson et al., 2020), but isolation or anxiety may require increasing proximal care for these patients. A specific telemedicine assessment of SUD was recently validated (Deacon et al., 2020), and may help clinicians to improve their practice. Persons receiving take-home methadone could be co-prescribed naloxone, an opioid reversal agent that may mitigate the risks of fatal overdose among those at high risk (Alexander et al., 2020). In-home initiation of buprenorphine is a routine in some Western countries (Poloméni and Schwan, 2014) and newer long-acting injectable formulations of buprenorphine may be preferred. Buprenorphine initiation via telemedicine is legally possible in the U.S and has been successfully reported in a case report study (Harris et al., 2020). A retrospective two years study found no difference
