Covid-19 has made life much harder for people with opioid addiction. But the response to the virus has also revealed a way forward that could radically expand effective treatment and reduce overdose deaths.

Until now, getting effective treatment depended on where you lived. Forty percent of American counties -- much of Appalachia, for example -- have no providers licensed to prescribe buprenorphine, the most successful treatment so far.

But the pandemic has made it possible to see a licensed provider from home, and that could make buprenorphine treatment available anywhere.

Michelle (she asked me to not use her family name) is 57, lives near Wilkes-Barre, Pa., and works from home as a customer service representative. Her computer allows her to live a good life -- after eight years on heroin that followed many years on other drugs.

Roseanna Melle, who offers light counseling and prescribes the widely used drug Suboxone -- a combination of buprenorphine and the overdose reversal drug naloxone. It blocks her cravings and prevents withdrawal symptoms, but doesn't get her high. She feels ... normal.

Before starting telemedicine in April, Michelle got Suboxone at a local addiction medicine clinic. "It was a revolving door -- sometimes standing room only," she said. "Who wouldn't want to just do your appointment in the comfort and privacy of your own home?"

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