The effect of opioids on driving and psychomotor performance in patients with chronic pain.
OBJECTIVE
This study compared the psychomotor performance and driving ability of patients with chronic pain managed with stable regimens of opioid analgesics with that of normal healthy volunteers. The hypothesis was that patients with chronic pain on stable opioid analgesic regimens operate their automobiles safely with proficiency equal to normal volunteer controls.


METHODS
Patients were evaluated for errors while driving their own automobile through a predetermined route in the community, including variable residential and highway conditions, and for speed and accuracy on repeated trials through a 5-station obstacle course that evaluated forward and reverse driving, turning, and parallel parking. Patients also completed the Test of Variables of Attention and the Digit Symbol Substitution Test.


RESULTS
No significant differences were observed among groups in driving performance in the community and on the obstacle course or on the Test of Variables of Attention. Results on dependent measures within the opioid group generally were not correlated with morphine equivalent daily opioid doses, which averaged 118 mg (median 40 mg).


CONCLUSIONS
Many patients with chronic pain, even if treated with potent analgesics such as morphine and hydromorphone, show comparable driving ability as normals.
Byas-Smith
Michael G
MG
Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA 30322, USA. michael_byas-smith@emory.org
Chapman
Stanley L
SL
Reed
Barbara
B
Cotsonis
George
G
D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000328:Adult; D000701:Analgesics, Opioid / Q000494:pharmacology* / Q000627:therapeutic use*; D000704:Analysis of Variance; D001288:Attention / Q000187:drug effects; D001334:Automobile Driving / Q000331:legislation & jurisprudence / Q000523:psychology*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D004091:Hydromorphone / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000494:pharmacology / Q000627:therapeutic use; D010146:Pain / Q000188:drug therapy* / Q000523:psychology; D011597:Psychomotor Performance / Q000187:drug effects*; D011930:Reaction Time / Q000187:drug effects; D014887:Weather; D014888:Wechsler Scales
D000701:Analgesics, Opioid; D009020:Morphine; D004091:Hydromorphone