I think I've on occasion paid by PayPal, and had Craigslist items shipped to me. A lot of sellers ignore out of town buyers.
Craigslist has started giving statewide searches by default (which I used to use SearchTempest for). However, since I'm car-free now, I tend to only look at local ads, or perhaps anticipate where I'll be heading in a week or so.
Another member in southern Washington (Vancouver area) frequently drove to Seattle to pick up interesting stuff.