PSYCHOACTIVE MEDICATIONS AND INJURIOUS MOTOR-VEHICLE COLLISIONS INVOLVING OLDER DRIVERS

Older drivers have the second highest risk for motor vehicle collision s of any age group, after adolescents. Psychoactive medications may pl ace older drivers at increased risk for injurious motor vehicle collis ions. We conducted a population-based matched case-control study of ol der drivers who were involved in injurious crashes during 1987 and 198 8. The 234 cases and 447 controls were members of a large Seattle-base d health maintenance organization. Use of anti depressants and opioid analgesics by older drivers was associated with increased risk for inj urious motor vehicle collisions. Compared with non-users, current user s of cyclic antidepressants had an adjusted relative risk (RR) of 2.3 [95% confidence interval (CI) = 1.1-4.8]. Opioid analgesic use was als o associated with an elevated crash risk (adjusted RR = 1.8; 95% CI = 1.0-3.4). We found no evidence of a dose-related effect with either cl ass of drug. Current use of benzodiazepines or sedating antihistamines had little association with increased risk for injurious collisions.