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The U.S. is the only country that has “more guns than people.” With “120 guns for every 100 Americans,” the U.S. massively overtakes the rest of the world. Some people see gun ownership as a core part of the American identity, but others see it as the country’s greatest threat. As a result, gun freedoms and restrictions are a divisive subject in the lead-up to the 2024 elections.
News coverage of the gun control debate has split along party lines, with the Democratic-leaning Washington Post stressing the need for stricter gun control and Republican Fox News celebrating the fact that the U.S. became a “constitutional carry majority” country in 2023. Constitutional carry means that, besides the legal framework, no other qualifications can prevent someone from owning a gun. A recent surge in additional states becoming constitutional carry states has happened following a June 2022 Supreme Court decision, which recognized the right to “carry a handgun in public.”
As guns become more and more widespread, so do their dangers. The pandemic had a huge effect on gun violence, which peaked in 2021 as more than 21,000 people died of gun-related injuries (this number excludes suicides, which account for more than half of gun deaths in the U.S.). Additionally, roughly twice as many people sustain non-fatal injuries from gun violence. These numbers have decreased slightly since then but remain significantly higher than pre-pandemic levels. Additionally, gun violence survivors are still largely overlooked in the discussion about gun control.
One of the primary reasons that gun violence survivors are left out of the conversation is due to the lack of a nationwide database. Organizations like Everytown and Gun Violence Archive have attempted to bridge this gap by collecting data from different sources. In 2021, an estimated 36,357 people were admitted for gun-related injuries, changing their lives forever.
The Economic Burden
Gun violence has a strong connection to poverty, meaning that people in poorer communities are more likely to be victims. This correlation also means the medical bills related to these injuries will hit them harder. An average emergency room visit for a gun-related injury costs around $1,500. If the hospital accepts the victim as an inpatient, the price shoots up to $31,000, which is roughly triple the average patient cost for other complaints — enough to bankrupt survivors and their families. In 2021, the Government Accountability Office (GOA) reported “51,000 emergency room visits” and “33,000 inpatient stays” due to gun injuries, which came out to around $1 billion in initial costs.
The costs, however, do not stop there. Care for gunshot victims is often considerable and long-lasting since proper pain management and mental health treatment plans are crucial to recovery. The costs usually peak a month after the incident, at $25,000 per patient in “medical spending.” The average medical cost for the first year of treatment is $35,000, roughly “17 times higher” than the average annual medical costs victims would have paid before the incident.
Insurance coverage also presents additional complications for the entire country. For Americans with private or employer-covered insurance, their deductibles and copays may go up by “an average of $102 per month” after the incident. However, many victims cannot afford private insurance; they instead rely on state-funded programs to cover their medical bills.
In New York City alone, only two health insurance programs covered 70% of gun-related medical costs since 2010: Medicare and Medicaid. These tax-payer-funded insurance programs aim to help those unable to cover their medical costs. Without these programs, most survivors of gun violence would have to pay their medical bills out of pocket, which could lead to financial ruin. However, due to the public nature of these programs, each of these gun injuries costs taxpayers more than $25,000. As a result, the lack of gun restrictions not only has a devastating human cost but also places a heavy financial burden on taxpayers.
The Problem of Long-Term Care
The violent nature of gunshot injuries often leads to psychological trauma and chronic pain. According to a Health Affairs study that tracked the recovery of young gunshot victims, young survivors had “a 117% increase in pain disorders” and “a 68% increase in psychiatric disorders” compared to those unharmed.
Managing pain and mental health issues can be very expensive. Because of their public nature, the rates Medicaid and Medicare programs have to pay hospitals are much lower than commercial rates. As a result, hospitals often go for the least expensive course of treatment for patients who use these programs to avoid collecting unprofitable costs. Furthermore, COVID-19 federal relief bills were cut by the U.S. government, placing more of Medicaid’s financial burden on the states. This shift in funding comes when states are seeing their tax revenues drop in the aftermath of COVID-19.
Given the limited insurance coverage, many of the victims have a lot of their healthcare done through the prescription of drugs instead of corrective procedures or physical therapy. However, many of these drugs are very addictive, and the trauma most gunshot victims have endured places them at an even higher risk of developing substance abuse issues. Gunshot victims “become addicted to various drugs at more than double the rate of those that do not experience gun violence”, with most of them addicted to alcohol, marijuana, or opiates.
How Gun Violence Contributes to the Opioid Crisis
The American Opioid Crisis further complicates the path to recovery. Though some courts disagree on the cause of the crisis, many accredit it to the widespread over-prescription of highly addictive painkillers. When the medical industry doubled back and no longer prescribed these drugs, thousands of Americans were left addicted but no longer able to obtain clinical-grade opioids. As a result, many turned to the streets to meet their needs, leading to a rise in heroin addictions and overdoses.
To make matters worse, the presence of fentanyl, a powerful and inexpensive drug used to cut other drugs, has steadily increased since 2014. The addition of fentanyl to the market has led to a rise in overdoses because heroin users may know what their limit is when only taking heroin, but that dose changes drastically once the heroin has fentanyl in it. Although naloxone — the medication used to reverse an opioid overdose — and fentanyl test strips are available, they are challenging to access. Sadly, there are nationwide naloxone shortages, leaving many victims without life-saving medication.
For gun violence victims battling both physical and psychological pain, these conditions put them at even more risk. Medicaid receivers, which gun violence victims often are, are prescribed painkillers at a higher rate than privately insured patients to avoid the costs of more invasive procedures. The high rate of prescription puts gun violence victims at a higher risk of becoming dependent on these painkillers, which often results in them turning to street drugs when their habit exceeds their prescription.
This is what happened to Austin Eubanks, a survivor of the Columbine school shooting in 1999. He was prescribed opioids to manage the pain of his injuries but became addicted to the relief they offered him emotionally as well. Once his doctors stopped prescribing the medication he needed, he moved on to other drugs, leading to a decades-long downward spiral that had him arrested multiple times and in and out of rehab facilities.
Eubanks later became a motivational speaker regarding the link between the opioid and gun crises. Unfortunately, he died of an overdose in 2019. His death, like so many others, is not counted as gun-related. Since 1999, more than 350,000 children have experienced gun violence at school, and the consequences of these tragedies on survivors remain largely unrecorded.
Violence Brings About More Violence
Gun violence trauma is one of the strongest predictors of future gun violence. This relation is in part due to the traumatic effect violence has, which can numb victims to its dangers, and make them more likely to do acts of gun violence in the future. It also is a matter of structural instability. Those affected by gun violence disproportionately come from marginalized groups — mainly Black and Latino men — in under-resourced neighbourhoods. These neighbourhoods have higher rates of unemployment, poverty, and police brutality. As a result, people often resort to informal channels of justice, such as retaliation and revenge, to solve their problems, meaning that those shot are likely to commit gun violence themselves. This phenomenon is an example of the intersection between race, infrastructure — or lack thereof — and violence.
In addition to the direct link between gun violence and future violence, addiction can also lead to a more violent, gun-involved life, especially for opioid addicts. Not only do they run the risk of overdose and infection, but they are also at risk of gun-related violence. According to a study published in the journal Drug and Alcohol Dependence, “more than half of opioid users [surveyed were] present when shots fired,” and “about one-third (…) owned a gun, carried a gun or had been shot at.” Compared to those who heavily consume alcohol, opioid users are “12 times more likely to carry a gun for protection.”
Gun violence is widespread across the U.S., with tragic and often fatal consequences. Even for those who survive the incident, gun violence has ongoing harsh and invisible effects on those it victimizes. It places significant financial stress on survivors and their families, who often already are grappling with economic instability, and opens the door to addiction and future violence. For as long as survivors are not in the equation, the true cost of gun violence will remain underestimated. This neglect is harmful to all American citizens but hurts those already marginalized most of all.
Edited by Melanie Miles
