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Gaba: The opioid epidemic and gun violence

I am grateful that the American Medical Association is taking a leading role in dealing with the opioid crisis. We as physicians are part of the problem, and today should be part of the solution. Through collaborative efforts between physicians and pharmacies we can now better track opioid consumption in our communities. When communities suffer—be it from an opioid crisis, heart disease or cancer—physicians are working at the forefront of national efforts to decrease mortality. In 2016, approximately 42,000 deaths in the United States were the result of opioid use. Breast cancer takes approximately 40,000 lives annually. The flu takes about 40,000. The number of deaths caused by gun violence in our country hovers around 35,000 per year.

These statistics matter.

The president has declared the opioid crisis a national emergency. We encourage women to get mammograms regularly, and spend over $3 billion annually in our efforts to treat and cure the disease. Millions more are spent to administer flu vaccines and research the latest strains to ensure that deaths are minimized.

How are we doing with our efforts to decrease mortality from gun violence? Like with all issues of public health, we need to know what systematic interventions will prove most effective, but this requires research. Funding for this research, however, is nearly non-existent. In 1996, by way of the Dickey Amendment and heavy lobbying from the National Rifle Association, Congress banned the Center for Disease Control from using funds for any research that may ultimately be used to promote gun control. Moreover, we are still paying the price.

Physicians should care. Our country should care.

Why do we fall silent when it comes to death from gun violence? Only if we, as responsible citizens, can begin to acknowledge that deaths from guns are a problem, can we begin efforts to prevent these needless deaths.

We cannot blame all deaths from gun violence as a product of mental illness. This has become a defense for inaction, a gross simplification of a multifaceted epidemic. There will always be those who seek to harm, and use whatever means possible to achieve that goal. However, guns make it a whole lot easier. Guns do not just wound people and hurt them; they kill right away. There is no second chance, those lives cannot be returned, be it a suicide or homicide. The argument is often brought up that if not for guns, the killer would have used knives, but knives do not take life as a gun can.

The U.S. is the only developed country where mass shootings continue—not once in 10 years, but every few months--and that frequency is only increasing. When the shooter is a Muslim or an immigrant, our current president immediately announces immigration restriction policies and extreme vetting. What does he do when the shooter is a white male? He relegates the tragedy to an "act of pure evil," and ensures that "our prayers are with the victims." Life moves on, and little changes. What are we as a country to do about deaths from gun violence? Is this the price of our freedom? Is this the price we pay so that a minority of the U.S. population can blatantly amass weapons of murder in the name of the Second Amendment? What about the rights of the majority as granted to them in the Declaration of Independence- the right to life, liberty and pursuit of happiness, particularly for those who have been victims of this needless violence?

I am not arguing against the Second Amendment. However, in any society, every right comes with a responsibility. Physicians have earned the right to prescribe opioids, and they along with pharmacists and pharmaceutical companies, have a responsibility to ensure that the opioids are used safely and stay out of the wrong hands. Similarly, it is the responsibility of gun manufacturers, gun salespersons and gun owners to take the lead in promoting responsible gun ownership, and at the very least, support research and efforts to decrease deaths from gun violence.

Gaba is a medical oncologist practicing in Fargo.

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