Skip to main content
NCBI home page
Canadian Family Physician logoLink to Canadian Family Physician
. 1998 Apr;44:799–808.

Benzodiazepine use and motor vehicle accidents. Systematic review of reported association.

R E Thomas 1
PMCID: PMC2277821  PMID: 9585853

Abstract

OBJECTIVE: To examine the relationship between benzodiazepine (BZD) use and motor vehicle accidents (MVAs). DATA SOURCES: MEDLINE was searched from 1980 to 1997 using the key words traffic accidents or motor vehicle accidents and benzodiazepines (and alternative terms and outcomes) in English, German, French, or Italian. STUDY SELECTION: Case-control studies of BZDs and MVAs; police or emergency studies of BZD use among travelers; driving tests with subjects taking BZDs. Outcomes were impaired driving, accidents; mortality; postaccident medical attention, emergency ward care, or hospitalization. Quality criteria were whether all driving BZD users and non-users had an equal chance of entering the study; whether medication dosage and timing were ascertained; whether all kilometres driven by BZD users and non-users were studied; whether all types of accidents were ascertained; and whether medical conditions were controlled for. SYNTHESIS: In case-control studies, the odds ratios for mortality and emergency medical treatment ranged from 1.45 to 2.4 in relation to time of use and quantity of drug taken. In police and emergency ward studies, BZD use was a factor in 1% to 65% of accidents (usually 5% to 10%). In two studies where subjects had blood alcohol concentrations less than the legal limit, BZDs were found in 43% and 65% of subjects. In one study with controls, 5% of drivers and 2% of controls in accidents had used BZDs. CONCLUSIONS: Case-control studies suggest using BZDs approximately doubles the risk of motor vehicle accidents. The risk for drivers older than 65 of being involved in reported motor vehicle collisions is higher when they take longer-acting and larger quantities of BZDs.

Full text

PDF
799

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arditti J., Bourdon J. H., David J. M., Lanze L., Thirion X., Jouglard J. Imprégnation en benzodiazépines de conducteurs impliqués dans des accidents de la circulation. Presse Med. 1993 May 1;22(16):765–766. [PubMed] [Google Scholar]
  2. Augsburger M., Rivier L. Drugs and alcohol among suspected impaired drivers in Canton de Vaud (Switzerland). Forensic Sci Int. 1997 Feb 28;85(2):95–104. doi: 10.1016/s0379-0738(96)02084-1. [DOI] [PubMed] [Google Scholar]
  3. Biehl B. Studies of clobazam and car-driving. Br J Clin Pharmacol. 1979;7 (Suppl 1):85S–90S. doi: 10.1111/j.1365-2125.1979.tb04671.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Binnie G. A. Psychotropic drugs and accidents in a general practice. Br Med J (Clin Res Ed) 1983 Nov 5;287(6402):1349–1350. doi: 10.1136/bmj.287.6402.1349. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Christensen L. Q., Nielsen L. M., Nielsen S. L. Traffic accidents and drivers suspected for drug influence. Forensic Sci Int. 1990 Apr;45(3):273–280. doi: 10.1016/0379-0738(90)90184-z. [DOI] [PubMed] [Google Scholar]
  6. Cimbura G., Lucas D. M., Bennett R. C., Warren R. A., Simpson H. M. Incidence and toxicological aspects of drugs detected in 484 fatally injured drivers and pedestrians in Ontario. J Forensic Sci. 1982 Oct;27(4):855–867. [PubMed] [Google Scholar]
  7. Crouch D. J., Birky M. M., Gust S. W., Rollins D. E., Walsh J. M., Moulden J. V., Quinlan K. E., Beckel R. W. The prevalence of drugs and alcohol in fatally injured truck drivers. J Forensic Sci. 1993 Nov;38(6):1342–1353. [PubMed] [Google Scholar]
  8. Currie D., Hashemi K., Fothergill J., Findlay A., Harris A., Hindmarch I. The use of anti-depressants and benzodiazepines in the perpetrators and victims of accidents. Occup Med (Lond) 1995 Dec;45(6):323–325. doi: 10.1093/occmed/45.6.323. [DOI] [PubMed] [Google Scholar]
  9. Fortenberry J. C., Brown D. B., Shevlin L. T. Analysis of drug involvement in traffic fatalities in Alabama. Am J Drug Alcohol Abuse. 1986;12(3):257–267. doi: 10.3109/00952998609007395. [DOI] [PubMed] [Google Scholar]
  10. Girre C., Facy F., Lagier G., Dally S. Présence de benzodiazépines dans le sérum de sujets accidentés. Relation avec l'alcoolisme. Presse Med. 1988 Jun 4;17(22):1135–1138. [PubMed] [Google Scholar]
  11. Gjerde H., Beylich K. M., Mørland J. Incidence of alcohol and drugs in fatally injured car drivers in Norway. Accid Anal Prev. 1993 Aug;25(4):479–483. doi: 10.1016/0001-4575(93)90078-b. [DOI] [PubMed] [Google Scholar]
  12. Gjerde H., Kinn G. Impairment in drivers due to cannabis in combination with other drugs. Forensic Sci Int. 1991 Jul-Aug;50(1):57–60. doi: 10.1016/0379-0738(91)90133-4. [DOI] [PubMed] [Google Scholar]
  13. Hansotia P., Broste S. K. The effect of epilepsy or diabetes mellitus on the risk of automobile accidents. N Engl J Med. 1991 Jan 3;324(1):22–26. doi: 10.1056/NEJM199101033240105. [DOI] [PubMed] [Google Scholar]
  14. Hemmelgarn B., Suissa S., Huang A., Boivin J. F., Pinard G. Benzodiazepine use and the risk of motor vehicle crash in the elderly. JAMA. 1997 Jul 2;278(1):27–31. [PubMed] [Google Scholar]
  15. Holmgren P., Loch E., Schuberth J. Drugs in motorists traveling Swedish roads: on-the-road-detection of intoxicated drivers and screening for drugs in these offenders. Forensic Sci Int. 1985 Jan;27(1):57–65. doi: 10.1016/0379-0738(85)90105-7. [DOI] [PubMed] [Google Scholar]
  16. Honkanen R., Ertama L., Linnoila M., Alha A., Lukkari I., Karlsson M., Kiviluoto O., Puro M. Role of drugs in traffic accidents. Br Med J. 1980 Nov 15;281(6251):1309–1312. doi: 10.1136/bmj.281.6251.1309. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Irving A., Jones W. Methods for testing impairment of driving due to drugs. Eur J Clin Pharmacol. 1992;43(1):61–66. doi: 10.1007/BF02280756. [DOI] [PubMed] [Google Scholar]
  18. Koepsell T. D., Wolf M. E., McCloskey L., Buchner D. M., Louie D., Wagner E. H., Thompson R. S. Medical conditions and motor vehicle collision injuries in older adults. J Am Geriatr Soc. 1994 Jul;42(7):695–700. doi: 10.1111/j.1532-5415.1994.tb06526.x. [DOI] [PubMed] [Google Scholar]
  19. Lillsunde P., Korte T., Michelson L., Portman M., Pikkarainen J., Seppälä T. Drugs usage of drivers suspected of driving under the influence of alcohol and/or drugs. A study of one week's samples in 1979 and 1993 in Finland. Forensic Sci Int. 1996 Jan 12;77(1-2):119–129. doi: 10.1016/0379-0738(95)01848-4. [DOI] [PubMed] [Google Scholar]
  20. Logan B. K., Schwilke E. W. Drug and alcohol use in fatally injured drivers in Washington State. J Forensic Sci. 1996 May;41(3):505–510. [PubMed] [Google Scholar]
  21. Mason A. P., McBay A. J. Ethanol, marijuana, and other drug use in 600 drivers killed in single-vehicle crashes in North Carolina, 1978-1981. J Forensic Sci. 1984 Oct;29(4):987–1026. [PubMed] [Google Scholar]
  22. McLinden V. J. Experiences in relation to drugs/driving offences. J Forensic Sci Soc. 1987 Mar-Apr;27(2):73–80. doi: 10.1016/s0015-7368(87)72712-1. [DOI] [PubMed] [Google Scholar]
  23. Merlin G., Lepoittevin L., Turcant A., Mylonas J., Cavellat J. F. Responsabilité des neuropsychotropes dans les accidents de la voie publique. Presse Med. 1991 Mar 9;20(9):409–412. [PubMed] [Google Scholar]
  24. O'Hanlon J. F., Vermeeren A., Uiterwijk M. M., van Veggel L. M., Swijgman H. F. Anxiolytics' effects on the actual driving performance of patients and healthy volunteers in a standardized test. An integration of three studies. Neuropsychobiology. 1995;31(2):81–88. doi: 10.1159/000119177. [DOI] [PubMed] [Google Scholar]
  25. O'Hanlon J. F., Volkerts E. R. Hypnotics and actual driving performance. Acta Psychiatr Scand Suppl. 1986;332:95–104. doi: 10.1111/j.1600-0447.1986.tb08985.x. [DOI] [PubMed] [Google Scholar]
  26. Orsay E. M., Doan-Wiggins L., Lewis R., Lucke R., RamaKrishnan V. The impaired driver: hospital and police detection of alcohol and other drugs of abuse in motor vehicle crashes. Ann Emerg Med. 1994 Jul;24(1):51–55. doi: 10.1016/s0196-0644(94)70162-8. [DOI] [PubMed] [Google Scholar]
  27. Oster G., Russell M. W., Huse D. M., Adams S. F., Imbimbo J. Accident- and injury-related health-care utilization among benzodiazepine users and nonusers. J Clin Psychiatry. 1987 Dec;48 (Suppl):17–21. [PubMed] [Google Scholar]
  28. Ray W. A., Fought R. L., Decker M. D. Psychoactive drugs and the risk of injurious motor vehicle crashes in elderly drivers. Am J Epidemiol. 1992 Oct 1;136(7):873–883. doi: 10.1093/aje/136.7.873. [DOI] [PubMed] [Google Scholar]
  29. Rivara F. P., Mueller B. A., Fligner C. L., Luna G., Raisys V. A., Copass M., Reay D. T. Drug use in trauma victims. J Trauma. 1989 Apr;29(4):462–470. doi: 10.1097/00005373-198904000-00008. [DOI] [PubMed] [Google Scholar]
  30. Staub C., Lacalle H., Fryc O. Présence de psychotropes dans le sang de conducteurs responsables d'accidents de la route ayant consommé en même temps de l'alcool. Soz Praventivmed. 1994;39(3):143–149. doi: 10.1007/BF01299658. [DOI] [PubMed] [Google Scholar]
  31. Steentoft A., Worm K., Christensen H. Hyppigheden af benzodiazepiner i blodprøver indsendt til alkohol- og/eller medikamentundersøgelse på Retskemisk Institut i København. Ugeskr Laeger. 1988 Oct 3;150(40):2383–2386. [PubMed] [Google Scholar]
  32. Stoduto G., Vingilis E., Kapur B. M., Sheu W. J., McLellan B. A., Liban C. B. Alcohol and drug use among motor vehicle collision victims admitted to a regional trauma unit: demographic, injury, and crash characteristics. Accid Anal Prev. 1993 Aug;25(4):411–420. doi: 10.1016/0001-4575(93)90070-d. [DOI] [PubMed] [Google Scholar]
  33. Sugrue M., Seger M., Dredge G., Davies D. J., Ieraci S., Bauman A., Deane S. A., Sloane D. Evaluation of the prevalence of drug and alcohol abuse in motor vehicle trauma in south western Sydney. Aust N Z J Surg. 1995 Dec;65(12):853–856. doi: 10.1111/j.1445-2197.1995.tb00575.x. [DOI] [PubMed] [Google Scholar]
  34. Ulrich L., Rudin O., Amsler A., Zink P. Häufigkeit von Medikamenten im Strassenverkehr. Eine Pilotstudie an Verkehrsteilnehmern in der Schweiz (Region Bern). Z Rechtsmed. 1984;93(2):95–110. doi: 10.1007/BF00200768. [DOI] [PubMed] [Google Scholar]
  35. White J. M., Clardy D. O., Graves M. H., Kuo M. C., MacDonald B. J., Wiersema S. J., Fitzpatrick G., Pearce D. S. Testing for sedative-hypnotic drugs in the impaired driver: a survey of 72,000 arrests. Clin Toxicol. 1981 Aug;18(8):945–957. doi: 10.3109/15563658108990323. [DOI] [PubMed] [Google Scholar]
  36. de Gier J. J., 't Hart B. J., Nelemans F. A., Bergman H. Psychomotor performance and real driving performance of outpatients receiving diazepam. Psychopharmacology (Berl) 1981;73(4):340–344. doi: 10.1007/BF00426462. [DOI] [PubMed] [Google Scholar]
  37. van Laar M. W., Volkerts E. R., van Willigenburg A. P. Therapeutic effects and effects on actual driving performance of chronically administered buspirone and diazepam in anxious outpatients. J Clin Psychopharmacol. 1992 Apr;12(2):86–95. [PubMed] [Google Scholar]

Articles from Canadian Family Physician are provided here courtesy of College of Family Physicians of Canada

RESOURCES