Australian Prescriber, Dec/19: "Psychoactive drugs and driving"

SUMMARY

Any drug or substance with effects on the central nervous system can impair the ability to drive safely.

When prescribing, consider the effects of each drug on driving as well as the use of other substances. Advise the patient of the risks.

Opioids, benzodiazepines, anticonvulsants, antipsychotics and sedating antidepressants increase the risk of crashing.

Erratic use of sedatives causes a higher level of impairment than stable regimens.Patients who have complex medical conditions and take multiple drugs should undergo a fitness-to-drive assessment.

Introduction

Any psychoactive substance acting on the central nervous system can impair driving skills. These substances may be prescribed drugs, alcohol or substances of misuse. Alcohol, cannabis, opioids, stimulants and sedating drugs, such as benzodiazepines, are the substances of greatest concern in road safety.

While alcohol use has been declining, there has been an increase in the detection of other impairing substances in drivers. Misuse of prescription drugs is a concern, especially in relation to deaths from opioid use. Drugs affecting the ability to drive safely that have an increasing profile in motor vehicle collisions include pregabalin and gabapentin. Gabapentinoids may be being misused for their euphoric and dissociative effects.1,2

In Victoria, prescription drugs were involved in approximately 21% of fatal road collisions from 2007–2013. The prevalence varies in other states and territories depending on jurisdictional practice and data collection.

Full Text:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6954869/pdf/austprescr-42-182.pdf