...patients with opioid withdrawal symptoms benefit from its agonistic properties in the form of diminished cravings; however, its ceiling effect prevents the consequences of respiratory depression and euphoria present with full μ-receptor agonists such as methadone.1 These characteristics contribute to buprenorphine's excellent safety and efficacy profiles, protecting patients with OUD from overdose and death. ...we respectfully disagree with the notion that “medication alone is not sufficient treatment for OUD.” 11 In addition to the difficulties accessing treatment for OUD—including buprenorphine or buprenorphine-naloxone—that our colleagues in Chicago describe and we have seen in Maine as well, emerging literature points to other pandemic-related challenges.12,13 First, evidence suggests that people with OUD may be at higher risk for experiencing COVID-19 infection due to a higher prevalence of pre-existing conditions, smoking, opioid-related immunosuppression, and the presence of structural lung disease.14-17 In addition, those with OUD are more likely to reside in congregate living situations such as group recovery housing, shelters, and correctional facilities where they may be unable to maintain social distancing.14,15 People with OUD also make up a disproportionate share of the United States unsheltered and unstably housed population, placing them at further risk for exposure to COVID-19.16,18 Although social distancing is an important public health measure, there is potential for the isolation associated with COVID-19 to cause harm for those with OUD.19 There is a strong association between social isolation, mood, and substance use disorders.20 Isolation can act as a trigger for some, exacerbating existing patterns of substance use or contributing to a return to use for those who are in recovery.19 In addition, many supportive and harm-reducing services for people with OUD are unavailable as a result of the current pandemic, including support groups, treatment programs, daily medication dispensing clinics, and needle exchanges.