Benzodiazepines and driving pharmacological and legal aspects

Objective: Benzodiazepines are a group of psychotropic drugs that are frequently prescribed. There are many published studies indicate that these drugs can affect driving ability. These studies are either epidemiological or experimental. Some efforts have been made recently toward the establishment of legal limits for benzodiazepines in the blood of drivers. Methods: A systematic review of the published literature was performed using PubMed and Medline databases, together with additional non-peer reviewed information sources, including books, and publications of state authorities in different countries concerning the effects of benzodiazepines on driving ability. The search terms used were “benzodiazepines,” “driving under the influence,” “impairment,” “traffic accidents,” and “legislation.” Results: The results of the collected epidemiological and experimental studies were presented and evaluated. In many cases, the results of different studies are controversial due to the fact that they have no uniform protocols. The efforts to establish legal limits for benzodiazepines remain to be proven effective. Conclusions: There is significant evidence that benzodiazepines affect negatively driving ability. Suggestions on how the problem of driving under the influence of benzodiazepines should be faced are made. Both physicians and pharmacists should advise their patients of the impairing effects of benzodiazepines, particularly in relation to drowsiness and sedation, and the implication of these effects on driving skills. Zero-tolerance legislation for benzodiazepines seems impracticable as these drugs are used extensively. The implementation of per se legislation by adopting legal limits would more properly secure traffic safety.