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Prescribed DUI: An alcohol-free danger

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When it comes to getting the attention of the media and the public, not many things work better than an unfiltered, celebrity mugshot. When Tiger Woods was arrested on Memorial Day for driving under the influence, his mugshot and the story of his arrest became easy fodder for the media. The man once known for being unstoppable on the golf course was found in a stopped car, asleep in the early hours of the morning. While it is easy to assume that anyone arrested for a DUI with a rough looking mugshot like Tiger’s must have been drinking, this was reportedly not  the case with Tiger. And it may have been hard to believe when Tiger himself dismissed alcohol as the culprit early on after the news broke. Yet according to the police report, Tiger blew a .000 on his breathalyzer. Tiger was not driving drunk. Tiger was driving drugged. And drugged driving can be just as deadly.

While it’s unclear exactly what regimen Tiger was taking or what drugs led to the interaction (some of the drugs listed on the police report are incorrect as they either don’t exist, are amazingly misspelled, or have been off the market since 2004), this appears to be another example of strong medications used in combination impairing one’s ability to drive. The one drug listed on the police report that is currently available by prescription only and recognizable is Vicodin, or otherwise known in generic form as hydrocodone in combination with acetaminophen (Tylenol). Vicodin, a commonly prescribed opioid, is known to cause drowsiness, something that is only amplified when given with other medications like a muscle relaxant (a type of medication commonly prescribed after back surgery which Tiger had last month).

And like many other celebrity stories that include opioid and/or prescription drug use, stories like this can often help illuminate more specific issues connected to the current overutilization problem we are realizing in the U.S. Tiger’s DUI should appropriately point our attention to the issue of drugged driving and the fact that it is not uncommon. A recent report by the Governors Highway Safety Association shows us that for the first time, fatal auto accidents are now more likely to involve drugs than alcohol. Per the report, in 2015, of those fatally injured drivers who were tested for drugs (57%), 43% tested positive for drugs of some kind. Out of those fatally injured drivers who were tested for alcohol (70%), 37% tested positive. And perhaps just as sobering as those statistics may be, is the realization there is no current breathalyzer available to check for someone’s consumption of the various prescription medications that could cause these types of interactions and impair driving. (It is also interesting to note that, of all the discussion that marijuana is a “safer option” compared to other prescription medications like opioids, marijuana was present in roughly one-third of the positive tests for drug use.)

Employers must be aware of how these strong medications, and their interactions, can greatly impact injured workers and their ability to work at their desk or in a warehouse, as well as their ability to drive.  My team  works daily to ensure the injured workers we advocate for are getting the most appropriate medications for their injury, and for the correct duration. The issues of our current opioid epidemic and drugged driving communicate the same message – their impact can easily reach beyond the person taking the medications and change not just the individual’s life and health, but also the lives of their families, friends and communities. For additional information and support resources, visit the Drug Enforcement Administration (DEA) website. If you have specific drug-interaction questions or observations, feel free to reach out to us in the comments.

Dr. Paul Peak, AVP, Clinical Pharmacy

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