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Driving Simulator Disposes of Myth

Chronic pain patients on regular medication do not become poor drivers with Tylex in their blood.

It is an accepted truth that strong pain killers and addictive medication such as Tylex and Panadeine Forte affect our driving skills negatively. The red warning triangle on the case also indicates that people taking this drug should stay away from the wheel.

This is definitely true if you are not using them regularly. However, if you are a chronic pain patient and a regular user of strong pain killers, the recommendations are only partly scientifically based. The potential connection between driving skills and medication called opioids has been established based on surveys and information provided by driving instructors.

Now, researchers at the Norwegian University of Science and Technology (NTNU) in Trondheim have conducted several tests using advanced simulation. For the very first time, a driving simulator is used for free research in this area.

”We wish to contribute to making the advice and recommendations from the health authorities as correct as possible,” say the two pain researchers behind the experiment – Petter Borchgrevink and Halvard Nilsen.

Same effect of pain

The tests include chronic pain patients regularly using Tylex or Panadeine Forte, corresponding patients not using such medication and a healthy control group not on medication. None of the patients suffer from malignant diseases, and all are experienced drivers.

Based on the first simulator test, the conclusion is more or less as follows: The best thing is to be free from both pain and medication behind the wheel. Both pain patient groups displayed poorer reactivity and steering skills whether they were on medication or not.

There is no doubt that addictive pain killers affect our reactivity and steering skills negatively if we are not used to them. However, chronic pain patients experience the same effect if they do not take their regular medication and drive with migraine or aching joints.

Compensate for «handicaps»

”We have established that driving skills are affected negatively by both chronic pain and opioids such as Tylex. A more detailed understanding of the connections, and the seriousness of the consequences, will follow when the next investigation on the subject has been thoroughly analyzed," the two doctors emphasize.

They do not see any reason why this group of regular users of pain killers should be branded as particularly dangerous in traffic. These patients are not overrepresented in accident statistics, nor are they stopped more often than others due to senseless driving.

According to Borchgrevink and Nielsen, the reason could be that most people almost automatically try to compensate for a handicap. In this case, it means that most drivers who know that they have a bad day with pain or opioids in their bodies drive more carefully than usual.

Increasing use of pills

The number of diseases people can contract are countless, and the use of addictive opioids is increasing in all of the Western world. So does the use of cars. And the recommendations for the medications are not necessarily correct – which is why the research being conducted at St. Olav’s Hospital and NTNU is very important.

And it could never have taken place without NTNU’s and SINTEF's advanced driving simulator. The simulator registers and measures the driver’s reactions, skills and eye movements as well as the general behaviour in traffic.

Here people get as close to real traffic situations as possible without actually being on the road.

”When we are testing driving skills and the use of medication, we are looking for situations that could be dangerous. That means we cannot stuff the patients full of opioids and send them out on the road,” explains Nilsen.

”And so far it has been impossible to evaluate driving skills equally standardized and objectively using normal cars in traffic," Borchgrevink adds.

First in the world with simulator?

In principle, any medication can be tested in a driving simulator, and not only pain killers. It quite simply does not happen. These advanced simulators are expensive, and the few that exist overseas are used solely for commissioned research. That does not necessarily result in public knowledge. But NTNU’s and SINTEF’s driving simulator is available to others.

Borchgrevink and Nilsen therefore claim that the work they carry out in cooperation with SINTEF could be called ground-breaking. ”We have a unique opportunity to build free, open and scientifically based research at top international level on the connection between medication and driving skills," they state.

Petter Borchgrevink is chief physician at the National Competence Centre for Complex Sufferings/The pain Centre at St. Olav’s Hospital and adjunct professor at NTNU. Halvard Nilsen is chief physician at Ålesund Hospital and research fellow at NTNU.

By Lisa Olstad/Gemini

Nina Tveter | alfa
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