153800 Drugs and firearm deaths in Massachusetts, 2000-2005

Tuesday, November 6, 2007

William G. Fernandez, MD, MPH , Department of Emergency Medicine, Boston University, Boston, MA
Sandro Galea, MD, DrPH , Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY
Casey Rebholz, MPH , Department of Emergency Medicine, Boston University, Boston, MA
Doug A. Smith, MS , Department of Emergency Medicine, Boston University, Boston, MA
Holly Bullock, MPH , Department of Emergency Medicine, Boston University, Boston, MA
Amanda J. Fantry, MS , Department of Emergency Medicine, Boston University, Boston, MA
Katherine Markham, MPH, CSW , Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York, NY
Dhana Balakrishnan, MS , Department of Emergency Medicine, Boston University, Boston, MA
Mark Flommenbaum, MD, PhD , Office of the Chief Medical Examiner, Boston, MA
Objective

Drugs (including alcohol) may play a role in firearm deaths. This may present an opportunity for intervention to mitigate firearm-related morbidity and mortality. We examined the role that drugs play in fatal firearm injuries among Massachusetts residents.

Methods

Autopsy and toxicology results were collected from the Massachusetts Office of the Chief Medical Examiner on deaths caused by firearm from January 2000 to December 2005. Analysis was limited to firearm deaths among state residents, occurring within the state during the study period. Rates of annual firearm deaths and drug-positive firearm deaths were directly standardized to the age distribution of the Massachusetts population in 2000.

Results

Overall, 1096 of 1157 firearm death cases (94.7%) were reviewed; 92.0% of cases were male. The overall firearm death rate during the study period was 2.82 deaths per 100,000 person-years among Massachusetts residents. Decedents were: Caucasian 58.6%, African-American 26.2%, Hispanic 12.9%, and other races 2.3%. Most firearm deaths occurred at the victim's residence (45.5%). Toxicology results were positive in 474 (47.8%) of firearm deaths (1.23/100,000 person-years); among them were 252 homicides (53.2%) and 215 suicides (45.4%). Alcohol (36.6%) was the most common agent identified, followed by cocaine (11.8%), and opioids (6.4%).

Conclusions

Drugs are present in nearly half of all firearm decedents in Massachusetts. This suggests that drugs may be an important element of the circumstances surrounding firearm use. There is a greater need for surveillance and interventions targeting substance use in situations where firearms are present.

Learning Objectives:
1. To identify trends in drug/alcohol-positive firearm-related deaths in Massachusetts from 2000-2005. 2. To discuss the role that drugs and alcohol play in firearm-related deaths in Massachusetts.

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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