Background: Driving under the influence of drugs (DUID) is a term used to designate the action of
driving an automobile after the consumption of drugs or medications other than alcohol that interfere
with the capacity to operate a vehicle safely. Unlike recreational drugs, prescription medications pose
a unique challenge to those attempting to harness their benefits yet protect the driving public. As
studies demonstrate a steady increase in opioid use and abuse in the United States, these same
constituencies must regulate a significant percentage of drivers who are under the influence of
opioids.
Objective: This article examines current DUID policy and attempts to present unified suggestions for
improvement based on best scientific evidence of opioid-induced psychomotor impairment.
Study Design: Literature Review
Methods: A literature search was conducted regarding the epidemiology of opioid use and abuse,
psychomotor effects of opioids, DUID, and state policy concerning DUID. A total of 23 epidemiological
studies, 3 studies on acute psychomotor effects, 32 on chronic psychomotor effects, and selected
pertinent law and policy were reviewed.
Results: Current state law concerning DUID is variable and often relies on prosecutorial discretion to
provide protection of the driving public and prosecution of the truly impaired.
Limitations: The design of various studies included in this review imposes limitations on the
epidemiological data extracted. Relationships between opioids and automobile accidents are
commonly reviewed in retrospect. The data on opioid-induced psychomotor impairment and its
effects on driving an automobile require further direct study to examine current inferences.
Conclusions: A sizable percentage of the driving public has detectable levels of opioids within
their bodies. The best available evidence demonstrates psychomotor impairment following acute
administration of opioids or an increase in opioid dosage, but impairment diminishes with chronic,
stable opioid usage. Policy makers must account for this evidence when balancing the benefit of pain
relief against the need for public roadway protection when drafting DUID legislation.
Key words: Driving under the influence of drugs, DUID, psychomotor impairment, opioids,
regulation, automobile accident(s), driver impairment, prescription drugs, chronic opioid analgesic
therapy, driving under the influence
Benzodiazepines in Miami-Dade County, Florida Driving Under the Influence (DUI) Cases (1995-1998) with Emphasis on Rohypnol(R): GC-MS Confirmation, Patterns of Use Psychomotor Impairment, and Results of Florida Legislation
