Gun Carrying Adolescents –Why We Are Going to See More School Shootings

A recent cross-sectional study (RMC Kagawa et al. J Pediatr 2019; 209: 198-203) shows a high rate of gun carrying among adolescents in the U.S.

Key findings:

  • Based on a sample of 10,112 adolescent who completed surveys, 2.4% of adolescents reported carrying a gun in the prior 30 days.
  • Carrying a gun was more common among adolescents with a conduct disorder (adjusted prevalence ratio 1.88), drug use disorders (APR 1.91) and patients with specific phobias (APR 1.54)
  • The authors estimate that 1.1% of adolescents with a disorder associated with self- or other-directed violence also carry guns.  This extrapolates to 272,000 adolescents with both risk factors.
  • Nearly two-thirds of adolescents who report gun carrying had a mental health disorder

My take:

  1. Guns are everywhere.  Gun carrying among adolescents, while only a small percentage of all adolescents, represent a grave risk; especially, since the majority who report carrying guns (in this study) have mental health issues.
  2. Safe storage needs to be a requirement of gun ownership.  Gun access and misuse by adolescents is a ‘clear and present danger’ (apologies to Tom Clancy).

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Do Gun Law Restrictions Work?

Those opposed to gun safety provisions (a.k.a. gun control legislation) argue that laws  will not prevent criminals from obtaining firearms illegally.  A recent commentary in NY Times provides some data that shows that states with more gun safety provisions have lower levels of gun-related deaths (especially suicides).

NY Times: A Gun Killed My Son. So Why Do I Want to Own One?

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March for Our Lives

Today there is a “March for Our Lives

Some relevant tweets:

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Update: Florida Physician Gag Rule Overturned

In a previous blog post, Politics and Limiting Physician Speech, I discussed the Florida Gag Rule intended to prevent physicians from discussing firearm safety with patients. At the time, I expressed outrage that “there are laws curtailing a physician’s free speech and efforts to dictate practice based on political philosophy.”

It looks my views have been vindicated.  NEJM report (full text): Physicians, Firearms, and Free Speech

An excerpt:

In February, the full U.S. Court of Appeals for the Eleventh Circuit issued its long-awaited ruling in Wollschlaeger v. Governor, State of Florida, invalidating parts of Florida’s Firearm Owners’ Privacy Act (FOPA) and affirming that the First Amendment applies to the speech between physicians and patients. The decision ensures that physicians may continue to make efforts to protect their patients from gun-related injuries, many of which are fatal and which in aggregate account for approximately as many deaths annually as do motor vehicle accidents….

the majority affirmed that laws regulating physician speech must be designed to enhance rather than harm patient safety. The majority took this mandate seriously and required the state to show some meaningful evidence that the regulation was apt to serve the state’s interest in protecting patients.

The state could not do so for two reasons. First, the decision to keep a gun in the home substantially increases the risk of death for all household members, especially the risk of death by suicide, and particularly so when guns are stored loaded and unlocked, as they are in millions of homes where children live.3 Second, the majority of U.S. adults who live in homes with guns are unaware of the heightened risk posed by bringing guns into a home.4 Indeed, by providing accurate information about the risks created by easy access to firearms, as well as ways to modify that risk (e.g., by storing guns unloaded and locked up, separate from ammunition), a physician’s counseling can not only enhance a patient’s capacity for self-determination, but also save lives…

The fact is that most clinicians, including those who routinely encounter suicidal patients, rarely, if ever, provide firearm-safety counseling.5 This reticence predated the FOPA and has persisted since its passage..The court has done its duty. It’s now the physicians’ turn.

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