drauk
You're expected to fly the outbound on the localizer, not the ADF. That gives you a little lead time as the needle comes alive, though the intercept angle is large.
If it's an NDB approach with similar patterns, you do have to wait for station passage. However in the UK (i.e. under ICAO PANS-OPS) a turn of more than 30 degrees directly on to the outbound would not be permitted, and you'd have to go once round the hold. I don't think that's the case in the US.
MasterCaution
Good question. Where the level at the IAF exceeds the sector safe altitude, I've always felt justified descending to the latter, which usually gives you a minute or so to get to the point where 5 degrees is wider than your cockpit.
However, PANS-OPS requires that you are established (or +-5deg) before descending only for the inbound leg. I wouldn't want to be too far off though! I don't have PANS-OPS Vol 2 so I can't tell you how large the protected area is. Maybe one of the procedure experts could help. I'll ask on Tech Log.