Abstract: This publication reaffirms Scotland's commitment to support our Armed Forces community - Service personnel, veterans and families. It recognises some major achievements in supporting the Armed Forces community and sets out future priorities for action. There is a small but important number of veterans who struggle to make an effective transition to civilian life. I am adamant that no one should suffer disadvantage as a result of service, and they deserve the best possible help that society can offer. We have made significant progress over the course of this Parliament to address gaps in service provision and to improve support for those who need it most. I give my assurance that, despite the financial pressures we all face, the Scottish Government will continue to support and champion our Armed Forces and veterans.
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