Your Weekly Checkup: The Dangers of Driving While Medicated

Many drivers, particularly older ones, may be using potentially inappropriate medications, all of which have been linked to driving impairment and increased crash risk.

A red sedan crashing hood-first into a tree.

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“Your Weekly Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive. 

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We are a nation of automobile drivers.

In 2016, we made 186 billion driving trips covering 2.62 trillion miles in about 70 billion hours, according to telephone interviews of a sample of respondents conducted by the AAA Foundation for Traffic Safety.

More than 225 million people — or almost 90 percent of American adults older than 16 years — reported that they drove a car at least occasionally in 2016.

The proportion of drivers older than 75 years has increased each year and has contributed to more drivers on the road. However, teens and older folks made fewer trips each day than the average 2.24 daily trips that took about 50 minutes to cover slightly more than 30 miles. Women drove more trips than men but averaged nine minutes less driving time. Couples reported more driving time than single people.

While age, gender, and marital status all play a part in driver behavior, a factor that may come as a surprise is medication usage and its impact on drivers. A recent study looked at medications used by older drivers. Many medications, including antihistamines, narcotic analgesics, central nervous system (CNS) drugs, muscle relaxants, and tricyclic antidepressants – have been associated with increased crash risk.

Almost three thousand drivers 65 to 79 years old who underwent a medication review took a median of seven medications. Cardiovascular medications accounted for 19.0% of all medications reported; vitamins 15.9%; and central nervous system agents 15.9%. At least one cardiovascular medication was used by 73% of the sample, higher for males (79%) than females (69%), with higher rates of use for older people.

Another study showed that the use of potentially inappropriate medications in older adults is associated with high levels of morbidity, mortality and health care expenditures. Overall, 18.5% of the study sample used at least one potentially inappropriate medication, most commonly benzodiazepines (for example Ativan, Xanax or Valium), accounting for 16.6% of the total potentially inappropriate medications identified, followed by nonbenzodiazepine hypnotics such as Ambien and Lunesta (15.2%), antidepressants (15.2%), and first-generation antihistamines (10.5%).

The odds of potentially inappropriate medication use increase with the number of medications taken and were particularly high among white female older drivers in urban areas.

Important lessons come from these studies:

  • The number of drivers overall has increased.
  • Older individuals make up an increasingly greater percentage of U. S. drivers and contribute to more drivers on the road.
  • Teens and older persons drive less than middle age groups but account for a greater number of accidents.
  • Many drivers take large numbers of medications, some of which can impact driving skills.
  • Almost 20 percent of study participants with medication data used at least one potentially inappropriate medication that should generally be avoided while driving.
  • Older drivers in particular use potentially inappropriate medications, most commonly benzodiazepines, nonbenzodiazepine hypnotics, antidepressants, and first-generation antihistamines, all of which have been linked to driving impairment and increased crash risk.
  • All drivers, but particularly inexperienced teens and older drivers, need to be cautious about taking any medications that might impair driving ability.

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