@article{ref1,
title="Updated estimate of the number of extreme risk protection orders needed to prevent 1 suicide",
journal="JAMA network open",
year="2024",
author="Swanson, Sonja and Studdert, David M. and Zhang, Yifan and Miller, Matthew",
volume="7",
number="6",
pages="e2414864-e2414864",
abstract="IMPORTANCE: 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. <br><br>OBJECTIVE: 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. EXPOSURE: Handgun ownership. MAIN OUTCOMES AND MEASURES: 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. <br><br>RESULTS: 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. <br><br>CONCLUSIONS AND RELEVANCE: 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.<p /> <p>Language: en</p>",
language="en",
issn="2574-3805",
doi="10.1001/jamanetworkopen.2024.14864",
url="http://dx.doi.org/10.1001/jamanetworkopen.2024.14864"
}