Over the past several decades, the impairing effects of alcohol on driving have become common knowledge. More recently, the use of illicit drugs such as cocaine, cannabis and methamphetamine have become the focus of increasing concern for its impact on road safety. However, it is less well understood that some psychoactive prescription drugs can also affect driving. Psychoactive prescription drugs, such as opioids, sedative-hypnotics and stimulants, are associated with serious harms including injury and death. In an effort to address these and other harms, the Canadian Centre on Substance Abuse (CCSA), together with over 40 partners, released First Do No Harm: Responding to Canada’s Prescription Drug Crisis, a 10-year pan-Canadian strategy that outlines 58 recommendations for collective action in a number of key areas, including prevention, education, treatment, monitoring and surveillance, enforcement, and legislation and regulation.

The current review explores the extent to which psychoactive prescription drugs can adversely affect the cognitive and motor functions essential for the safe operation of a motor vehicle and thereby increase the risk of crash involvement. More specifically, the objectives of this report are:
• To review and summarize the scientific literature on the impairing effects of psychoactive prescription drugs on the skills and abilities required to operate a vehicle safely;
• To examine the epidemiological evidence on the extent to which psychoactive prescription drugs are used by drivers and increase the risks of crash involvement; and
• To identify approaches for enhancing the safety of drivers who use psychoactive prescription drugs in Canada.

The evidence reviewed in this report will help to inform policies and practices aimed at reducing injuries associated with driving impairment involving psychoactive prescription drugs.