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7 TFAH • WBT • PaininTheNation.org 2. Reduce access to lethal suicide means As a suicide prevention measure, healthcare systems can also encourage their providers to counsel patients to safely store both firearms and medications. A proven successful method is the Counseling on Access to Lethal Means (CALM) approach. One study of this intervention at Children's Hospital Colorado found that parents of children being treated for suicide risk who were educated about safe storage of medications and guns made significant changes in their behavior. In follow-up interviews, 76 percent of parents who had been counseled about safe storage reported that all medications were now locked up (compared to 10 percent before counseling) and 100 percent of those with guns reported their guns were now locked up (an increase from 67 percent). 42 In recent years, there have been efforts in a number of states to pass legislation prohibiting doctors from counseling their patients about safe gun storage, and Florida became the first state to pass such a law in 2011. 43 However, a federal court in 2017 struck down the bulk of the Florida law as a violation of the First Amendment. 44 While three other states—Minnesota, Missouri and Montana—have legal restrictions related to health providers collecting firearm information, none of them explicitly prevent clinicians from counseling patients about safe gun storage. 45 Medication "take back" programs can help prevent drug misuse by reducing the number of unused medications available in homes and institutions. Given that a majority (53 percent) of people who misuse prescription drugs get them from friends and family, 46 these can serve as important prevention efforts. Some healthcare systems have installed drop boxes in hospitals and pharmacies where patients can deposit medication. Another strategy is to supply patients with safety bags along with their medications where they can seal unused medicines and dispose of them in the regular garbage. 47 Reported effectiveness of counseling regarding the safe storage of medications and guns on parents. Before Counseling After Counseling All Medications are Locked up 10% 76% 67% 100% Before Counseling After Counseling All Guns are Locked up

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