Countermeasures Against Prescription and Over-the-Counter Drug-Impaired Driving
This report describes prescription and over-the-counter countermeasures related to pharmacy and medical; data recording and toxicology; law enforcement and judicial; and education and advertising.
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Driving under the influence of potentially impairing prescription and over-the-counter (OTC) drugs is a large public health concern. This report describes prescription and OTC countermeasures related to pharmacy and medical; data recording and toxicology; law enforcement and judicial; and education and advertising.
In comparison to alcohol’s impact on traffic safety, much less is known regarding the impact of other drugs, and potentially impairing prescription and OTC drugs in particular. These drugs are used frequently and have been shown to impair driving and driving-related psychomotor skills. In addition, they have shown prevalence estimates of presence in up to 13% of drivers on U.S. roadways. Although there is a large need for methods to reduce the prevalence of driving under the influence of prescription and OTC drugs, there is currently a lack of research on effective countermeasures to address this problem. Many existing published reviews of countermeasures focus on driving under the influence of alcohol—a very large societal problem to be certain, but also a behavior for which significant research has been conducted. Similarly, many studies focus on impairment by illegal drugs. Based upon differences in etiology, public perceptions, and existing countermeasures, many countermeasures designed for alcohol and illegal drugs may not be effective for prescription and OTC drugs.
This research was designed to fill this gap by assessing the current state of knowledge on countermeasures to prescription and OTC drug-impaired driving.
A variety of methods were used to collect data for this effort. These included a comprehensive literature review, an expert roundtable, targeted subject matter expert interviews, and a review of existing data sources. These approaches worked synergistically to identify, develop, and evaluate countermeasures to prescription and OTC drug-impaired driving. Countermeasures were classified into the following four categories: (1) Pharmacy and Medical, (2) Data Recording and Toxicology, (3) Law Enforcement and Judicial, and (4) Education and Advertising.
The research resulted in the identification of approximately 60 specific countermeasures to prescription and OTC drug-impaired driving. Some areas of particular promise included: patient counseling, prescription labeling, implementation of new technologies (e.g., oral fluid drug testing and electronic pharmacy prompts for impairing medications), increased coordination across the legal system for impaired driving offenses, refinements to existing databases, advertising, education, and increased attention and resources to this important problem.
While a number of countermeasures were identified, there was generally a lack of empirical support and published research on specific countermeasures. One significant challenge is that research is lacking on the specific effects of a number of drugs on driving performance. Furthermore, individual differences in the effects of a given drug make it even more challenging to systematically predict if a given drug or dosage will impair an individual (even more so with polydrug usage). This knowledge is often critical for the effective development and implementation of countermeasures.
It was also identified that while not all prescription and OTC drugs are impairing, drivers may not possess the knowledge necessary to distinguish between impairing and non-impairing medications or the interactions of various medications. Healthcare professionals, law enforcement officers, judicial personnel, and others closely involved with drivers are instrumental in preventing prescription- and OTC-drug-impaired driving. However, they too may be unaware of the severity of the problem and may lack the resources to address it. Thus, countermeasures should not only be focused on the driver, but also on the numerous other professionals who have an opportunity to intervene with the individual.
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