ROLE OF THE PHARMACY WORKFORCE IN PREVENTING ACCIDENTAL AND INTENTIONAL FIREARM INJURY AND DEATH

To recognize that accidental and intentional firearm injury and death in the U.S. is a public health crisis; further,

To affirm that the pharmacy workforce has important roles in the comprehensive public health and medical approach to reducing death and disability from firearm injury.

Rationale

Firearm-related injury is a leading cause of death in the U.S. The Centers for Disease Control and Prevention reported over 48,000 deaths were caused by firearm-related injuries in 2022 (56.1% from death by suicide, 40.8% by homicide, 3.1% by legal intervention, unintentional injuries, or unknown intent). Mass shootings represent approximately 1% of firearm-related deaths.

Studies estimate that the incidence of nonfatal firearm-related injuries is double that of fatal firearm-related injuries. Firearm-related injury is a medical and public health problem that hospitals and health systems play an important role in preventing and treating. Evidence-based public health strategies can be employed when violence and firearm-related injury are framed as a complex disease. This approach enables identification of primary, secondary, and tertiary levels of prevention and intervention strategies. Primary prevention, measures taken before the onset of injury (i.e., before the gun is fired), seek to interrupt the transmission of violence and improve the safety of communities. Examples of primary prevention include surveillance to gain insight into causes and determine the impact of interventions of firearm-related injury and violence; identification of risk factors associated with violence from firearms; and development, dissemination, and implementation of prevention strategies. Secondary prevention begins when the firearm causes injury and includes strategies for early response to triage care and minimize morbidity and mortality through emergency and inpatient medical care. Lastly, tertiary prevention provides long-term strategies aimed at caring for the victim following injury. It offers opportunities to not only provide acute care for the injured but to deploy services such as hospital-based violence intervention programs screening and treatment for post-traumatic stress disorder, and case management aimed at preventing firearm-related violence and injury recidivism.

In 2024, U.S. Surgeon General Dr. Vivek Murthy released a first-ever Surgeon General’s Advisory on Firearm Violence, declaring it to be a public health crisis. Among other recommendations, the advisory calls for the following community risk reduction and education prevention strategies:

• Implement community violence interventions to support populations with increased risk of firearm violence involvement.
• Incorporate organizational violence prevention and emergency preparedness elements into safety programs.
• Encourage health systems to facilitate education on safe and secure firearm storage.
• Address structural determinants that increase the risk of firearm violence.

ASHP recognizes that a comprehensive public health and medical approach to reducing death and disability from firearm injury is needed. The pharmacy workforce has important roles in implementing the interventions needed to reduce death and disability from firearms.