Are opioid-dependent/tolerant patients impaired in driving-related skills? A structured evidence-based review.

摘要: Previous reviewers have concluded that opioids cause dose-related impairment in opioid-naive volunteers on psychomotor skills related to driving. Data relating opioid-dependent/tolerant patients not yet been reviewed. To determine what evidence, if any, exists for or against opioid-related driving skill patients, we performed a structured evidence-based review of all available studies addressing the issue whether are impaired driving-related skills. A computer and manual literature search produced 48 relevant reports. These references were reviewed detail, sorted, placed into tabular form according following subject areas: (1) abilities studies; (2) cognitive function (3) effect opioid dosing (4) motor vehicle violations accident (5) as measured simulators off/on road studies. For each topic area, study was categorized type it represented guidelines developed by Agency Health Care Policy Research (AHCPR). The strength consistency evidence area also then AHCPR quantitative method. This indicated following: There moderate, generally consistent no opioid-maintained patients; inconclusive multiple opioid- maintained strong immediately after being given doses opioids; strong, greater incidence violations/motor accidents versus comparable controls patients. Based above results, can be majority appeared indicate do impair four out five research areas investigated, but one. As such, additional controlled required. Until more data available, however, physicians may wish consider approach this problem recommended review.