Has your physician or pharmacist ever told you not to drive a car while taking a medication? About the only time patients are warned not to drive is after a medical procedure that requires anesthesia or a powerful pain drug. But driving while taking medicine can often be surprisingly dangerous. Most people are unaware that the pills they take routinely could be slowing reaction time, interfering with judgment or making them hazardous behind the wheel.
Do Health Professionals Know Which Drugs Are Dangerous?
Is your physician or your pharmacist aware of which medications might make you a hazard on the highway? Would they prepare you adequately if they did know? If you were told that driving while take medicine makes you dangerous to yourself and others, would you pay attention?
Research published in the Journal of Studies on Alcohol and Drugs (Nov. 2017) reveals that many health professionals are unaware how many different kinds of drugs can have a negative impact on driving.
The authors warn:
“These findings suggest an urgent need for health care providers to fully understand the driving-related risks of the medications they prescribe and effectively relay these risks to individual patients. These interventions are crucial from both a health and safety perspective and a criminal justice perspective.
“Unfortunately, there is little information on the extent to which U.S. drivers receive medication-related impairment warnings from providers. Perhaps the only study to date, limited to adults 55 years and older, found that fewer than one in four of those taking potentially impairing medications received a provider warning and less than half had any awareness that their medications might impair driving.”
What Causes Accidents?
There are more than 5 million car crashes in the US each year. Over 40,000 people die as a result.
The blame for these accidents is usually placed on drunk driving, speeding, drowsy or distracted driving or failure to use seatbelts. One factor that is rarely mentioned, though, is the use of drugs. We’re not referring to illicit or recreational drugs, but rather prescribed medications.
Scientists in St. Louis, MO, recruited nearly 200 individuals over 65 from the Knight Alzheimer’s Disease Research Center (JAMA Network Open, Sept. 29, 2023). These volunteers took vision and cognitive tests every year to ensure that they were cognitively healthy and could see well. They also took annual driving tests with a professional driving instructor in the passenger seat to evaluate their performance over a 12-mile in-traffic route.
The investigators wanted to know whether common medications would be associated with failure to pass the driving exam. Indeed, they found that people taking any of several categories of medicines were more likely to fail.
Driving While Taking Medicine Can Be Dangerous!
Antidepressants:
One category of medicines included antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). Millions of people take drugs such as citalopram, duloxetine, desvenlafaxine, escitalopram, fluoxetine, paroxetine, sertraline or venlafaxine. Such medications may cause sleep problems, dizziness, fatigue, headache and agitation. Antidepressants can also interact with other drugs.
We doubt that many physicians or pharmacists warn patients about the dangers of driving while taking antidepressants.
Anti-Anxiety Agents:
It’s not surprising that the researchers found sedatives and hypnotics such as benzodiazepines were linked to poor performance on driving tests.
The authors of the research point out that:
“…benzodiazepines (including hypnotics) use may cause sedation, impaired motor coordination, and drowsiness, and this can impair drivers’ ability to focus and react quickly to changes in the environment, such as other vehicles, pedestrians, or traffic signals.”
People who take alprazolam, clonazepam, clorazepate, diazepam or lorazepam may not be told by the prescriber or dispenser not to drive. And even if they were told that driving while taking medicine for anxiety could be dangerous, many people might ignore the warning.
Driving While Taking Medicine for Pain:
Most people who are put on powerful opioid pain meds like hydrocodone or oxycodone are warned about driving dangers. But here is something most people are never warned about! The study in JAMA Network Open, Sept. 29, 2023 produced surprising results for pain relievers such as NSAIDs or acetaminophen.
The authors of the study noted that NSAIDs:
“…have several adverse effects, including dizziness or lightheadedness, drowsiness, vision impairments, and difficulty concentrating, that can affect driving ability. This may explain the negative association observed between NSAID use and performance on the road test. Long-term use of NSAIDs by older patients is common and could result in drug-drug interactions that exacerbate existing medical conditions known to contribute to driving impairment, such as hypertension and heart failure.”
Tens of millions of people take NSAIDs daily for arthritis pain, athletic injuries or headaches. Ditto for acetaminophen. We suspect that few, if any, have ever been told that driving while taking medicine for pain could be hazardous.
What About Sleeping Pills?
The take-home message from this research is that prescribers and pharmacists should warn patients that some commonly prescribed medications pose hazards for safe driving. The official prescribing information for many anti-anxiety drugs advises health professionals to warn patients not to operate machinery or drive a motor vehicle while taking the drugs. We suspect it is frequently ignored.
The popular sleeping pill zolpidem (Ambien) carries a warning for health professionals:
“Caution patients against driving and other activities requiring complete mental alertness the morning after use.”
One reader reported this experience:
“I took zolpidem as prescribed, then went to bed. I woke up with my face in an airbag. I had totaled my car and was charged with a DUI citation.
“I could have killed myself or someone else. Most disturbing, I have no recollection of getting in the car and driving.”
A father described his experience the morning after taking zolpidem:
“A few years ago I started taking Ambien for a sleep disorder. One day I drove my seven-year-old daughter to school in the morning after taking Ambien the night before. Luckily the school was only a half mile from my house. I didn’t truly wake up until I was sitting in my car in the garage after returning home.
“I found out later that I had repeatedly driven into the curb. One of my tires was flat as a result. My daughter was so traumatized by the incident that she wouldn’t let me drive her to school again.
“I think this drug is dangerous. I got even more than a full night’s sleep but I still turned into a dangerous driving zombie in the morning.”
Medications that Raise Blood Alcohol Levels:
One more thing! Very few people are warned that some medicines can boost blood alcohol levels. We have been interested in this problem for decades, but there is surprisingly little research on the topic. An article published in the journal Alcohol Clinical & Experimental Research, Aug. 1995 reported on the heartburn medicine cimetidine (Tagamet).
Here’s the summary:
“…under conditions mimicking social drinking, cimetidine increased blood alcohol to concentrations known to impair psychomotor skills and they persisted at those levels over prolonged periods of time.”
There has been very little follow up on this preliminary report. We wish there were more research so we could provide you with a list of medications that could lead to higher levels of alcohol in the bloodstream. Here is an article that has some useful information, but it dates back to 1999. We wrote about this problem quite a long time ago at this link. You can also access our *free* Guide to Drug and Alcohol Interactions under the Health eGuides tab.
Final Words About Driving While Taking Medicine:
Perhaps it’s time for people to realize that some medications can impair driving ability almost as much as alcohol. The precautions that come with many prescriptions should be highlighted rather than ignored.
Please share your own experience about driving while taking medicine. Have you ever received a citation for driving while on a medication? Have you ever had an accident while taking an antidepressant or a pain reliever like celecoxib, ibuprofen, meloxicam or naproxen? What about acetaminophen?
If you think this information might be helpful for someone you know, please scroll to the top of the page and send it along either by email or social media. Thank you for your support.
