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25th January 2001
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Which of the following most accurately describes the problem?

Evidence is increasingly emerging that over-thecounter and prescription drugs can seriously affect your driving. A question mark even hangs over stimulant drinks following a recent mysterious death. Mike Sherrington reports on the

legal drugs whose side effects could lead drivers into trouble.

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UK 400m champion Mark Richardson lost his chance of competing in last year's Olympic games because he was accused of drug abuse after innocently using an overthe-counter cold remedy. A Romanian gymnast was stripped of her Olympic gold medal for the same reason.

But drive a 44-tonne lorry on legal medication? No problem at all. Or is there?

There has been very little research into the effects of legal drugs on driving. The Road Haulage Association and the Freight Transport Association say this is an area that they have not explored; that also goes for the Transport & General Workers Union and the United Road Transport Union.

An RHA spokeswoman says there are clear guidelines for drugs manufacturers, which are required to list side effects of their products on the packaging. The main problem seems to be lack of communication between the manufacturers, GPs or pharmacists, and the customers.

But now Leeds University's department of transport studies is launching a three-year European Commission-funded project to investigate the effects of legally prescribed or over-the-counter drugs on driving ability. Such research is almost unique in the UK and department spokeswoman Samantha Jamson explains why: "There is very little capital to be gained from this type of research and it is very difficult and expensive to do."

The most definitive exercise in the country dates back to a study in the late 198os by the then Transport and Road Research Laboratory—and that study suggested there could be a link between legal drugs and road fatalities.

Nervous system

The TRRL examined 1,300 road accident corpses and found that 7.5% of them contained legal drugs that would affect the central nervous system (CNS). Of these by far the largest number contained traces of diazepam (r.r%).

When the exercise was repeated in years later similar levels of legal drugs were found, but no cases involving CNS drugs involved drivers of HGVs or PS Vs.

There was no evidence of a direct link between drug use and any accidents, but many legal drugs are known to have a serious effect on driving— either for better or worse—and road safety organisations are becoming increasingly concerned about their impact. Mary Williams, director of the road safety campaign group Brake, says: "Many drivers are unaware of the effect that any kind of drug may have on their driving. If you are unsure of a drug's effect you should always seek advice from a pharmacist; even for medicines for common complaints."

Brake cites research by Green Flag indicating that one in six of all drivers admit to driving after taking prescribed or over-the-counter drugs they knew could make them drowsy.

The Royal Sodety for the Prevention of Accidents (RoSPA) has called for all drug packets to be dearly marked and for better advice to be given by GPs and pharmacists to drivers on the effects of prescription drugs.

Traffic light

The RAC Foundation takes this one step further by calling for a "traffic-light" system of labelling all drugs, with red indicating a drug which is unsafe to use while driving; amber indicating a drug which drivers should use only after consulting a doctor; and green indicating a drug which is safe to drive on.

However, the British Medical Association says that such a system would be flawed because certain drugs could react with others to cause drowsiness; because drugs act differently on each individual; and because it could be safer to drive while using some drugs than to suffer the effects of illness.

The BMA also points out that while Section 4 of the 1988 Road Traffic Act empowers the police to arrest a person suspected to be driving under the influence of drugs, there is no defined safety limit for drug use, and establishing such a limit would be difficult, due to the range of drugs and the lack of available research.

It would be wrong to over-state the negative effects of legal drugs. Some are regarded as helping drivers; the most significant being the stimulating fizzy drink Red Bull. Research by Loughborough University's Sleep Research Centre indicates that drinking two cans of Red Bull can fend off driver fatigue for up to two hours. But even this has to be treated with caution: last year 18-yearold Irish basketball player Ross Cooney died of Sudden Adult Death Syndrome after drinking three cans of Red Bull. An inquest jury found that more research was needed into the effects of all stimulant drinks.

The manufacturer of Red Bull has denied any responsibility for the death, saying that a bil lion cans of the drink were sold last year with no adverse consumer reactions, and that it is the only stimulant drinks company which is continuing to carry out research into the effects of its product. This sort of research has been backed by David Byrne, the EU Commissioner for Health and Consumer Protection, who has asked his organisation's scientific committee to look into the matter.

Stimulant drinks, despite popular conceptions, contain less caffeine than a cup of coffee. But the other two main ingredients, taurine and glucuronolactone, also contribute to the

mix. In 1999 the EU scientific commission found that there was too little data to establish a safe upper limit for these substances.

The effects of legal drugs on drivers remains largely uncharted territory, but that could change over the next few years. The Rosita project, which is being pioneered by representatives from eight European countries, has just finished a report on how best to test for legal and illegal drugs. This testing, which is already widespread in Belgium and some German states, currently relies on urine tests which are impractical to give at the roadside, but saliva tests are in the pipeline.

Once this method of testing is established, it is a reasonable bet that it will eventually be introduced throughout the EU.


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