title: Medication use and the risk of motor vehicle collisions among licensed drivers: A systematic review.
abstract: OBJECTIVE
  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.
authors: Department of Epidemiology, West Virginia University, PO BOX 9151, Morgantown, WV, 26506, USA; Injury Control Research Center, West Virginia University, PO BOX 9151, Morgantown, WV, 26506, USA. Electronic address: trudisill@hsc.wvu.edu.
authors: Toni M
authors: TM
authors: Rudisill
authors: Department of Epidemiology, West Virginia University, PO BOX 9151, Morgantown, WV, 26506, USA; Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA; Injury Control Research Center, West Virginia University, PO BOX 9151, Morgantown, WV, 26506, USA. Electronic address: Motao.Zhu@NationwideChildrens.org.
authors: Motao
authors: M
authors: Zhu
authors: Department of Biostatistics, West Virginia University, PO BOX 9151, Morgantown, WV, 26506, USA. Electronic address: gkelley@hsc.wvu.edu.
authors: George A
authors: GA
authors: Kelley
authors: Department of Epidemiology, West Virginia University, PO BOX 9151, Morgantown, WV, 26506, USA. Electronic address: cpilkerton@hsc.wvu.edu.
authors: Courtney
authors: C
authors: Pilkerton
authors: 103 Sun Valley, Morgantown, WV, 26508, USA. Electronic address: brandonrudisill@gmail.com.
authors: Brandon R
authors: BR
authors: Rudisill
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D000928:Antidepressive Agents / Q000009:adverse effects*; D001334:Automobile Driving / Q000592:standards*; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D000066448:Driving Under the Influence / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018986:Motor Vehicles; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D000928:Antidepressive Agents
keywords: Ability; Driving; Drugs; Prescription; Review