2010 BC Guide in Determining Fitness to Drive

Non-steroidal anti-inflammatoriesNSAIDs are among the most commonly used pharmacological agents, with 10 millionprescriptions dispensed annually in Canada. The use of NSAIDs is predicted to increase with theaging population due to the association between age and musculoskeletal disorders such asosteoarthritis and rheumatoid arthritis.Sedatives and hypnoticsData from 2002 Canadian Community Health Survey indicated that the percentage of those whohad used a sedative or hypnotic increased with age, moving from 3.1% of the general population15 years and older, to 11.1% for those 75 and older. Overall, 7.2% of those with anxietydisorders had taken a sedative-hypnotic over the two days preceding the survey.Benzodiazepine use made up most of the sedative-hypnotic use in all analyzed demographic anddiagnostic groups. Information from this survey and other studies indicate that benzodiazepinesare one of the most frequently used classes of drugs by seniors and women.Stimulants (for ADHD) and NarcolepsyNo data is available on the prevalence or incidence of the use of stimulants as a treatment forADHD in Canada. An indication of the use of stimulants for ADHD may be gleaned from theprevalence of the condition itself. Research indicates that ADHD affects between 3% and 10%of children and between 4% and 6% of adults. Of adolescents and adults with ADHD, 76%achieve a therapeutic response with stimulant medication.29.3 Psychotropic drugs and adverse driving outcomesOpioidsResearch indicates that the use of opioids can adversely affect driving performance, with thedegree of impairment dependent on the particular opioid used, dosage, previous use, developedtolerance, and time of day taken.AntidepressantsCurrently, there is little evidence to associate SSRIs or dual action agents with impaired drivingperformance. Although limited, research indicates that the use of tricyclic antidepressants isassociated with impairments in driving performance. This is evidenced by elevated crash rates,as well as measures of on-road performance and laboratory tests of psychomotor and cognitivefunctioning.358