Driving Records of Methadone Maintenance Patients in New York State

Abstract

The driving records of methadone maintenance patients are examined for two main interrelated reasons: first, methadone maintenance is growing in use as a treatment modality for heroin addicts and acceptance of such patients into the mainstream of life is partially dependent upon the public's awareness of their ability to function normally and safely while medicated; and second, a key factor in employability, and hence, continuing rehabilitative improvement for many such patients, lies in obtaining a driver's license and automobile insurance. More than 1,500 patients admitted to the methadone maintenance program initiated by Drs. Dole and Nyswander were matched against the 11 million records in the New York State Department of Motor Vehicles files. The search, on an exact match basis, produced 448 patients with driving records. A sample of New York City regular male drivers in the same period (182 cases) was also drawn for comparison purposes. When a comparison was made within specific age groups, it was learned that the accident and conviction rates were about the same for methadone maintenance clients as for a sample of New York City male drivers within the same period. In addition, the clients' accident and conviction records were no more serious than the sample of regular drivers. The findings from this study are consistent with those from other related studies, which are discussed. This suggests that methadone maintenance clients should at least be given serious consideration in their efforts to obtain a driver's license or automobile insurance as they strive to support themselves.

Influence of Peak and Trough Levels of Opioid Maintenance Therapy on Driving Aptitude

“…The results of these investigations confirm previous findings that opioids appear to be well tolerated when medically administered at stable doses over long time periods [3,4] . The fact that prescribed opioids in long-term treatment do not significantly impair psychomotor or cognitive functioning suggests that tolerance or habituation occurs [5,6] .…”

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

“…Earlier studies have suggested that patients receiving methadone maintenance therapy should have no restrictions in driving (n = 104-718; Babst et al 1973;Blomberg and Preusser 1974;Maddux et al 1977). On the other hand, 2 recent and large pharmacoepidemiological studies (Bramness et al 2012;Orriols 2010) found an increased risk of traffic accident involvement among MMPs and an increased risk of being responsible for an accident when exposed to methadone, respectively.…”

“…When comparing the MMPs with Texas-licensed drivers, the MMPs did not significantly differ in terms of frequency of accident involvement. Babst et al (1973) examined driving records among MMPs in a treatment program. A total of 448 MMPs with a driving record were identified.…”

Opioid Therapy for Chronic Nonmalignant Pain

“…Patients are encouraged to be active and there is no admonition to limit driving or similar activities unless overt impairment is observed. Clinical experience in the methadonemaintenance population has been similar (146), and studies of driving records have not demonstrated any differences in the rates of infractions or accidents between methadone-maintained addicts and other drivers (147,148). In the absence of definitive studies, clinicians who administer opioids to patients with non-malignant pain must carefully assess the potential for subtle cognitive impairment over time; occasionally, this may require formal neuropsychological testing.…”