Driving forces: Medications and driving under the influence

Most DUI/DWI laws (driving under the influence / driving while intoxicated) are based on the effects of alcohol. This is a major problem for people who take strong medications for pain, nausea, or other medical conditions which are known for their intoxicating effects.

Unlike recreational users, patients taking drugs like morphine, cannabis, or amphetamines under a doctor’s supervision tend to use the smallest effective dose, balancing impairment from the symptoms of illness with impairment from the drugs we take to treat those issues. People who take these medications long term also develop tolerance to the side effects (don’t get as high as recreational users, and many of us don’t get high at all). In the long term those of us who don’t develop immunity to the perception altering effects of our medications learn to adapt to our medicated state, as long term use of medications makes that state our new normal. Many of us are very safe drivers on our meds and would be UNsafe without the symptom management they provide, but the law rarely takes that into account.

Exacerbating the issue still further is the issue of testing. Blood alcohol content can be quickly, easily, and reliably measured with a breath test, and confirmed with a more accurate blood test in cases where people end up in the hospital. Its effects on driving have been studied more than any other drug. Unfortunately, law enforcement agencies the world over tend to assume this holds true for other drugs as well.

That assumption is inaccurate, and the consequences of its wide acceptance by lawmakers and police is a major stumbling block for sick people who wish to maintain some level of independence. The only way to get an accurate picture of a driver’s chemical state is through an invasive and somewhat painful blood test, which then must be taken to a lab for analysis. The specific chemical processes are not well understood in many cases, and even with those test results having exact knowledge the presence, absence, or amount of specific metabolites in the body is a rough guideline at best, and utterly useless in many cases.

What constitutes a therapeutic level of a drug (and what amount makes a given person unsafe to drive) varies a great deal based on a number of factors. These include such variables as weight and body fat percentage, liver and kidney function, the specific combination of drugs in their system, diet, blood sugar, specific medical conditions, hormone balance, overall state of mental health, sleep issues, and many more.

Someone with low blood sugar, who hasn’t slept well, who is going through a bad breakup and just lost their job is an accident risk of the highest order even if they’re stone cold sober. Testing for impairment should mean actually testing a person’s impairment, not auditing their internal chemistry and making a rough guess based on rough guidelines and ill-understood science.

Further reading:
Driving Under the Influence of Drugs (FindLaw – US specific)
DUIs involving prescription drugs difficult to prove (USA Today – US specific)
Drugs and driving: the law (gov.uk – UK specific)
Warning over drug-driving law and prescribed medication (BBC – UK specific)

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