Can Patients Receiving Opioid Maintenance Therapy Safely Drive? A Systematic Review of Epidemiological and Experimental Studies on Driving Ability With a Focus on Concomitant Methadone or Buprenorphine Administration

This article reports on a study undertaken to perform a systematic review of the present scientific literature on the treatment with methadone or buprenorphine related to traffic accident risk in epidemiological studies and their effects on cognitive and psychomotor functions of relevance to driving in experimental studies. Searches for corresponding literature were conducted in MEDLINE, EMBASE, and PsycINFO throughout March and June of 2010. The search strategy consisted of words colligated to accident risk and culpability, in addition to cognitive and psychomotor functions of relevance to driving, all in relation to methadone or buprenorphine administration. In total, 59 studies were included. Early epidemiological studies found no substantial difference in motor vehicle accident risk between methadone maintenance therapy patients (MMPs) and control groups. However, more recent studies have found an increased risk of traffic accident involvement for both MMPs and buprenorphine maintenance therapy patients (BMPs). In experimental studies, impairments of cognitive and psychomotor functions have been observed among both MMPs and BMPs when compared to control groups. When comparing MMPs with BMPs, the latter appeared to be less impaired than MMPs, but this difference may be unrelated to the maintenance therapy. Further impairments have been observed among MMPs after single doses, after an additional versus regular daily dosing, in multiple versus single dosing, and after long-term treatment compared to baseline levels. All studies showed impairments among opioid-naïve subjects after the administration of a comparatively low and single dose of either methadone or buprenorphine. The authors conclude that both methadone and buprenorphine have impairing potentials in opioid-naïve subjects. At least some opioid maintenance therapy patients are observed having only slight impairments of relevance to driving. Knowing this when approaching the question of ability to drive, an individual evaluation of the driving performance, pertaining to the opioid maintained patient, may be the most useful and conclusive procedure.

• Record URL:
  https://doi.org/10.1080/15389588.2012.689451
• Availability:
  • Find a library where document is available. Order URL: http://worldcat.org/oclc/49192340
• Supplemental Notes:
  • Abstract reprinted with permission of Taylor & Francis.
• Authors:
  • Strand, Maren Cecilie
  • Fjeld, Bente
  • Arnestad, Marianne
  • Morland, Jorg
• Publication Date: 2013-1

Language

• English

Media Info

• Media Type: Web
• Features: Figures; References; Tables;
• Pagination: pp 26-38
• Serial:
  • Traffic Injury Prevention
  • Volume: 14
  • Issue Number: 1
  • Publisher: Taylor & Francis
  • ISSN: 1538-9588
  • Serial URL: http://www.tandf.co.uk/journals/titles/15389588.html

Subject/Index Terms

• TRT Terms: Automobile drivers; Automobile driving; Cognitive impairment; Drug effects; Drug use; Drugged drivers; Highway safety; Human factors in crashes; Medication; Psychotropic agents; Risk assessment
• Uncontrolled Terms: Buprenorphine; Methadone
• Subject Areas: Highways; Safety and Human Factors; I83: Accidents and the Human Factor;

Filing Info

• Accession Number: 01502660
• Record Type: Publication
• Files: TRIS
• Created Date: Dec 30 2013 11:05AM