CDME Module 8: Drug Abuse & Alcoholism-Schedule II Medications and Stimulants. Opinions of the Medical Expert Panel regarding Commercial Driver Performance and Crash Risk. 2012

Schedule II Medications and Stimulants. Opinions of the Medical Expert Panel regarding Commercial Driver Performance and Crash Risk. 2012

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Pdf Summary

A panel of medical experts conducted a systematic review of the literature to determine the impact of schedule II opioids and stimulants on commercial motor vehicle (CMV) driver performance and crash risk. For opioids, the panel found that the licit use of these drugs led to an increased risk of fatal accidents, injury accidents, and crash causation. However, the evidence is insufficient to determine whether opioids cause impairment on indirect measures of driving performance. The panel believes that chronic use of opioids may lead to dose escalation and addiction, making it incompatible with the routine completion of driving tasks. On the other hand, the licit use of stimulant medication for ADHD likely reduces the crash risk associated with the condition, but the timing of dosing can be complex and positive effects are limited to the time the medicine is present at therapeutic levels. The use of amphetamines outside of monitored ADHD treatment poses a substantially increased crash risk. The panel also found that the effects of opioids and stimulants vary across individuals based on metabolism and other pharmacokinetic factors, and the effects cannot be determined by serum levels. The panel also highlighted the lack of research on drug-drug interactions and the need for additional studies on the impact of other medications on CMV drivers. They recommended further evaluation of benzodiazepines, diphenhydramine, non-schedule II stimulants, and commonly used prescription opioids. They also suggested studying the patterns of actual medication use and their effects on CMV driver safety.

Keywords

schedule II opioids

stimulants

CMV driver performance

crash risk

licit use

driving performance

chronic use

ADHD

crash risk reduction

medication use