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 “This is the first large-scale study of prescription drug use at the
roadside. It gives us direction if we want to improve our knowledge
of how to better prescribe and dispense prescription drugs,” said
lead study author Robin Pollini, associate director of the West
Virginia University School of Public Health’s Injury Control
Research Center in Morgantown.
“The interesting thing about this finding is how many of these
people got some sort of warning about how their medicine could
impair them, but they were still on the road,” said James Hedlund,
an independent safety consultant with Highway Safety North in
Ithaca, New York, who was not involved in the research.
“The big take away from this study is that physicians and
pharmacists have to do a better job talking with patients about how
any drug can impair a driver’s abilities,” Hedlund, a former
National Highway Traffic Safety Administration (NHTSA) official,
told Reuters Health in a phone interview.
As reported online October 31 in the Journal of Studies on Alcohol
and Drugs, Pollini’s team analyzed data from the latest National
Roadside Survey of Alcohol and Drug Use, 2013-2014, in which random
drivers across 60 sites were asked about prescription drug use
within the past 48 hours.
Nearly 20% of the 7,405 drivers who completed that part of the
survey had used potentially dangerous medications, including
sedatives, narcotics, antidepressants and stimulants - all of which
can impair a person’s thinking and judgment - sometime in the past
two days.
Among the drivers who answered the drug question, 8% had taken
sedatives like Valium (diazepam), Xanax (alprazolam), Ambien (zolpidem)
and Lunesta (eszopiclone), and 7.7% had taken antidepressants like
Prozac (fluoxetine), Zoloft (sertraline) and Wellbutrin (bupropion).
Narcotics like methadone, codeine, Vicodin (acetaminophen and
hydrocodone) and similar prescription pain killers had been taken by
7.5%, and 3.9% had used stimulants like the ADHD medications Ritalin
(methylphenidate) and Aderall (amphetamine).
Among those who used sedatives or narcotics, 85% said they received
a warning from their healthcare provider or the medication label
about possible impairment. However, just 63% of drivers using
antidepressants and 58% of those using stimulants reported receiving
warnings about their risk.
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Asked if these drugs were potentially dangerous, study participants
thought sleep aids, followed by morphine/ codeine, most amphetamines
and muscle relaxants were safe to take while driving. They thought
use of ADHD medications was likely to cause a crash or result in
legal ramifications, however.
Men were less likely than women to say they'd been warned about
sedatives, researchers found. Night-time drivers were less likely
than daytime drivers to report warnings about antidepressants and
narcotics. Overall, black drivers were much more likely than
non-Hispanic white drivers to report being warned about the risks of
a prescription drug.
In an accompanying commentary. Dr. Benedikt Fischer of the Center
for Addiction and Mental Health in Toronto notes that “prescription
medications are considered therapeutic and thus seen as shielded
from causing risk to individuals or society.” But this thinking is
“misguided,” he writes, since many drugs have the potential to cause
injury and mortality.
Driving while on prescription or illicit drugs has become
increasingly common, whereas driving while intoxicated has declined
more than three quarters since 1973, according to the NHTSA survey.
Drugs were detected more frequently than alcohol among fatally
injured drivers in 2015, according to a report this year from the
Governors Highway Safety Association, a non-profit organization of
state highway safety offices. Forty-three percent of fatally injured
drivers tested positive for drugs.
Pollini told Reuters Health in a phone interview that she hopes her
research will remind physicians and pharmacists to have in-depth
talks with their patients about the potential risks of medications.
The U.S. should also take “solid steps” to improve warning label
practices, she said, adding that many European countries have
introduced color codes to drug labeling to increase patient safety.
SOURCES: http://bit.ly/2iqyA5B and http://bit.ly/2iU6CmC
J Stud Alcohol and Drugs 2017.
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