Common Medications and Multiple Drug Combinations Increasingly Linked to Fatal Car Crashes
Multiple Drug Combinations and Fatal Car Crashes
Here is a great article from Dr.Joseph Mercola, one of my favourite on-line physicians, about the problem of drug interactions and their impact on operating an automobile. This is especially relevant to the elderly driver, who may find him or herself tied down to a daily regimen of several, interacting medications.
October 22, 2014
By Dr. Mercola
According to statistics collected by the US Centers for Disease Control and Prevention (CDC), 2.5 million Americans wound up in the emergency room (ER) as a result of a car accident in 2012.
That equates to about 7,000 people per day, and the lifetime medical expenses associated with these accidents amount to about $18 billion. When you add in work lost over a lifetime due to injuries sustained, the cost jumps to $33 billion.
According to Ileana Arias, principal deputy director for the CDC:1
“Motor vehicle crash injuries occur all too frequently and have health and economic costs for individuals, the health care system, and society. We need to do more to keep people safe and reduce crash injuries and medical costs.”
While there are many factors that make driving risky, including the use of cell phones, texting, drunk driving, and not using a seat belt, there’s also the issue of prescription drug side effects.2 Many can cause drowsiness and/or other impairment that can make you dangerous on the road.
This may in fact be a major traffic safety issue that is largely ignored. Truly, if you’re taking medication that impairs your driving skills, it’s no different from driving drunk or high on illegal drugs.
FDA Admits: Certain Medications Make Driving Risky
According to research3 published earlier this year, prescription drugs and multiple drug combinations are frequently found in the blood of drivers involved in fatal car crashes on US roads.
Unfortunately, many simply assume that the combination of drugs prescribed to them is safe to take while driving because their doctor did not specifically warn them otherwise. This could turn out to be a fatally flawed assumption…
According to the US Food and Drug Administration (FDA), you should alwaysread the label on any and all prescription or over-the-counter (OTC) drug you’re taking before getting behind the wheel.
Also make sure you’re not taking more than one medication with the same active ingredient, as this will multiply its effect. And don’t make the mistake of assuming that OTC drugs are safe to use while driving simply because you can pick them up without a prescription. OTC allergy and cold medications are particularly notorious for making you sleepy and potentially dangerous behind the wheel.
One 2013 CDC report estimates up to 33 percent of all fatal car crashes involve a drowsy driver,4 and contrary to popular belief, sleep aids do not actually make you more well-rested. On the contrary, sleeping pills are also associated with next-day impairment that could make you a danger behind the wheel. As reported by Medicine Net:5
“The [FDA] cautions that some common nonprescription medicines can impair your ability to drive and operate other vehicles and machinery safely. Some of the most common of these drugs include certain types of nonprescription antihistamines, anti-diarrheals, and anti-nausea medications…
‘You can feel the effects some over-the-counter medicines can have on your driving for a short time after you take them, or their effects can last for several hours,’ Dr. Ali Mohamadi, a medical officer at the FDA, said in an agency news release.
“In some cases, a medicine can cause significant ‘hangover-like’ effects and affect your driving even the next day… ‘If you don’t read all your medicine labels and choose and use them carefully, you can risk your safety. If your driving is impaired, you could risk your safety, and the safety of your passengers and others,’ Mohamadi said.”
Polypharmacy Raises Your Risk of Impairment
Gone are the days when drunk drivers were our only concern—alcohol is but one of many drugs that can make you dangerous behind the wheel. And now many people, especially seniors, are on multiple prescription drugs (polypharmacy), which multiplies their impairment.
When you picture someone under the influence of drugs in your mind, you probably don’t envision a grey-haired grandmother or grandfather, a middle-aged professional, or a soon-to-be retiree.
But the face of drug addiction in the United States has changed dramatically over the past few decades, and a significant number of older adults are now struggling with both illicit and prescription drug abuse.
According to statistics from the Kaiser Health Foundation,6 seniors aged 65 and older fill, on average, 27 prescriptions per year, and National Institutes of Health7(NIH) statistics show that the number of people in their 50s who are abusing illicit drugs more than doubled from 2002 to 2010, going from 2.7 to 5.8 percent. Among those 65 and older, 414,000 used illicit drugs in 2010.
The most commonly abused prescription medications among seniors include:
- Opioids (painkillers such as morphine, codeine, oxycodone, hydrocodone, and fentanyl)
- Depressants (including Valium, Xanax, Ambien, and Sonata, prescribed for anxiety and sleep disorders)
- Stimulants (such as Ritalin, Concerta, and Adderall)
Many people are still under the illusion that prescription drugs are somehow safer than street drugs, but it’s important to realize that prescription medications like hydrocodone and oxycodone are opioids, very similar to heroin.
More Than One in Five Fatal Car Crashes Involve Driver on Multiple Medications
A CDC report8 issued this past summer analyzed data on drivers who tested positive for drugs after being involved in fatal crashes in the US between 1993 and 2010. Not surprisingly, the results were as disturbing as they were revealing. First of all, prescription drugs were involved in fatal car crashes at three times the rate of marijuana.
This is not meant to be an argument that driving under the influence of marijuana is safe, but it clearly shows that prescription drugs, especially when combined with alcohol, is an even greater hazard when you’re on the road.9 Moreover, the study found that between 1993 and 2010, the number of drivers with three or more drugs in their system nearly doubled, increasing from 11.5 to 21.5 percent.
|Source: White House Report, Drug Testing and Drug-Involved Driving of Fatally Injured Drivers in the United States: 2005-2009 (PDF)|
The fact that about one in five fatal car crashes involves an individual with multiple medications in their system should serve as a warning to all who think prescription drugs are safer than recreational drugs. As reported by Medicine Net,10 this trend is likely to worsen as aging Americans continue to rely on prescription drugs. At present, 90 percent of seniors aged 65 and over use prescription medications.11 According to the researchers, doctors can help prevent drugged driving by warning their patients about the risk of impairment while on certain drugs. They also suggested making mass transportation more affordable to dissuade drugged drivers from taking to the road.
Yet another study, published in the British Journal of Clinical Pharmacology12 in 2012, found that people involved in car accidents are more likely to have taken psychotropic drugs for a period of days, weeks, or months prior to their accident. Psychotropic drugs are those that alter your mental processes and are typically prescribed for anxiety, depression, insomnia, and other psychiatric disorders. Benzodiazepines, antidepressants, and insomnia drugs known as Z-drugs (including Sonata, Ambien, Imovane, and Lunesta) all have the potential to impair your driving.
Beware: Medications Also Cause Most Fatal Allergic Reactions
Even if a medication does not make you drowsy or less alert, it’s also important to be aware that certain drugs can cause fatal allergic reactions. According to one recent study,13 medicines are the most common cause of fatal allergic reactions in the US—absolutely dwarfing the death rate from other allergens such as bee stings and food. Antibiotics and radiocontrast agents used in imaging studies are among the most hazardous. According to the New York Times:14
“Using data from the National Center for Health Statistics, researchers found 2,458 cases of fatal anaphylaxis from 1999 through 2010. Almost 60 percent of the deaths, or 1,446, were caused by reactions to drugs, and in cases where the specific drug was known, half were caused by antibiotics. The rate of drug-induced fatal reactions almost doubled over the period. Insect stings caused 15.2 percent of the fatalities and food 6.7 percent. The cause was not recorded in a fifth of the cases.” [Emphasis mine]
Being a Responsible Driver Includes Avoiding Driving When Taking Drugs that May Impair Driving Ability
The risk of driving impairment from prescription medications has likely been underestimated for many years. There is no way to know how many of the accidents attributed to “drunk driving” have really been a combination of alcohol and prescription drugs. When you take combinations of drugs, even those prescribed by your doctor, the mental and physical effects can be complex and unpredictable.
So, if you do choose to take psychoactive medications, or drugs that impair judgment and reaction time either by itself or in combination with other drugs, please exercise good judgment and avoid getting behind the wheel. Needless to say, talking on your phone or texting while driving raises your risk of a potentially fatal car crash in and of itself—and doing so while impairedexponentially raises that risk.
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Sources and References
- 1com October 7, 2014
- 2Scientific American October 8, 2014
- 3Public Health Reports July/August 2014
- 4CDC January 4, 2013
- 5com October 7, 2014
- 6Kaiser State Health Facts
- 7NIH News June 6, 2012
- 8Medicine Net June 24, 2014
- 9SF Weekly June 26, 2014
- 10com June 24, 2014
- 11Science Daily June 23, 2014
- 12British Journal of Clinical Pharmacology 2012
- 13Journal of Allergy and Clinical Immunology September 30, 2014 [Epub ahead of print]
- 14New York Times October 6, 2014