Medication use and the risk of motor vehicle collisions among licensed drivers: A systematic review

Accid Anal Prev. 2016 Nov:96:255-270. doi: 10.1016/j.aap.2016.08.001. Epub 2016 Aug 29.


Objectives: Driving under the influence of prescription and over-the-counter medication is a growing public health concern. A systematic review of the literature was performed to investigate which specific medications were associated with increased risk of motor vehicle collision (MVC).

Methods: The a priori inclusion criteria were: (1) studies published from English-language sources on or after January 1, 1960, (2) licensed drivers 15 years of age and older, (3) peer-reviewed publications, master's theses, doctoral dissertations, and conference papers, (4) studies limited to randomized control trials, cohort studies, case-control studies, or case-control type studies (5) outcome measure reported for at least one specific medication, (6) outcome measure reported as the odds or risk of a motor vehicle collision. Fourteen databases were examined along with hand-searching. Independent, dual selection of studies and data abstraction was performed.

Results: Fifty-three medications were investigated by 27 studies included in the review. Fifteen (28.3%) were associated with an increased risk of MVC. These included Buprenorphine, Codeine, Dihydrocodeine, Methadone, Tramadol, Levocitirizine, Diazepam, Flunitrazepam, Flurazepam, Lorazepam, Temazepam, Triazolam, Carisoprodol, Zolpidem, and Zopiclone.

Conclusions: Several medications were associated with an increased risk of MVC and decreased driving ability. The associations between specific medication use and the increased risk of MVC and/or affected driving ability are complex. Future research opportunities are plentiful and worthy of such investigation.

Keywords: Ability; Driving; Drugs; Prescription; Review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Accidents, Traffic / statistics & numerical data*
  • Adult
  • Analgesics, Opioid / adverse effects*
  • Antidepressive Agents / adverse effects*
  • Automobile Driving / standards*
  • Cohort Studies
  • Dose-Response Relationship, Drug
  • Driving Under the Influence / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Motor Vehicles
  • Risk Factors
  • Young Adult


  • Analgesics, Opioid
  • Antidepressive Agents