new doctor question about medications and driving

[norcalmom]

My primary care doctor suddenly left and I had to change to a new doctor. My first visit with my new doctor was a few days ago and she looked at the medications I have been prescribed and she told me that I should not be driving at all because I am on the fentanyl patch and also have other medications for my chronic pain that I only take as needed. The ones I take as needed I only take at night time because I dont want to be too loopy during the day. I was set back because of all the years I have been taking vicodin initially, not one doctor told me I couldnt drive. This doctor told me just taking vicodin alone I should not be driving. I know that narcotic medications say it may cause drowsiness, but being on the patch Im on right now I have no side effects like that. In the begining I did, and wouldnt drive at all on the first day I put the patch on and slowly would begin to drive on the second day and now I can function with no problems. I felt very embarrased because I thought I did something wrong and also got scared because I need to be able to drive. She kept on telling me about stories that happened to others and I understand where she was going, but at the end she told me I wont contact dmv but you shouldnt be driving.

I am having surgery in a few months and this scares me that I have a doctor that feels this way and if I have issues with pain after surgery I dont feel like she will be there for me. I know I can change doctors but I dont like to because i use to work in Internal Medicine Dept and I know it is looked down on when you change doctors-doctor shopping.

Has anyone else had a doctor visit like this?

[Pike]

While there have been many studies and links to them here I believe that your Dr may feel the need to say this to you for whatever reason the Dr may have.

I do believe that anyone that gets tested after a stop or accident can be subject to prosecution for DUI ... in the event of an accident I am pretty sure that most lawyers would attempt to use this against a person ... my personal opinion is that many meds that are not against the law to drive on can be far more dangerous and if statistics were kept it would show that opiate use by a tolerant patient is less dangerous than Neurontin and other meds ... the degree of danger would depend upon the person as with any substance.

The studies I mentioned earlier were if memory is correct morphine with long term use against a patient in severe pain and the morphine taking patient was more alert than the hurting patient ... now we all know that any CNS depressent is going to have an effect even if very minor ... in accidents every second counts when trying to avoid a situation and again myth, legend could stack the deck against a driver regardless of the true cause.

The studies indicated that when a benzodiazapine was combined with morphine the skills, reaction times were slower and could more likely make a difference when a split second reaction time ... could have made a difference.

I wish I had the links but this was on the old board and gone I am pretty sure; I have a good idea that benadryl and many other meds either alone or in combination with morphine could contribute to a slower reaction time.

If all patients taking opiates were taken off of the roads millions would be without transportation with less quality of life ... the reason most non terminal patients take the medications ... I might add that I see more fentanyl patches are being prescribed to the active elderly as I have seen many patches at the YMCA while I never saw them 5 years ago.

I have to say that in most states the law is no person will drive with a controlled substance in the system or their metabolites ... it simply seems to be up to the county prosecutor, police chiefs to determine their highest priority deviation of the law as written; in some Ca cites the judges, prosecutors and police departments do not want to spend the time for simple pot cases and have chastised officers for arresting people for this ... 13 states have laws different that the federal law in this specific area.

So it boils down to where you are, what initiates police encounters and without any doubt personal injury for whatever reason.

This is not a black and white area, be careful and volunteer nothing if simply pulled over as this should be between you and your Dr once a patient is used to the effects of any medication and do not have alcohol involved as it is one area that I see more aggresive prosecution without regard to your location in our nation.

Best wishes,

Pike

[Mark N]

norcalmom, Pike said it like it is. I have had one doctor I was checking out that was going to try and take my drivers license away. We know that we are worse off in pain than when using our meds. I have my family monitor that I don't go driving when my meds are impairing me. I don't take my dose when driving and wait until the drive is over.

Each state handles this differently but I know I will challenge being impaired just because I am on a maintenance dose of pain medicine if the situation comes up. It is a shame that we have to prove ourselves to keep the privilege of driving but that is the way things are right now.

[Pharmacist.steve]

It is a proven fact that ~80% of accidents are caused directly/indirectly by distractions. Untreated chronic pain .. can be a DISTRACTION.. as is tuning the radio... talking on the cell phone .. smoking ... eating ... and on and on ...

IMO.. your doc is taking what may be the "letter of the law" to an extreme.. to the point that her obsession with the "letter of the law" is distracting her from providing good patient care!!!

I wonder if she is giving the same "warning" to all her patients that take medications that may impair operating equipment/driving.. if so ... she is probably going to take over HALF of her patient OFF THE ROAD!!

IMO... Unless the patient was opiate naive....giving a patient such a dire warning without observing if/how the medication affects a patient ... is unprofessional and irresponsible... I believe, in the end, she does not want to prescribe/maintain a chronic pain patient on opiates...and she is basically OPIOPHOBIC!!

My money is on the fact that she will want to wean you off opiates .. in the very near term...

[GJZH]

The PA to a neurologist that I saw a few times went off on me...She was the only medical personnell to react this way to my meds...She told me she worked in an emergency room and saw many car accidents from people like me driving while on pain medications...I am on very minimal doses...She said I would be arrested if ever in an accident and sent to jail...I truthfully do not drive that often...My husband does most of the driving...I determined the PA wanted to show her authority and was a jerk...I have not gone back to that office...I do not need that aggravation...I do not happen to like neurologists anyway...They are a bit odd when it comes to specialists....