[Driving ability with alcohol and drug dependence and schizophrenia]

Alcohol and drugs use are of great relevance for driving ability. The number of alcohol-related accidents with injuries in Germany showed a 40 % decline over the past decade (2011: 15,898 including 400 deaths, other drugs 1400). Road surveys indicate the risk of accidents to be high in psychostimulant users but only medium in opioid users. Guidelines for medical and psychological examinations of drunken drivers are given. Alcohol-related questions are the most commonly encountered in medical psychological expert opinions with 51 % followed by drugs and medications with 21 %. The fundamental principles of expert opinions are presented. At last count the proportion of all investigated persons who tested positive was 55 %. In the absence of other health-related limitations, most patients under substitution therapy for opiate addiction are barely impaired in the cognitive functions relevant for driving ability. The database for traffic offences and schizophrenia is much worse. Acute psychotic illness rules out driving ability. In patients with first onset disease this can usually be granted after 1 year of remission from symptoms but in cases of repeated exacerbations longer intervals of 3-5 years are warranted.