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Self-Reported Opioid Use and Driving Outcomes among Older Adults: The AAA LongROAD Study
Marian E Betz1, Hailey Hyde2, Carolyn DiGuiseppi2
1From the Department of Emergency Medicine, University of Colorado School of Medicine, Aurora (MEB, JH); Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora (HH, CD); Department of Emergency Medicine, University of North Carolina School of Medicine, Chapel Hill (TFPM); Bassett Research Institute, Cooperstown, NY (DS); Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY (HFA); Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY (HFA); Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (TJM, GI); Department of Family Medicine and Public Health, University of California-San Diego, La Jolla (LLH); Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (VJ); University of Michigan Transportation Research Institute and the Center for Advancing Transportation Leadership and Safety (ATLAS Center), Ann Arbor (LJM, DWE); Department of Anesthesiology, Columbia University-Vagelos College of Physicians and Surgeons, New York, NY (GI). marian.betz@ucdenver.edu.
Background:
Opioid medications are important therapeutic options to mitigate the harmful effects of pain but can also impair driving ability. We sought to explore opioid use, pain levels, and driving experiences among older drivers.
Methods:
Cognitively intact drivers ages 65 to 79 years were recruited for the multisite AAA Longitudinal Research on Aging Drivers (LongROAD) study (n = 2990). This cross-sectional analysis used data from the baseline questionnaire and "brown-bag" medication review.
Results:
Among LongROAD participants (47% male, 88% white, 41% aged 65 to 69 years), 169 (5.7%) reported currently taking an opioid, with a median daily dose of 20 morphine milligram equivalents. Participants did not differ significantly in opioid use by age, gender, race, or ethnicity (P > .05). After adjustment for age, gender, race and ethnicity, participants who were taking opioids (vs not) were significantly more likely to report self-regulated driving reduction and reduced driving ability. However, these effects became nonsignificant when hospitalization, impaired physical function and other factors associated with opioid use were controlled.
Conclusions:
In this study from a large, geographically diverse sample of older adults, there was an association between opioid use and several self-reported measures of driving behavior and ability. However, future work should clarify the effects on driving of opioid use from the effects of the painful medical conditions for which the opioids are being taken. Clinicians should continue to discuss the risks and benefits of opioid medications with patients, including risks related to driving safety.
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