Military Veteran Reintegration: Approach, Management, and Assessment of Military Veterans Transitioning to Civilian Life
Summary: This book offers a toolkit for researchers and practitioners on best practices for easing the reintegration of military veterans returning to civilian society. It lays out how transition occurs, identifies factors that promote or impede transition, and operationalizes outcomes associated with transition success. Bringing together experts from around the world to address the most important aspects of military transition, the book looks at what has been shown to work and what has not, while also offering a roadmap for best-results moving forward. The book contains evidence-based interventions for military veteran-to-civilian transition, features international experts from North America, Europe and Asia, includes how to measure transition outcomes, outlines recovery programs for the injured and sick and identifies factors that promote or impede successful transition.
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