Opioids and Traffic Safety – Focus on Buprenorphine

Abstract

Opioids as a class of drugs induce some impairment of driving ability, but less than other psychotropic agents or drugs of abuse. Personality features such as impulsivity, sensation seeking, low risk perception and antisocial behaviour, comorbid psychiatric and neurological disorders and additional substance use of opioid users are of relevance for traffic safety. Buprenorphine does not cause more cognitive impairment than methadone or may even cause less. Caution is required when initiating treatment with buprenorphine. The risk for driving ability impairment is probably less under steady state conditions. Finally, higher doses of buprenorphine are probably not associated with more impairment.

Driving Performance and Psychomotor Function in Depressed Patients Treated with Agomelatine or Venlafaxine

“…In a previous study we could demonstrate that depressive inpatients treated with mirtazapine or reboxetine showed distinct improvements in psychomotor functions related to driving skills and a significant decline in accident rates in a driving simulator test after 14 days of treatment [16]. These results were confirmed by a study conducted by Shen et al [18]. The authors observed a linear improvement in lane position and a significant decrease of crashes in a computerized driving simulator test in depressive patients treated with mirtazapine within a treatment period of 30 days.…”

“…Issues of road safety under psychopharmacological treatment are a matter of controversies and have been subject of recent reviews e. g., [18][19][20]. Results of the DRUID (driving under the influence of drugs) project [21] show that amongst medicines benzodiazepines are the most frequent finding with respect to injured or killed drivers.…”

Psychiatric comorbidities in opioid-dependent patients undergoing a replacement therapy programme in Spain: The PROTEUS study

“…The effects of OAT on patient´s driving ability are controversial (Baewert et al, 2007;Fishbain et al, 2003;Loeber et al, 2012;Schindler et al, 2004). Although OAT might impair driving ability, it does so to a less degree than other psychotropic agents or drugs of abuse (Soyka, 2014). Still, many patients on OAT do not drive (Roncero et al, 2013).…”

Medication-Assisted Treatment of Opioid Use Disorder

“…104,105 No studies specific to these professions have been conducted for agonist therapy of OUD, however, so this concern is empirical rather than evidence based at this time. For instance, the performance of pilots, physicians, professional athletes, or those carrying firearms could be compromised and even be dangerous because of opioid agonist treatment's cognitive or sedative effects or its impact on reaction times.…”