Firearm violence victimization in the United States: do drug preferences matter?

Objective: This study examined whether primary drug of choice is associated with risk of being injured or threatened by a gun. Methods: The sample included 401 Medicaid-eligible adults receiving addiction treatment services in the Midwest United States who completed life-course history surveys between 2021 and 2023 as part of the Removing Barriers to Recovery randomized controlled trial. Bivariate and multivariate analyses were conducted. Results: Bivariate analyses showed marginally and statistically significant differences in firearm victimization risk between individuals identifying alcohol as their primary drug of choice and those identifying cocaine, heroin/opioids, or crystal meth. Individuals identifying marijuana as their primary drug of choice had the lowest risk of gun victimization. Differences in drug use behaviors, demographics, family history, housing insecurity, behavioral health history, and criminality helped explain variation in firearm victimization across substances. Conclusions: Firearm victimization was common among people receiving addiction treatment, though less frequent among those preferring marijuana. Risk did not differ significantly by race or ethnicity. More than 40% of participants reported gun victimization, underscoring firearm violence as a major public health concern for this population and by association, their families.