Published by NEJM Catalyst

Sue Glod, MD, is frustrated with the nation’s opioid crisis, but not for the obvious reasons. As a palliative medicine specialist at Penn State College of Medicine in Hershey, Pennsylvania, she sees patients who are struggling with life-threatening illnesses such as advanced cancer. While her mission is pain relief, a flood of new prescribing rules severely limits her options and burdens her staff with extensive administrative hurdles, she says.

“Drugs are being denied by insurance companies” and pharmacies aren’t stocking sufficient quantities of opioids, she says, “leaving our staff to go through a lot of paperwork, so there are wait times.”

Glod describes a breast cancer patient who recently had trouble with a prior authorization policy for a prescription of opioids. After several days of pain and withdrawal symptoms, the patient landed in the emergency room.