North Carolina medical journal
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Patients with advanced degenerative joint disease of the hip or knee often experience chronic pain that can be effectively treated with joint replacement surgery. Joint replacement surgery remains beneficial even if patients have concurrent extrinsic pain or they are taking narcotics long term, although these groups are at higher risk for persistent pain and for dissatisfaction with their surgical results.
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The rate of unintentional deaths from opioid poisoning has reached epidemic proportions. One model of successful intervention is Project Lazarus, an integrated-care pilot program in Wilkes County, North Carolina. Community Care of North Carolina, supported by a grant of $1.3 million from the Kate B. Reynolds Charitable Trust and matching funds of $1.3 million from the North Carolina Office of Rural Health and Community Care, is now expanding the Project Lazarus approach statewide.
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Opioid analgesics are commonly used for the management of chronic noncancer pain. Although they can be beneficial for select patients, opioids are also at the heart of a nationwide epidemic of misuse and diversion.
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Reducing suffering and helping patients to control their symptoms are key components of palliative care. This commentary will offer a comprehensive definition of palliative care and will present a case history to illustrate how palliative care can benefit patients with chronic pain.