In the wake of the mass shooting in Las Vegas, gun control advocates are renewing calls for tightening regulation on firearms.
If the story sounds familiar, it's because a similar dynamic has played out time and time again in recent years, after every new gut-wrenching incident of gun violence makes headlines.
On the federal level, at least, the interest and attention in new legislation has led to almost no action in decades, despite numerous polls showing widespread public support for measures like strengthened background checks and banning certain types of high-capacity gun magazines and military-style assault rifles.
With such a high death toll this time, perhaps the pressure for change will be greater. Here are five big obstacles that stand in the way.
The National Rifle Association is one of the most influential interest groups in US politics - not just because of the money it spends on lobbying politicians, but also because of the engagement of its 5 million members.
It opposes most proposals to strengthen firearm regulations and is behind efforts at both the federal and state levels to roll back many existing restrictions on gun ownership.
In 2016 the NRA spent $4m on lobbying and direct contributions to politicians as well as more than $50m on political advocacy, including an estimated $30m to help elect Donald Trump president.
Its overall annual budget is roughly $250m, allocated to educational programmes, gun facilities, membership events, sponsorships, legal advocacy and related efforts.
More than just the numbers, however, the NRA has developed a reputation in Washington as a political force that can make or break even the strongest politicians.
It grades politicians on their votes and directs its resources and those of its membership - both financial and organisational - to supporting its fiercest advocates and defeating staunch opponents.
As one former Republican congressman told the New York Times in 2013: "That was the one group where I said, 'As long as I'm in office, I'm not bucking the NRA.'"
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