Road traffic crashes and prescribed methadone and buprenorphine: A french registry-based case–control study

• Published in: Drug and alcohol dependence Vol. 123; no. 1; pp. 91 - 97
• Main Authors: Corsenac, Philippe, Lagarde, Emmanuel, Gadegbeku, Blandine, Delorme, Bernard, Tricotel, Aurore, Castot, Anne, Moore, Nicholas, Philip, Pierre, Laumon, Bernard, Orriols, Ludivine
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.06.2012; Elsevier
• Subjects: Accidents, Traffic - statistics & numerical data; Addictive behaviors; Adult; Adult and adolescent clinical studies; Automobile Driving; Biological and medical sciences; Buprenorphine; Buprenorphine - adverse effects; Case-Control Studies; Databases, Factual; Desintoxication. Drug withdrawal; Drivers; Drug addiction; Epidemiology; Female; France - epidemiology; General aspects; Health care; Humans; Life Sciences; Male; Medical sciences; Methadone; Methadone - adverse effects; Middle Aged; Narcotic Antagonists - adverse effects; Narcotics - adverse effects; Opiate Substitution Treatment - adverse effects; Opiate Substitution Treatment - psychology; Police; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public health. Hygiene; Public health. Hygiene-occupational medicine; Registries; Reproducibility of Results; Risk-Taking; Road accidents; Road traffic crashes; Santé publique et épidémiologie; Socioeconomic Factors; Treatments; Wounds and Injuries - epidemiology; Wounds and Injuries - pathology; France; Europe; Buprenorphine; Road traffic crashes; Methadone; Human; Narcotic antagonist; Drug addiction; Replacement therapy; Poison withdrawal; Opiates; Traffic accident; Case control study; Narcotic analgesic; Epidemiology; French; Addiction; Register; Traffic safety; Road traffic; Public health; ACCIDENT; ASPECTS MEDICAUX; COMPORTEMENT DU CONDUCTEUR; ACCIDENT DE LA ROUTE; COMPORTEMENT
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2011.10.022

Abstract Background Opioids have been shown to impair psychomotor and cognitive functioning in healthy volunteers with no history of opioid abuse. Few or no significant effects have been found in opioid-dependant patients in experimental or driving simulation studies. The risk of road traffic crash among patients under buprenorphine or methadone has not been subject to epidemiological investigation so far. The objective was to investigate the association between the risk of being responsible for a road traffic crash and the use of buprenorphine and methadone. Methods Data from three French national databases were extracted and matched: the national health care insurance database, police reports, and the national police database of injurious crashes. Case–control analysis comparing responsible versus non responsible drivers was conducted. Results 72,685 drivers involved in an injurious crash in France over the July 2005–May 2008 period, were identified by their national health care number. The 196 drivers exposed to buprenorphine or methadone on the day of crash were young, essentially males, with an important co-consumption of other substances (alcohol and benzodiazepines). Injured drivers exposed to buprenorphine or methadone on the day of crash, had an increased risk of being responsible for the crash (odds ratio (OR) = 2.02, 95% confidence interval (CI): 1.40 and 2.91). Conclusions Users of methadone and buprenorphine were at increased risk of being responsible for injurious road traffic crashes. The increased risk could be explained by the combined effect of risky behaviors and treatments.