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Adolescents who seek ED care for assault have increased risk for firearm violence

Adolescents with a 6-month history of drug use who seek ED care for assault have a higher risk for firearm violence vs. peers with similar drug use history who do not seek ED care for assault, according to study findings in Pediatrics.

Researchers compared firearm carriage and ownership, firearm violence, substance use and mental health among 349 patients who presented to the ED with assault injuries and had a 6-month history of drug use vs. 250 age and gender matched, non-assaulted controls with similar drug use history. Study participants were aged 14 to 24 years. Assessments were made at baseline and then every 6 months for 2 years.

Patients presenting to the ED for assault care were approximately 40% times more likely to report firearm violence compared with controls (P < .001).

Patients who reported firearm violence were more likely to report firearm possession or carriage (P < .001) and attitudes favoring retaliation, agreeing with statements such as “I believe if someone hits you, you should hit them back” (P < .001) vs. controls.

Sixty-five percent of adolescents who reported firearm possession at baseline were involved in firearm violence during follow-up.

Adolescents who reported firearm violence were more likely to meet criteria for an alcohol (P < .001) or drug use disorder (P < .001) at baseline vs. those who did not report violence. Further, those who reported firearm violence were more likely to combine substance use with high-risk firearm behaviors, such as carrying a firearm while intoxicated (P < .001).

Fifty percent of participants who endorsed firearm violence meet diagnostic criteria for mental illness. Analysis indicated significantly higher rates of PTSD among participants with subsequent firearm violence (P < .05).

“Until recently, most health care providers have focused on the treatment of a patient’s physical wounds without capitalizing on this teachable moment to intervene and address their underlying risk for future firearm violence. This current study highlights that this risk is substantial,” the researchers wrote. “Secondary violence prevention initiatives that comprehensively address substance use, retaliatory violence, firearm possession, and mental health needs may have the potential to capitalize on this teachable moment and decrease the morbidity and mortality associated with urban firearm violence.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.