The Invisible Wounded Warriors in a Nation at Peace: An interview study on the lives of Swedish veterans of foreign conflicts and their experiences with PTSD, moral injuries, and military identities
Although there has not been war in Swedish territory for many years, this does not mean that the country has no veterans who have experienced the challenges of war zone deployments or suffer from combat trauma. The Invisible Wounded Warriors in a Nation at Peace gives a rare look at the international operations of the Swedish military, while offering the reader a unique and deeper understanding of life with PTSD. The book uses terms such as moral injury to further describe the complexity. Complex PTSD after deployment in a conflict zone is a uniquely complicated web of problems that can have medical, psychological, moral, existential and spiritual dimensions. The book discusses what this might mean from an identity and pastoral care perspective.
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