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Research Summary

People Receiving Buprenorphine and Methadone Are More Likely to Be Responsible for Traffic Crashes

Opioid agonist treatment (OAT) among opioid-dependent patients does not result in substantial driving impairment in driving simulation studies. The association between road traffic crashes and OAT has not been studied since buprenorphine became available. This French study of 72,685 car, bicycle, and scooter drivers involved in traffic accidents between 2005 and 2008 investigated the association between risk of being responsible for a crash and having a prescription for buprenorphine or methadone on the day of the crash. Responsibility was determined by police crash reports matched with a national crash database and linked to national pharmacy data.

  • In analyses adjusted for age, gender, road/vehicle conditions, and prescriptions for other medications known to impair driving ability, drivers who were prescribed buprenorphine or methadone had a 2-fold risk of being responsible for a road traffic crash compared with those who were not (odds ratio [OR], 2.02).
  • The 0.3% of drivers who were prescribed buprenorphine or methadone were more likely to be men, to be younger, and to have been prescribed other medications that impair driving ability (such as anxiolytics) than the 99.7% who were not.

Comments:

Past studies have suggested there is no increase in motor-vehicle accidents among drivers receiving OAT. Although OAT patients may not be involved in more crashes, when they are involved, this study suggests that they are more likely to be responsible. But, we do not know if the increased risk is because of OAT, because such persons tend to be riskier drivers, or if there is some other reason. Furthermore, we do not know how these risks stack up against the risk among patients with opioid addiction who are not receiving OAT. In any case, when discussing driving risk with patients, it seems reasonable to reassure them that driving is not impaired under experimental conditions, while at the same time recognizing that, under real-world conditions, such patients may be more likely to be responsible for a traffic crash. Tae Woo Park, MD* & Alexander Y. Walley, MD, MSc
*Contributing Editorial Intern, Clinical Addiction Research and Education (CARE) Unit, Boston University School of Medicine, Boston, MA.

Reference:

Corsenac P, Lagarde E, Gadegbeku B, et al. Road traffic crashes and prescribed methadone and buprenorphine: A French registry-based case-control study. Drug Alcohol Depend. November 18, 2011 [Epub ahead of print]. doi:10.1016/j.drugalcdep.2011.10.022.

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