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Effect of chronic opioid therapy on actual driving performance in non-cancer pain patients

  • Chronic non-cancer pain (CNCP) is a major health problem. Patients are increasingly treated with chronic opioid therapy (COT). Several laboratory studies have demonstrated that long-term use of opioids does not generally impair driving related skills. But there is still a lack of studies investigating on-the-road driving performance in actual traffic. The present study assessed the impact of COT on road-tracking and car-following performance in CNCP patients. Twenty CNCP patients, long-term treated with stable doses of opioid analgesics, and 19 healthy controls conducted standardized on-the-road driving tests in normal traffic. Performance of controls with a blood alcohol concentration (BAC) of 0.5 g/L was used as a reference to define clinically relevant changes in driving performance. Standard Deviation of Lateral Position (SDLP), a measure of road-tracking control, was 2.57 cm greater in CNCP patients than in sober controls. This difference failed to reach statistical significance in a superiority test. Equivalence testing indicated that the 95% CI around the mean SDLP change was equivalent to the SDLP change seen in controls with a BAC of 0.5 g/L and did not include zero. When corrected for age differences between groups the 95% CI widened to include both the alcohol reference criterion and zero. No difference was found in car-following performance. Driving performance of CNCP patients did not significantly differ from that of controls due to large inter-individual variations. Hence in clinical practice determination of fitness to drive of CNCP patients who receive opioid treatments should be based on an individual assessment.

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Author:Markus B. Schumacher, Stefan Jongen, Anja Knoche, Frank Petzke, Eric F. Vuurman, Mark Vollrath, Johannes G. Ramaekers
Document Type:Article
Date of Publication (online):2018/09/11
Year of first publication:2017
Contributing corporation:Maastricht University. Department of Neuropsychology and Psychopharmacology
Release Date:2018/09/11
Tag:Arzneimittel; Droge; Fahrtauglichkeit; Fahrzeugführung; Medizinische Gesichtspunkte; Sicherheit
Driving (veh); Driving aptitude; Drugs; Medical aspects; Medication; Safety
Außerdem beteiligt: Universitätsmedizin Göttingen, Georg-August-Universität, Göttingen ; Technische Universität Braunschweig, Institut für Psychologie, Ingenieur- und Verkehrspsychologie

Volltext frei verfügbar unter: doi.org/10.1007/s00213-017-4539-3
Source:Psychopharmacology 234 (2017), 6, S. 989-99
Institutes:Abteilung Verhalten und Sicherheit im Verkehr / Abteilung Verhalten und Sicherheit im Verkehr
Sonstige / Sonstige
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
collections:BASt-Beiträge / ITRD Sachgebiete / 83 Unfall und Mensch

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