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Tuesday, August 26 Driving Under the Influence

Ferrara S.D.
Centre of Behavioural and Forensic Toxicology, University of Padova, Via Falloppio 50, 35121 Padova, Italy

This lecture reviews the latest developments concerning the role played by psychoactive substances and drugs causing impairment, traffic, occupational and other accidents. Pharmacological and epidemiological knowledge acquired over recent years has given rise to a general consensus on the capacity of psychoactive substances (cannabinoids, hallucinogens, narcotics, psychomimetics and solvents) for producing impairment and causing accidents. For other classes of substances, evaluations need to be made of the effect of each drug, with the consequent careful use of those compounds which offer a better risk/benefit ratio.

The classes of Anticholinergics, Antidepressants, Barbiturates, Benzodiazepines, Hypnotics and Neuroleptics include some substances capable of causing impairment and others for which conclusions are not definitive. In other pharmacological classes, such as Anxiety-reducing substances and Antihistamines, drugs causing impairment coexist with others, more recently synthesized, with no effects on driving ability. For CNS stimulants, there is evidence both that they improve psychomotor performance and that they may play a role in causing road accidents. Recent studies on non-psychoactive substances (e.g. antibiotics, anti-mycotics, Ca-antagonists) in tollerant subjects or in patients undergoing prolonged treatment, have shown results which are not always in line with those reported in the past on healthy volunteers.

A number of guiding principles should be followed in future studies. In particular, creative and international synergistic research should be related to the real world in order to link laboratory results to field observations reflecting individual actual reality, often affected by other impairing conditions such as personality and comorbid psychiatric disorders.

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