Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts.
Department of Health Policy, Stanford School of Medicine, Stanford, California.
JAMA Netw Open. 2024 Jun 3;7(6):e2414864. doi: 10.1001/jamanetworkopen.2024.14864.
Extreme risk protection orders (ERPOs)-also known as red flag, risk warrant, and gun violence restraining orders-authorize law enforcement, family members, and sometimes others to petition a court to remove firearms from and prevent the acquisition of new firearms by a person judged to pose an immediate danger to themselves or others. Previous estimates suggest that 1 suicide is prevented for every 10 ERPOs issued, a number needed to treat that depends critically on the counterfactual estimate of the proportion of suicidal acts by ERPO respondents that would have involved firearms in the absence of ERPOs.
To empirically inform updated estimates of the number of ERPOs needed to prevent 1 suicide.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data from California for method-specific suicides by handgun ownership (October 18, 2004, to December 31, 2015). Handgun-owning suicide decedents in California were identified using individual-level registry data about lawful handgun ownership linked to cause-specific mortality for a cohort of more than 25 million adults. The study also used data from Connecticut for method-specific suicides among ERPO respondents who died by suicide, extracted from published data (October 1999 to June 2013). Data analysis was performed in December 2023.
Handgun ownership.
The primary outcomes were the number and distribution of suicidal acts by handgun owners in California, estimated using method-specific suicide mortality data and published case fatality ratios, and the counterfactual number and distribution of suicidal acts and deaths among ERPO respondents in Connecticut had no ERPOs been issued.
A total of 1216 handgun owners (mean [SD] age, 50 [18] years; 1019 male [83.8%]) died by suicide during the study period. Among male handgun owners in California, 28% of suicidal acts involved firearms, 54% involved drug poisoning, 9% involved cutting or piercing, 3% involved hanging or suffocation, 2% involved poisoning with solids and/or liquids, and the remaining 4% involved other methods. Assuming this distribution approximates the counterfactual distribution among ERPO respondents in Connecticut in the absence of ERPOs, 1 suicide death was prevented for every 22 ERPOs issued.
The estimates produced by this cohort study of California handgun owners suggest that ERPOs can play an important role in averting deaths among high-risk individuals.
极端风险保护令（ERPO）-也称为红旗、风险逮捕令和枪支暴力限制令-授权执法人员、家庭成员，有时还授权其他人向法院申请，将枪支从被判定对自己或他人构成直接危险的人手中夺走，并阻止其获得新的枪支。先前的估计表明，每发出 10 份 ERPO 就可以预防 1 起自杀，这一需要治疗的数量取决于对没有 ERPO 的情况下 ERPO 受访者自杀行为中涉及枪支的比例的反事实估计。
根据实证数据，为预防 1 例自杀所需的 ERPO 数量提供最新估计。
设计、设置和参与者：这项队列研究使用了来自加利福尼亚州的关于特定用枪自杀方法（2004 年 10 月 18 日至 2015 年 12 月 31 日）的数据。通过将关于合法持枪的个人登记数据与 2500 多万成年人的特定死因死亡率相关联，确定了加利福尼亚州用枪自杀的持枪自杀死者。该研究还使用了来自康涅狄格州的关于特定用枪自杀的 ERPO 受访者的数据，这些数据是从已发表的数据中提取的（1999 年 10 月至 2013 年 6 月）。数据分析于 2023 年 12 月进行。
持枪。
主要结果是使用特定方法的自杀死亡率数据和已发表的病死率估计，估计加利福尼亚州持枪者的自杀行为数量和分布，以及康涅狄格州 ERPO 受访者在没有发布 ERPO 的情况下的自杀行为和死亡的反事实数量和分布。
在研究期间，共有 1216 名持枪者（平均[标准差]年龄，50[18]岁；1019 名男性[83.8%]）自杀身亡。在加利福尼亚州的男性持枪者中，28%的自杀行为涉及枪支，54%涉及药物中毒，9%涉及切割或刺穿，3%涉及悬挂或窒息，2%涉及固体和/或液体中毒，其余 4%涉及其他方法。假设这种分布近似于康涅狄格州 ERPO 受访者在没有 ERPO 的情况下的反事实分布，那么每发出 22 份 ERPO 就可以预防 1 例自杀死亡。
这项对加利福尼亚州持枪者的队列研究估计表明，ERPO 可以在避免高危个体死亡方面发挥重要作用。
