New Law to Combat Drug Impaired Driving

From next week (1 November 2009) it will be an offence to drive a motor vehicle while impaired by drugs – including prescription medicines.  Note that the offence is to drive while impaired.  Driving having ingested a medicine that may impair driving is not an offence.  An offence is only created if driving is impaired such that it comes to the attention of the police.

Driving a motor vehicle is a responsibility, not a right.  One responsibility is to ensure you are fit to drive and not affected by any drug or medicine.  Medicines that can affect driving include those that may cause sedation, those that may affect eyesight and those that may cause hypotension/hypoglycaemia/dizziness.  For patients prescribed medicines that may cause these effects, pharmacists are advised to recommend they not drive until they are aware of how the medicine will affect them and for how long after a dose is taken that medicine affects their ability to drive safely.  Usually this would be during the first 7 to 10 days of treatment and for 3 to 4 days after any dose increase.

Very few, if any, medicine datasheets include an instruction prohibiting driving.  Instead there will be a warning that the medicine may affect the person's ability to drive or operate machinery.  It is over to the person then to determine how the medicine affects them, and it may be appropriate for some people, as a result of that experience, to decide not to drive while under the influence of that medicine.

Pharmacists have available to them the PSNZ Cautionary and Advisory Label (CAL) number 1 – to warn patients prescribed medicines that may cause sedation that the medicine may make them sleepy and make it dangerous to drive or operate machinery, and to limit alcohol intake.  The Pharmaceutical Society strongly recommends that the yellow CAL sticker is used to warn patients in this way.  Although the shortened computer-generated CAL number 1 on a dispensing label has from November been extended to refer to driving, it does not include the warning about operating machinery.  It is also important that the written warning is supported by clear verbal advice to ensure patients understand the significance of the information and do not, for instance, unnecessarily stop their medicines so they can continue to drive.

CAL number 1 is not routinely used on medicines that may cause hypotension, hypoglycaemia or dizziness so pharmacists should provide a verbal warning about these medicines.  CAL number 2 is applied to sedating agents when they are used at bedtime to induce sleep and therefore when driving and operating machinery will be unlikely.  If they are prescribed to be taken during waking hours, then CAL number 1 would be appropriate.

The process and penalties of the new legislation will be similar to those for driving while under the influence of alcohol but, instead of a breathalyzer, a compulsory road-side impairment test (walk a straight line, stand on one leg, pupil reaction etc) will be performed.  If failed police can forbid the person to drive until no longer impaired.  A blood sample may be taken and if a "qualifying drug" is found, the driver may be prosecuted.  Note that to trigger this process a police officer has to have "good cause to suspect" that a driver has consumed a drug or prescription medicine and is impaired – i.e. is driving erratically.

"Qualifying drugs" include all the illicit controlled drugs (cannabis, methamphetamine etc), some other controlled drugs (e.g. morphine, methadone, oxycodone, fentanyl benzodiazepines) and all prescription medicines.  If prosecuted, it will be a defence in court if the medicine had been consumed in accordance with a current and valid prescription and with any instructions from a health practitioner or from the manufacturer of the medicine.

The most important feature of this legislation is that it will empower a police officer to stop a person from continuing to drive while impaired.  It has a road safety focus.  It is not about drug use, nor does it create any new obligations for pharmacists, nor affect your existing obligations to patients.

Answers to commonly asked questions can be found on the Ministry of Transport website at

www.transport.govt.nz/legislation/acts/Pages/QAsdrugimpaireddrivinglaw.aspx

Click here for the Land Transport Amendment Act 2009 incorporating amendments made by Supplementary Order Paper which replaced the definition of controlled drug with the definition of a new term 'qualifying drug' and included benzodiazepines in the new definition.

Euan Galloway

Chief Pharmacist Advisor

29 October 2009