Opioid Use and Driving Performance

Cameron-Burr, Keaton T.; Conicella, Albert; Neavyn, Mark

doi:10.1007/s13181-020-00819-y

Cited by 12 publications

(10 citation statements)

References 85 publications

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“…The majority of reviews included studies that lacked an adequate reference group and failed to control for relevant confounders, such as concomitant illness or the consumption of alcohol or other psychoactive medications/drugs, and Authors were unable to find consistent evidence supporting the notion of a relationship between opioid use and intoxicated driving, crashing, or dying in RTCs [ 113 ]. A very recent review argues that illicit assumption, the use of opioid drugs in combination with other psychoactive medications and the initiation of opioid therapy are clearly associated with impairment of neurocognitive and psychomotor functions as they pertain to complex tasks including driving-related functions and/or operation of a motor vehicle [ 117 ].…”

Section: Methodsmentioning

confidence: 99%

Driving under the influence of drugs: Correlation between blood psychoactive drug concentrations and cognitive impairment. A narrative review taking into account forensic issues

Blandino

Cotroneo

Tambuzzi

et al. 2022

Forensic Science International: Synergy

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Section: Methodsmentioning

confidence: 99%

Driving under the influence of drugs: Correlation between blood psychoactive drug concentrations and cognitive impairment. A narrative review taking into account forensic issues

Blandino

Cotroneo

Tambuzzi

et al. 2022

Forensic Science International: Synergy

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“…Experimental studies demonstrate that opioids produce moderate and possibly dose-dependent acute impairment in cognitive functioning and driving performance. 9,69 Cognitive and psychomotor impairment may help explain the increase in fatal crash culpability due to failure to stay in the proper lane and other unsafe driving actions associated with opioid use. 17,23 Of interest, we found that risk of motor vehicle crashes may peak at doses .60 to 90 MME/day.…”

Section: Discussionmentioning

confidence: 99%

“…9-CM (September30, 2015). Emergency claims only model counted only claims for emergency department services as motor vehicle crash events.…”

mentioning

confidence: 99%

Association between prescribed opioid dose and risk of motor vehicle crashes

Quinn

Chang

Pujol

et al. 2022

Pain

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Opioid-involved motor vehicle traffic fatalities have increased over the past 2 decades. However, the extent to which prescribed opioids increase the risk of motor vehicle crashes remains uncertain. This study used real-world healthcare claims data to examine the association between prescription opioid dose and motor vehicle crash risk. Using nationwide US commercial insurance claims data for 2010 to 2018, we identified 772,404 adults who received incident, noncancer opioid therapy. We examined associations between daily prescription opioid dose, calculated in morphine milligram equivalents (MME) from filled prescription claims, and risk of motor vehicle crashes, assessed as diagnoses of motor vehicle injuries in claims for emergency visits, inpatient hospitalizations, and ambulance transportation. We estimated associations using a within-individual design, which ruled out all time-stable confounding. We complemented the design with time-varying statistical adjustment for other pharmacotherapies and a negative control pain pharmacotherapy analysis (with incident cyclic antidepressant prescriptions). During 2,150,009 person-years of follow-up, there were 12,123 motor vehicle crashes (5.64 crashes per 1000 person-years). In within-individual comparisons, crash risk was greater during opioid prescription periods involving doses #60 MME/ day (odds ratio [OR], 3.86; 95% confidence interval [CI], 3.54, 4.21), .60 to 120 MME/day (OR, 5.46; 95% CI, 4.44, 6.73), and .120 MME/day (OR, 3.45; 95% CI, 2.31, 5.15) than during off-treatment periods. The negative control analysis supported the specificity of the results to opioids rather than to other processes associated with pharmacologic pain management. These findings suggest that the receipt of prescription opioids, even at doses #60 MME/day, is associated with an increased risk of motor vehicle crashes.

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“…Clinical studies suggest that opioid administration is associated with high risk of immune suppression and the development of inflammatory mechanisms, enhancing CP status itself ( Kosciuczuk and others 2020 ). Moreover, it is well known that opioid consumption has a dual effect in CP patients, by inducing at the same time tolerance, dependence, and a risk for opioid use disorders ( Cameron-Burr and others 2021 ; Thong and others 2018 ). Thus, understanding the role of peripheral opioid receptors in CP conditions could also be helpful in minimizing central nervous system opioid side effects, such as addiction, sedation, respiratory depression, and nausea.…”

Section: The Impact Of Exogenous Opioids On the Immune System In Cp C...mentioning

confidence: 99%

The Interplay between Chronic Pain, Opioids, and the Immune System

et al. 2021

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Chronic pain represents one of the most serious worldwide medical problems, in terms of both social and economic costs, often causing severe and intractable physical and psychological suffering. The lack of biological markers for pain, which could assist in forming clearer diagnoses and prognoses, makes chronic pain therapy particularly arduous and sometimes harmful. Opioids are used worldwide to treat chronic pain conditions, but there is still an ambiguous and inadequate understanding about their therapeutic use, mostly because of their dual effect in acutely reducing pain and inducing, at the same time, tolerance, dependence, and a risk for opioid use disorder. In addition, clinical studies suggest that opioid treatment can be associated with a high risk of immune suppression and the development of inflammatory events, worsening the chronic pain status itself. While opioid peptides and receptors are expressed in both central and peripheral nervous cells, immune cells, and tissues, the role of opioids and their receptors, when and why they are activated endogenously and what their exact role is in chronic pain pathways is still poorly understood. Thus, in this review we aim to highlight the interplay between pain and immune system, focusing on opioids and their receptors.

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Opioid Use and Driving Performance

Cited by 12 publications

References 85 publications

Driving under the influence of drugs: Correlation between blood psychoactive drug concentrations and cognitive impairment. A narrative review taking into account forensic issues

Driving under the influence of drugs: Correlation between blood psychoactive drug concentrations and cognitive impairment. A narrative review taking into account forensic issues

Association between prescribed opioid dose and risk of motor vehicle crashes

The Interplay between Chronic Pain, Opioids, and the Immune System

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