Differential effects of stimulant versus opiate drugs on driving performance

Trends in Prescription Opioid Use in Motor Vehicle Crash Injuries in the United States: 2014-2018

Motor vehicle crashes (MVC) cause over three million people to be nonfatally injured each year in the United States alone. We investigated trends and patterns in prescription opioid usage among nonfatal MVC injuries in 50 states in the US and the District of Columbia from 2014 to 2018. All emergency department visits for an MVC event (N = 142,204) were identified from the IBM^® MarketScan^® Databases. Using log-binomial regression models, we investigated whether the prevalence of prescription opioids in MVC injuries varied temporally, spatially, or by enrollees' characteristics. Adjusting for age, relationship to the primary beneficiary, employment status, geographic region, and residence in metropolitan statistical area, the prevalence decreased by 5% (95% CI: 2-8%) in 2015, 18% (95% CI: 15-20%) in 2016, 31% (95% CI: 28-33%) in 2017, and 49% (95% CI: 46-51%) in 2018, compared to 2014. Moreover, the prevalence decreased by 28% (95% CI: 26-29%) after the publication of the CDC Guidelines for Prescribing Opioids for Chronic Pain. Spatial variations were observed in the prevalence and temporal trend of prevalence. The decreasing trend in the prevalence of prescription opioids in MVC is consistent with the decrease in the dispensing rate of opioids and the percentage of high-dosage opioids in the study population.

Effects of psychotropic drugs on ocular parameters relevant to traffic safety: A systematic review

Driving is a complex neurobehavioural task necessitating the rapid selection, uptake, and processing of visual information. Eye movements that are critical for the execution of visually guided behaviour such as driving are also sensitive to the effects of psychotropic substances. The Embase (via Ovid), EBSCOHost, Psynet, Pubmed, Scopus and Web of Science databases were examined from January 01st, 2000 to December 31st, 2021. Study selection, data extraction and Cochrane Risk of Bias (RoB2) assessments were conducted according to PRISMA guidelines. The review was prospectively registered (CRD42021267554). In total, 36 full-text articles examined the effects of six principal psychotropic drug classes on measures of oculomotor parameters relevant to driving. Centrally depressing substances affect oculomotor responses in a dose-dependent manner. Psychostimulants improve maximal speed, but not accuracy, of visual search behaviours. Inhaled Δ-9-tetrahydrocannabinol (THC) increases inattention (saccadic inaccuracy) but does not consistently affect other oculomotor parameters. Alterations to composite ocular parameters due to psychoactive substance usage likely differently compromises performance precision during driving through impaired ability to select and process dynamic visual information.