US Gun Culture Connected to Elevated Youth Suicide Rates

Suicide rates have declined in other wealthy countries over the last decade but increased in the US alongside rates of gun ownership.

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A new study, recently published in Archives of Suicide Research, links gun ownership rates and rising suicide rates in the United States.

The authors, Colin Pritchard, Lars Hansen, Rosslyn Dray, and Jalil Sharif, utilized the most recent suicide statistics from the World Health Organization (WHO). They then compared these statistics to data collected by the Small Arms Survey of the Swiss Graduate Institute of International Development, which assesses the number of firearms per 1,000 persons.

While suicide rates have declined in other Western nations over the last decade, American rates have increased. Further, they find a significant correlation between young adult suicide rates and gun ownership/access.

“The finding that there are more guns than people in the USA was startling—1,205 firearms for every thousand persons and was more than six times the average Western gun ownership rate. The positive significant correlation of Young Adult suicides and gun ownership suggests that there may be a link between the impulsivity of young people and easy access to firearms and suicide,” the authors report.
“This result matches a number of USA studies that found an association between gun ownership and higher levels of both suicide and homicide in some American States. Surely putting beyond question that compared with other Western countries, access to guns is very likely to be a factor in more than a quarter of a million American suicides in this century, of which more than one hundred and fifty thousand were Young Adults.”

A 45 caliber handgun and ammunition resting on a folded flag against the United States constitution.The conversation concerning “access to means” and suicidality is a nuanced topic in mental healthcare and public policy. Gun owners are more likely to die by suicide than non-gun owners. And, in some states, like Utah, the vast majority of gun deaths are suicides—indeed, an estimated 50% of all suicides in the United States are completed with a gun.

The catalyst of suicidality also appears to be connected to social determinants of health, including poverty, unemployment, discrimination, and unmet interpersonal needs.

It is important to note that the link between interpersonal gun violence and mental illness is weak. However, current public discourse in the US often links mass gun violence with mental health, despite the lack of evidence for this connection.

The authors explored the connections between the United States’ rising suicide rates and its gun culture in this new study.

The authors utilize the WHO’s May 2018 Age-Standardized-Death-Rates (ASDR) per million in tandem with American gun ownership data drawn from the world ‘Small Arms Survey’ as well as the Center for Disease Control’s statistics of USA deaths related to firearms in 2015 and compare US rates of suicide to Other Western Countries (OWC) and their respective rates of gun ownership.

The OWCs identified in the article are Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Netherlands, New Zealand, Norway, Portugal, Spain, Sweden, Switzerland, and the United Kingdom.

To assess any significant differences in suicide rates between the OWC and the United States, a series of chi-square tests and Spearman Rank Order (Rho) tests were done to ensure a consistent and significant correlation and probability level.

Although there was no significant general correlation between gun ownership and total suicide rates in the twenty nations, there were noteworthy differences between different ages. For example, USA mature adult suicide rates (55-74) had risen by 35%, while eleven OWC had reductions in suicide rates in this age group.

Notably, for young adults (15-34), the USA had the second-highest young adult suicide rates (after New Zealand). They found that rates among young adults in the USA had risen by 211% and that gun ownership and suicide rates were significantly positively correlated.

“In terms of numbers of total firearms deaths, in 2015 there were 36,927, predominately by suicides and homicide, of which 14,418 were by Young Adults (15–34).”

The authors argue that the positive correlation between gun ownership and suicide rates among young adults suggests that there may be a “link between the impulsivity of young people and easy access to firearms and suicide.” Moreover, they point out that this is a uniquely American problem. For instance, in 2015, “12,438 young adult Americans died by suicide, at least half using firearms, a number of fatalities that exceeds the average annual US military deaths in the Gulf and Afghan wars.”

“In 2015 in America, there were 44,193 confirmed suicides; if the USA had matched the average Western rate of 86 pm, there would have been 19,445 fewer suicides. More than half a million Americans died by suicide in this century, half of which were by firearms is an indictment of the nation’s inadequate gun safety.”

 

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Pritchard, C., Hansen, L., Dray, R., & Sharif, J. (2022). USA Suicides Compared to Other Western Countries in the 21st Century: Is there a Relationship with Gun Ownership? Archives of Suicide Research, 1-13. (Link)

7 COMMENTS

  1. “suicidology, at its best, is social justice work”

    You are writing on Mad in America, not for the World Economic Forum Newsletter. Do you really recommend that we go down Australia’s or Canada’s path?

    Suicidology is SSRIs. ANTIDEPRESSANTS ARE THE ROOT CAUSE OF MASS SHOOTINGS AND SUICIDES. Here is my article from robertyoho.substack.com: https://robertyoho.substack.com/p/antidepressants-are-the-root-cause?s=w#details

    The following was published in Butchered by “Healthcare,” my 2021 book. The chapter is titled, “PROZAC AND RELATIVES,” and it explores the relationship between SSRIs, suicide, and violent behavior.

    Wendy Dolin learned the hard way about antidepressants. Her husband Stewart threw himself in front of a train a week after he started taking generic Paxil. Mr. Dolin’s doctors gave him the drug for job-related anxiety, but it creates intolerable restlessness in three to five percent of people using it. He was last seen pacing back and forth on the train platform.

    He killed himself despite what his family thought was a perfect life. His two grown children adored him, and he loved his career, travel, skiing, and his work. He was happily married to his high school sweetheart. When Ms. Dolin sued the drug company, testimony established that it had hidden Paxil-related suicides.

    For two decades, while making billions of dollars, the manufacturer had been quietly settling thousands of similar cases. In 2017, Ms. Dolin won a three million dollar judgment. Her attorneys had spent a million dollars, but the company filed an appeal. It claimed that the original manufacturer was not responsible for subsequent generic versions of the medication.

    The following story may be worse. David Carmichael took Paxil for two periods of several months each and felt suicidal each time. His doctor advised him that increasing his dose would decrease his stress. When he did, he went from suicidal to homicidal and killed his 11-year-old son. The circumstances indicted Paxil, and Mr. Carmichael believes it was the cause. Since blaming the drug was impractical for his legal defense, this was not brought forward at his trial. The court acquitted him of murder because he was believed to be temporarily psychotic, which means out of touch with reality.

    SSRIstories.org has about 5000 first-hand news stories about situations like these. The drug companies claim that the drugs are bystanders and that the perpetrators are prone to violence. A half-hour spent on this website makes a compelling circumstantial case that the drugs are the cause.

    I wrote about a thousand Prozac-type SSRI prescriptions over my career, which might have been a half-million dollars in drug sales. I screened my patients, as I was trained, by merely asking them a few questions.

    Peter Kramer’s bestselling Listening to Prozac (1997) duped me. He said Prozac could save patients from common symptoms of guilt, fatigue, sadness, sleep disturbance, and even aches or digestive problems. He also claimed it could be a lifestyle drug similar to today’s Viagra, boosting ordinary peoples’ performance. I learned later that the SSRIs are toxic, have limited utility, and the hype has produced vast overuse.

    Industry marketed SSRIs as an improvement on the older tricyclic antidepressants. These cause sedation, and only a month’s supply is needed for suicide. Part of the promotion of the Prozac-class drugs was that sleepiness is mild and even enormous doses rarely cause fatality.

    Before the drug era, doctors thought depression was rare and most often self-limited to about three months. Now (2020), Wikipedia claims that 17 percent of the US population becomes depressed during their lifetime, making them all candidates for expensive, indefinite medication usage. Legions of paid Wiki contributors, many of whom work for pharmaceutical companies, make this source only a little better than a drug industry link farm.

    A simple checklist is used to diagnose depression. A primary care medical assistant often administrates it. It is a list of nonspecific symptoms from the DSM. Many are opposites.

    DSM criteria for depression:
    ✪ Depressed mood most of the time
    ✪ Lack of pleasure most of the time
    ✪ Significant weight loss or gain, appetite up or down
    ✪ Slow or speeded up thoughts and movements
    ✪ Feeling worthless or guilty most of the time
    ✪ Either fatigue or excess energy
    ✪ Cannot think or concentrate most of the time
    ✪ Thinking of death or suicide with or without a plan
    No physical tests exist to verify the diagnosis. After waiting two weeks, doctors might commit a patient to these drugs for years—or even a lifetime. The industry promotes the disease, the medications, and the casual approach to treatment together.

    “Prozac is not addictive,” according to the package label written by the manufacturer. True, there are no opioid-type withdrawals. However, after discontinuation, severe anxiety and depression are common. Other issues include suicide, feeling “electric shocks,” and tardive dyskinesia (TD), which is often manifest by continuous mouth movements. The drug companies claim most of this is because of the depressed state itself, rather than medication effects. There were many consumer complaints to the Federal Trade Commission about these claims that antidepressants were not addictive.

    When my patients sometimes stopped the SSRI drugs and had symptoms of depression and anxiety, I believed that it was their disease and not the drug withdrawal. I was told that they must use the medications long-term for them to work, so I told everyone to continue. It was bogus information, however.

    The Selective Serotonin Re-uptake Inhibitor (SSRI) name was pseudoscience dreamed up in the marketing department of SmithKline Beecham. The “chemical imbalance in the brain” idea was the brainstorm of a sales copywriter in the 1950s. Knowledge of serotonin and other neurotransmitters was even more sketchy when Prozac was invented than it is now. Today, this seductive but mythical gibberish embarrasses researchers.

    Similarly, “ACE inhibitor” or “angiotensin-converting enzyme” blood pressure medications were gobbledegook names used for branding. Lithium is an old therapy for bipolar illness with no sparkling, pseudo-scientific story associated with it. It is not patented and not a money-maker, so no one will pay a copywriter to invent a marketing idea for it. Note: lithium causes sedation and occasional tardive dyskinesia. It becomes toxic in doses only slightly higher than the therapeutic ones. This can cause permanent brain damage.

    The marketers said depression was like diabetes, and SSRIs were an “insulin” for brain disease. However, no clear relationship between depression and serotonin or other neurotransmitters was ever established, and the drugs all work about the same, with a similar lack of benefit. Jill Moncrieff in The Bitterest Pills (2013) confirmed this:

    No chemical imbalance or other biological process that might explain drug action in a disease-centered way has been substantiated for any psychiatric disorder … Most authorities now admit that there is no evidence that depression is associated with abnormalities of serotonin or noradrenaline, as used to be believed (Dubovsky et al., 2001). There is also little empirical support for the dopamine hypothesis of schizophrenia.

    Ronald Pies, editor-in-chief emeritus of the Psychiatric Times, agreed: “The ‘chemical imbalance’ notion was always a kind of urban legend—never a theory seriously propounded by well-informed psychiatrists… [it was a] myth.”

    Despite this consensus, nearly everyone still believes the metaphor and parrots the message. The idea is 1) your brain is damaged, 2) the drugs fix something, and 3) you need to take medications indefinitely.

    SSRIs cause substantial harm. A 2017 literature review of randomized controlled trials in Frontiers in Psychiatry said these drugs are ineffective and damaging. It linked them to osteoporosis and movement disorders, including akathisia and tardive dyskinesia. They may double the risks of miscarriage and congenital disabilities. But physicians use them off-label for pregnant women and during breastfeeding. Expectant mothers get severe withdrawal symptoms just like anyone else.

    Sexual side effects occur in a range from 2% to 59% in various trials. In some studies, they never asked the patients about the issue. When used for premature ejaculation, about a third of men permanently improved, sometimes after just a few pills or even a single dose. This suggests significant long-term effects that are adverse for most people. Many patients report having long-lasting problems with orgasms after taking and then stopping these drugs.

    In the first nine years of Prozac’s use, between 1988 and 1996, there were 39,000 FDA complaints, a record for any drug. This included reports of suicide, psychosis, abnormal thinking, and sexual dysfunction. Many patients taking the medication have sexual difficulties, are “emotionally numb,” and have “reduced positive feelings.” In October 2004, the FDA introduced a written warning about suicide in children and adolescents treated with SSRIs. The agency extended this in 2006 to include young adults up to age 25.

    Antidepressants are touted as preventing depression in people having medical problems. Prophylaxis is a market for nearly anyone.

    Industry hid SSRI-related suicides and violence. The manufacturers have always claimed suicide was because of the underlying depression and not the drugs. They altogether avoided addressing violence, and the psychiatrists parroted this. Even Dr. Healy believed it before he worked as a plaintiff’s expert in the Stewart Dolin case. So did I. Healy changed his mind after he read the secret corporate documents produced by the defendant corporation during the lawsuit’s discovery process.

    Dr. Healy learned from his review that Lilly concealed suicides. Their executives had written internally that they could “go down the tubes if we lose Prozac,” and that a single big news story could do it. In 1985, a Lilly internal memorandum said that the increased suicides were 5.6 times greater than those associated with imipramine, an older antidepressant. Gøtzsche later evaluated a 2006 FDA meta-analysis of 100,000 patients and estimated that it under-reported suicide by a factor of fifteen.

    SSRIstories.org has thousands of news clips about SSRI violence. Martha Rosenberg summarizes:

    The only thing more shocking than the number of newspaper stories on the site is the number of previously healthy people who committed violence with no precipitating events. Twenty people mentioned here set themselves on fire. Ten bit their victims (including a biter who was sleepwalking, and a woman on Prozac who bit her eighty-seven-year-old mother into critical condition). Three men in their seventies and eighties attacked their wives with hammers. In Midwest City, Oklahoma, a woman accepted a cup of tea from an elderly nurse she’d just met—and then strangled her. A twelve-year-old boy left in his cousin’s car while she shopped at Target killed her five-week-old daughter, who had also been left in the vehicle. All were under the influence of psychoactive drugs. Did events like these ever happen before the psychoactive drug revolution? In one month of reports on the site, a fifty-four-year-old respiratory patient with a breathing tube and an oxygen tank and no previous criminal record held up a bank in Mobile. An enraged man in Australia chased his mailman and threatened to cut his throat… for bringing him junk mail. A fifty-eight-year-old Amarillo man with no criminal history tried to abduct three people and killed an Oklahoma grandmother in the process. A sixty-year-old grandmother in Seattle killed three family members and herself. And fourteen parents drowned their children, a crime no one had heard of before…

    Lilly’s publicity machine tried to claim that Scientologists perpetrated the entire story. They are well-known to hate psychiatry and their reputation is cultish, litigious, and generally unpopular.

    The internal documents obtained at discovery when Lilly was sued revealed that their policy was to settle and seal Prozac cases. By 2000, they had spent about $50 million on these settlements. Other internal records showed that the corporate employees believed this was a “relatively insignificant” cost. If a lawsuit forced them to alter the labeling or withdraw the drug, losses might have been in the billions of dollars.

    Completed suicides are ordinarily 4:1 men to women, but SSRI-related suicides are about the same rate for each sex. A New Zealand study of 1829 people taking SSRIs found suicidal thinking in 39 percent. Healy did a simple one-month project where he gave Prozac to twenty healthy volunteers who had no depression. Two of the twenty had severe suicidal thoughts that slowly went away after stopping the drug. When mild depressives are treated, the primary drug effect could be akathisia, the unbearable agitation. This is the symptom Stewart Dolan experienced.

    Suicides for people between 15 and 64 years old increased by a third during the era when SSRI prescribing took off. The data is from the CDC’s National Center for Health Statistics between 1999 to 2017.

    In Let Them Eat Prozac (2004), David Healy says that we are trusting the pharmaceutical companies just like patients trusted Harold Shipman, a physician who murdered over 200 people using heroin. Healy says that relationships of trust like this make serial killings easy, comparing the drug companies to killers⁠1.

    PROZAC AND RELATIVES CONCLUSION

    The Japanese judge antidepressants as harshly as they judge the stimulants, if that is possible. Their public health system is at least as good as ours. Taking these drugs into Japan is illegal. You can go to jail if their customs agents find Prozac in your luggage. To avoid this, you must petition them to bring your supply in with you.

    Japanese studies of the SSRIs versus the older antidepressants found a negligible difference, just like the Western studies. They have allowed only a few drugs of this type into their country.

    German regulators did not believe Prozac was worthwhile at first. Their FDA-type agency looked at the evidence during its original approval process. They said, “Considering the benefit and the risk, we think [this drug is] totally unsuitable for the treatment of depression.” They noted the patients’ self-ratings in the studies showed the drug did not work. This was contrary to those of the doctors,’ whose evaluations claimed it did⁠2. Germany later capitulated to the drug companies and allowed Prozac into their country. However, they required a stern warning on the product labeling about issues in the first weeks of therapy and the potential need for accompanying sedatives.

    Summary: SSRIs may help for severe depression, but only for a brief time. If your depression puts you in bed full time for months and you can barely resist killing yourself, you may want to risk the drugs. If you do, you must accept the risk that the medications themselves will enable you to get up and commit suicide or harm others. For moderate depression, the drugs work poorly or not at all. For mild depression, which is their current primary use, these medications are ineffective.

    The casual prescription of SSRIs is unconscionable. Allowing the pharmaceutical publicity machine to promote them for brief adjustment disorders, mild sleep problems, and even grief reactions is a travesty. I wish I could say that awareness of this situation has percolated through psychiatrists and primary care physicians. Unfortunately, industry propaganda has overwhelmed all the other narratives. In some years, SSRIs have been the most prescribed drugs, even ahead of blood pressure medications. Between 1996 and 2005, US antidepressant usage rose from 5.8 percent to 10 percent of the population, and by 2017, it was 12.7 percent.

    1 For much more about this violence than most readers can stomach, see Deadly Psychiatry and Organized Denial (2015) by Peter Gøtzsche.

    2 May 25th, 1984 communication to Lilly US from Lilly Bad Homburg

    • I was in the prozac drug trial. I felt so fantastic on it that it was a miracle to me. Many months later, still on it, I had a row with someone and promptly took an overdose of prozac. I was in hospital with grand mal seizures and oxygen tanks. The next morning a man in a suit was flown to the hospital to take blood from me. I recall it was all thrillingly shifty as the porters wheeled me off down ever labyrinthine corridors to a half built eerie basement of the hospital. A small room was there. I was laid on a table like an Area 51 manniquin and out of a black brief case with foam lining the drug rep waved two huge syringes, big enough to siphon off a horse’s quart of blood. It was all a bit Steven King novel. Off he flew back to the lab at Eli Lilly. I recall naively writing a little postcard asking what they found out about my blood since I had been getting head zap sensations no one had ever heard of. They all thought I was being neurotic. A formal reply closed all enquiry. I got on with life. I knew the pills were risky but a few months later I asked to go back on them….because the initial benefit was not me being neurotic. The pills can lift mood. People do clamour to go back on them. But that does not mean that these days I think anyone should imbibe such pills. They are too risky. But when young and suicidal you don’t really care if a party drug will usher you to the hereafter so you probably wouldn’t care if a prescribed pill did. It is easy to be moral about these things but this can obscure the equally important need to get to the bottom of why people just don’t care if they live or die. Why are people not each others anti depressant. My guess is it is because we have become to moral to tolerate each individual’s uniqueness of despair. We are totalitarian in only listening to approved models of despair that have research backing. We need to listen to those who choose to be on the drugs and not just those who choose to be off drugs. We need to listen to the supposedly “dirty” not just the supposedly “clean”. Telling addicts to quit can come across as a failure to hear.

      But above all we need to be politely educating people about the alternatives….polite because for some young and desperate tonight there aren’t any.

    • I will reitterate that even though I KNEW that prozac was flagged up as what possibly tipped me into overdose, for many years after that I went back to scrounge more. I did not deny the evidence of how risky such pills were to me. Nor does a heroin addict. Something “more” than sneering at needles needs to occur to a heroin addict before they themselves give up poppies. They are the ones who deal to children knowing the hazards, not Big Pharma. Yes, rattle the cage of the industry. But eveyone I know already knows the pills are bad, yet I have never had AnY success in helping ANY of the people I know on such pills to come off them. I am an articulate persuasive person yet I have NEVER managed to help anyone to read the data. Despite sending many MIA articles.

      Dunno tho…maybe I shall try this one on someone on fentanyl patches.

      I fear that “logic” may not inspire them much in a world with an abiding sense of runaway climate change hopelessness.

      Like Freddie Mercury sang…

      “Who wants to live forever”.

      When people understand why that song is so haunting to the lost THEN people might be able to flutter more than stacks of research at the broken and bewildered.

      I have a friend on SSRIs. For years I have been guiding him to wean off pills he is loathe to take but he CANNOT bear to endure the withdrawals because he has heard horror stories of people who tried to. I keep telling him there is nothing to fear but at some point I realized he has memory deficits from aging and we went round and round in circles as he kept forgetting my encouragement to keep titrating down. He is marooned on pills that are almost the demise of him but like a heroin addict he cannot bring himself to learn science “lessons” from data. So what do we do with him? Confiscate his pills and plummet him into possibly suicidal withdrawal fenzy or leave him differently suicidal on his failing drug? He is stuck between two kinds of suicide. There is no way he can bear either path.

      HE CANNOT BEAR the suicidal prospect of staying on pills or suicidal prospect of coming off them.

      HE CANNOT.

      Everyone likes the excitement of being a sleuth to the machinations of systems. No one wants to hand a tissue to a snot wiping desperate suicidal pill addict.

      I am weary of research, research, research. How long does the list of harms have to be before someone rolls up their sleeves and builds a FIELD HOSPITAL for the stricken? A war kicks off in a desert and suddenly there are so many NGO tents helping to wean people off what is breaking them that the reflection of canvas is enough to reflect back the heating from climate change.

      So what is stopping people? I want to be reading WHY field hospitals are NOT being set up in tandem to data?

      It has reminisences to the difference in theology between orthodoxy and orthopraxis. In other words the way Christainity might do all fine rhetoric or talk versus practical deployment of actual baby caring healing.

      He CANNOT bear staying on his pills or withdrawing. He is sandwiched between a rock and and a hard place. Not a lovely sunny field hospital. A stone cold vault or cist into which there is no light for him to read the research. He CANNOT BEAR IT…
      EITHER DIRECTION.

  2. One of the things in the article that I immediately noticed was that these companies make no effort to explore their patients’ experiential worlds in some detail, which would eliminate or reduce much of this nonsense caused when their pet drugs are mistakenly used, causing their patients to go bananas.
    But then I noticed these companies are only interested in their bottom lines, where one drug failure can be “corrected” by using another (company manufactured) drug, thereby generating more profit.
    Viva pharmacotherapy!

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