Driving While Distracted: Too Dangerous to Research

truck in rainDan* drove while I rode shotgun and panicked.  “Don’t rent a car,” he had instructed me.  “I’ll pick you up at the airport and drive you to the meeting.”  The offer had seemed kind, so I accepted.

Together we rocketed down the South Georgia interstate.  A light morning rain was falling.  He tailgated trucks, jumped from one lane to the other and back, sped too fast, braked too hard, and looked away from the road for far too long when he talked to me about his ADHD.  Medication had helped him remarkably, he said.  He took it “whenever I need it.”  Today, curiously, was not one of those days. We had 12 more miles to go.  I couldn’t watch any more, so I looked down at my laptop and pretended to go through emails, hoping he wouldn’t look over my way so much.  And so that I could pray.

God was gracious, and I live to tell this story.  “Dan drove you here?” asked one of his coworkers over pre-meeting bagels and coffee.  “His driving is legendary.  Glad you made it.” This happened almost 10 years ago, and my heart is racing a little just recounting the story.  I didn’t mention this one to my wife who always worries a bit when I’m on the road. Maybe she won’t see this blog.

My last post, Ritalin Saves Truck Drivers’ Lives.  Soccer Moms’, Too., discussed a Swedish study in which injury rates dropped when ADHD drivers took medication at least some of the time.  One wonders what collision rates would be if ADHD drivers took their medications every day.

Daytrana

Image from manufacturer’s website showing proper application of patch to wearer’s hip.

Dr. Daniel Cox at the University of Virginia wondered precisely that, so he studied collision rates in 17-25 year old drivers who wore a medicated skin patch, brand-named ‘Daytrana’, which delivers a consistent dose of methylphenidate, the active ingredient in Ritalin, when it is affixed to the wearer’s skin.  The patch was very useful in this study, because researchers could be certain precisely when drivers were medicated.  Or not.

8 Crashes in 3 Months vs No Crashes

The participants wore a dummy patch each day for 3 of the months and a medicated patch daily for the other 3, but were not told which patch they were wearing. In-car cameras and crash detectors were used to record collisions. Unmedicated drivers had 8 crashes in 3 months, and they were at-fault in all but one. The same individuals, when medicated, had none.

This was a very small study. It only involved 17 drivers. Normally, academics would scoff at a study this small, but you should know why it was so small.

Original plans called for a study of at least 100 drivers. Medical ethicists monitor studies like this while underway to make sure the study design doesn’t endanger participants. The study failed that test. Ethicists stopped it after only 17 complete results were in, because driving with unmedicated ADHD is too dangerous for universities to study on actual roads that are filled with people who didn’t agree to be in the study.

Think about this for one more moment.  The danger of driving unmedicated is so clear that It’s not ethical to send an ADHD driver out on the road without medication, even for the sake of science.

This is a reality check for the parents of teenage ADHD drivers as well as adults with ADHD.  “I take my medication when I need it” often means “when I’m trying to get a lot done in a day.” Sometimes it means, “Whenever I both think about it and get around to it.” At the very least, “When I need it” ought to include, “Any time I’m driving a loaded weapon down the street.”

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*Details are changed to preserve privacy.

Physician specializing in diagnosis and management of attention deficit disorders and related conditions.

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Posted in ADD, ADHD, driving, medications

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Oren Mason MD
Oren Mason MD

Oren Mason MD

Physician specializing in diagnosis and management of attention deficit disorders and related conditions.

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