UMass Chan Medical School Faculty Publications


Opioid Use and Driving Performance

UMMS Affiliation

Division of Medical Toxicology, Department of Emergency Medicine; School of Medicine

Publication Date


Document Type



Cognitive Neuroscience | Emergency Medicine | Medical Toxicology | Musculoskeletal, Neural, and Ocular Physiology | Pharmacology, Toxicology and Environmental Health | Substance Abuse and Addiction


INTRODUCTION: The USA is in an opioid epidemic, with an increased number of individuals taking psychoactive drugs while executing the tasks of everyday life, including operating a motor vehicle. The pharmacology of opioids has been widely studied, but the effects of opioids on psychomotor function, driving performance, and the risk of motor vehicle collision remain less clear. Clinicians are faced with the challenge of controlling patient pain while also reconciling conflicting messages from the literature about how safe it is for their patients taking opioids to engage in potentially dangerous routine tasks.

DISCUSSION: This review assesses the current literature regarding opioids as they relate to neurocognitive function, driving performance, and accident risk. Manuscripts are categorized by study context and subject matter: controlled experimental administration, illicit use, prescription use, retrospective forensic toxicology, and polydrug consumption.

CONCLUSION: Illicit use, initiation of therapy, and opioid use in combination with other psychoactive medications are contexts most clearly associated with impairment of driving-related functions and/or operation of a motor vehicle. Clinicians should counsel patients on the risk of impairment when initiating therapy, when co-prescribing opioids and other psychoactive drugs, or when a patient is suspected of having an opioid use disorder.


Driving, Impairment, Opioid, Psychomotor, Vigilance

DOI of Published Version



Cameron-Burr KT, Conicella A, Neavyn MJ. Opioid Use and Driving Performance. J Med Toxicol. 2021 Jan 5. doi: 10.1007/s13181-020-00819-y. Epub ahead of print. PMID: 33403571. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

Journal of medical toxicology : official journal of the American College of Medical Toxicology

PubMed ID