At AffirmHealth we have focused extensively on covering our nation's drug crisis -- it’s impact on patients, physicians and their practices. We have studied the changing laws and dynamics around how practitioners prescribe and the resulting effect on patients. Today we are taking the discussion to the open road, a topic that has been covered by many a country and western ballad and is part of the American way of life.
We have widely reported on the leading cause of unintentional deaths in the United States--drug overdose. Second on that list, however, is motor vehicle crashes. The dangers of driving while under the influence of alcohol or while distracted have been clearly demonstrated, but what about driving under the influence of drugs--specifically prescription opioids.
Drug-Impaired Driving vs. Alcohol-Impaired Driving
The prevalence of prescription opioids detected in fatally injured drivers has increased markedly in the past 2 years in the US. 1 Currently, it's unclear whether driver use of opioids plays a role in the cause of a fatal crash because drug-impaired driving is notably more complex than alcohol-impaired driving:
- hundreds of drugs can impair drivers
- some drugs are illegal, some are legal, and some can be obtained over-the-counter
- drug effects on drivers is subjective
- insufficient data
- drug impairment is harder to detect
- laws differ from state to state
However, as the drug misuse & overdose crisis has gripped the US, more attention and resources have focused on better understanding drug-impaired driving.
Opioid Use + Driving = 2x Risk of Fatal Crash
Last week, a JAMA Network study assessing the association between driver use of prescription opioids and the risk of being culpable of crash initiation in fatal 2-vehicle crashes was released. The study found that the use of prescription opioids, independent of alcohol use, is increasingly implicated as a contributory cause in fatal motor vehicle crashes. The study included 36 ,642 drivers involved in 18 ,321 fatal 2-vehicle crashes.
“When an individual takes an opioid and gets behind the wheel, their driving behavior is inevitably less safe. In fact, the study showed that use of prescription opioids more than doubled the risk of causing a fatal two-car crash.”
- Study author, Dr. Guohua Li
What can be done?
Clinicians must take into consideration the adverse effects of opioid analgesics on driving safety when prescribing these medications and counseling patients. The potential risk of driving when taking prescribed controlled substances is similar like to the risk of addiction or misuse. Much like those topics, the communication between physician and patient is critical and must be individualized for each patient. AffirmHealth partners with clinicians to help navigate the complex path of patient-centered pain management.
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2. Image: https://www.ghsa.org/sites/default/files/publications/files/DruggedDriving2017_Infographics_R3_1.jpg