Scottish Government support for Veterans and the Armed Forces Community in Scotland
Abstract: This document sets out current achievements and future priorities, and highlights the work that the Scottish Government is taking forward to respond to the recommendations made in the Scottish Veterans Commissioner’s three reports: Transition in Scotland, Provision of Information on Housing for Service Leavers and Veterans in Scotland in 2015 and the Veterans Community - Employability, Skills and Learning in 2016. An overview of the progress made against each of these reports is set out in this document and includes a general update on additional work being undertaken in support of our Armed Forces, veterans and their families.
Abstract: Context: In response to the opioid crisis, federal guidelines were implemented, including the Veterans Health Administration's (VA) Opioid Safety Initiative in 2013. The impact of policies on patients near the end of life is unknown. Objective: Examine temporal trends in opioid prescribing, pain, and opioid overdoses among Veterans near the end of life. Methods: Retrospective, time series analysis of VA decedents between October 2009 and September 2018 whose next-of-kin participated in VA's Bereaved Family Survey (BFS). Using multivariate regression to adjust for sociodemographic and clinical covariates, we examined temporal trends in outpatient opioid prescribing, uncontrolled pain based on BFS report, and opioid overdose-related hospitalizations, in the last month of life, overall and by clinical diagnosis (cancer versus non-cancer). Results: Among 79,409 decedents, mean daily outpatient opioid dose in morphine milligram equivalents in the last month of life decreased from 4.6 mg in 2010 to 2.1 mg in 2018 (adjusted change -0.20 mg/year; P