Opioids and Driving

Opioids and driving

New drug driving legislation came in to force in England and Wales in 2015
 

• It remains illegal in England and Wales to drive when taking prescription medicines if the medication impairs a patient’s ability to drive

• The new offence refers to driving with a specified controlled drug in the body, in excess of a specified limit

• The drugs include licensed medicines, including morphine and methadone but not other opioids. The specified limits are generally above the normal therapeutic range so most patients prescribed these drugs are unlikely to be driving with a concentration of a specified drug in their body above the specified limit.

• The new offence has a statutory “medical defence” to protect patients who may test positive for certain specified drugs taken in accordance with the advice of a healthcare professional or the patient information leaflet that accompanies the medicine

• It remains the responsibility of all drivers, including patients, to consider whether they believe their driving may be impaired on every occasion when they drive

• Drivers who tested positive for morphine were between 8 and 32 times more likely to be injured or responsible for a road traffic collision compared with those who did not have a positive test result.

• A patient on high dose morphine (around 200mg/24hours) could be as impaired as someone with blood alcohol around the level above which it is illegal to drive.

• A patient also drinking or taking other sedative drugs could be impaired at a lower morphine dose.

• Patients should be aware that during the period following dose adjustment (up or down) they may be particularly vulnerable to impairment.

• Prescribers of opioid medicines must be aware of the likely impairing effects of the drugs and must advise patients accordingly.

• Although this legislation will particularly impact on patients taking morphine, prescribers should be aware that equi-analgesic doses of other opioids are likely to be equivalently impairing.

• Prescribers should also advise patients of the potentially distracting effects of pain, and other co-morbidities such as fatigue and poor sleep in relation to driving.

• Discussions in relation to drugs and driving must be clearly documented in the medical notes and a copy given to the patient.

Further Reading

• Department for Transport. Guidance for healthcare professionals on drug driving. 2014