Issue 48 | Eating Disorders in Military and Defence Personnel
Military and civilian service professions, such as the Australian Defence Force (ADF) and emergency services, as well as elite sports professions, require a certain level of physical fitness, discipline and performance. The intensive training undertaken by those in high performance occupations may not always prepare them for the potential psychological impacts (VVCS, 2016; Bartlett & Mitchell, 2015).
In this e-Bulletin issue, the National Eating Disorders Collaboration (NEDC) gives an overview of the research on eating disorders in ex-serving military personnel, and takes a closer look at appropriate self-care and support pathways for Veterans, Australian Defence personnel and other elite professionals. This issue also discusses the risks and warning signs associated with eating disorders, to better assist health care providers, coaches and others working alongside people currently or previously involved in high performance occupations to appropriately identify and respond to symptoms.
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