Epidemiol Rev. 2016;38(1):5-31. doi: 10.1093/epirev/mxv008. Epub 2016 Feb 11.
A causal relationship between controlled substances and firearm violence has been widely assumed in the United States, and federal law prohibits individuals who are "unlawful users of or addicted to any controlled substance" from purchasing or possessing firearms (68 FR 3750. 2003. Codified at 27 CFR §478.11). However, the law does a poor job of defining "unlawful users," resulting in recent calls for a revised, actionable definition. Such a definition should be informed by research evidence, but to date the epidemiologic research on the relationship between controlled substances and violence has not been comprehensively reviewed. The initial goal of this review was to summarize the best available evidence on the relationship between controlled substances and firearm violence, but only 1 study specific to firearm violence was identified. We therefore reviewed studies of this relationship using broader measures of interpersonal violence and suicide, all of which included but were not limited to firearm violence, and measures of illicit firearm carrying. Prospective longitudinal studies (n = 22) from 1990 to 2014 were identified by using searches of online databases and citation tracking. Information was extracted from each study by using a standardized protocol. Quality of evidence was independently assessed by 2 reviewers. Aggregate measures of controlled substance use were associated with increased interpersonal violence and suicide, but evidence regarding the relationship between specific substances and violence was mixed. Involvement in illegal drug sales was consistently associated with interpersonal violence. To effectively revise extant federal law and delineate appropriate prohibiting criteria, more research is needed to understand the relationship between controlled substances and firearm violence.
在美国，人们普遍认为管制药物与枪支暴力之间存在因果关系，联邦法律禁止“非法使用或成瘾于任何管制药物”的个人购买或拥有枪支（68 FR 3750. 2003. 编入 27 CFR§478.11）。然而，该法律在定义“非法使用者”方面做得很差，导致最近有人呼吁修订可操作的定义。这样的定义应该以研究证据为依据，但迄今为止，关于管制药物与暴力之间关系的流行病学研究尚未得到全面审查。本次审查的最初目标是总结关于管制药物与枪支暴力之间关系的最佳现有证据，但仅确定了一项专门针对枪支暴力的研究。因此，我们使用更广泛的人际暴力和自杀措施，以及非法携带枪支的措施，审查了该关系的研究，所有这些措施都包括但不限于枪支暴力，并且包括但不限于枪支暴力。通过使用在线数据库和引文跟踪进行搜索，确定了 1990 年至 2014 年的 22 项前瞻性纵向研究。通过使用标准化协议从每项研究中提取信息。由 2 名评审员独立评估证据质量。药物使用的综合指标与人际暴力和自杀增加有关，但关于特定物质与暴力之间关系的证据却不一致。参与非法毒品销售始终与人际暴力有关。为了有效修订现有的联邦法律并划定适当的禁止标准，需要进行更多的研究以了解管制药物与枪支暴力之间的关系。
