Weleff Jeremy, Butler Robert S, Streem David, Barnett Brian S
Department of Psychiatry and Psychology, Center for Behavioral Health, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
Drug Alcohol Depend Rep. 2022 Mar 2;2:100034. doi: 10.1016/j.dadr.2022.100034. eCollection 2022 Mar.
Up to one-third of firearm-related suicides were carried out by individuals who had consumed alcohol shortly before their death. Despite the critical role of firearm access screening in suicide risk assessment, few studies have examined firearm access among patients with substance use disorders. This study examines the rates of firearm access among those admitted to a co-occurring diagnosis unit over a five year period.
All patients admitted to a co-occurring disorders inpatient unit from 2014 to mid-2020 were included. An analysis contrasting the differences among patients reporting firearms was performed. A multivariable logistic regression model using factors from initial admission were chosen based on clinical relevance, past firearms research, and statistical significance on bivariate analysis was used.
Over the study period there were 7332 admissions representing 4055 patients. Documentation of firearm access was completed in 83.6% of admissions. Firearm access was reported in 9.4% of admissions. Patients reporting firearm access were more likely to report never having suicidal ideation ( = 0.001), be married ( = <0.001), and report no past history of suicide attempts ( = <0.001). The full logistic regression model revealed that being married (OR: 2.29 and < 0.0001) and employed (OR: 1.51 and = 0.024) were factors associated with firearms access.
This is one of the largest reports assessing factors associated with firearm access among those admitted to a co-occurring disorders unit. Firearm access rates in this population appear lower than rates in the general population. The roles employment and marital status play in firearm access deserve future attention.
高达三分之一的与枪支相关的自杀事件是由那些在死前不久饮酒的人实施的。尽管枪支获取筛查在自杀风险评估中起着关键作用，但很少有研究考察物质使用障碍患者的枪支获取情况。本研究考察了在五年期间入住共病诊断科室的患者中枪支获取的发生率。
纳入2014年至2020年年中入住共病障碍 inpatient 科室的所有患者。对报告有枪支的患者之间的差异进行了分析。基于临床相关性、以往枪支研究以及双变量分析中的统计学意义，选择使用首次入院时的因素构建多变量逻辑回归模型。
在研究期间，共有7332例入院病例，代表4055名患者。83.6% 的入院病例完成了枪支获取情况的记录。9.4% 的入院病例报告有枪支获取情况。报告有枪支获取情况的患者更有可能报告从未有过自杀意念（P = 0.001）、已婚（P = <0.001）以及报告无既往自杀未遂史（P = <0.001）。完整的逻辑回归模型显示，已婚（比值比：2.29，P < 0.0001）和就业（比值比：1.51，P = 0.024）是与枪支获取相关的因素。
这是评估入住共病障碍科室患者中与枪支获取相关因素的最大规模报告之一。该人群中的枪支获取率似乎低于一般人群。就业和婚姻状况在枪支获取中所起的作用值得未来关注。
