The New Straits Times, July 15, 2001
By Professor Dzulkifli Abdul Razak
In Ops Bersepadu early this month, more than 300 road users along the highways tested positive for dadah. Some were detained for allegedly taking ganja, heroin and cocaine (Malay Mail, July 10).
Operations in April and May showed more than a thousand dadah-dependent public transport and commercial vehicle drivers are still on the road. This is indeed shocking given that these drugs are psychoactive and could alter one's perception as well as mood.
These and other effects could endanger not only the drug user but also other road users. It is suprising many are still willing to risk their lives and that of other despite such well-publicised harmful effects.
An interesting question to ask is of course, what if the drug used are "medicinal drugs"? Are they completely safe to the drivers and road users? The answer would depend on whether such drugs too can impair driving skills. While the medicines are legal, their effects or side-effects can be harmful, especially when driving.
Generally, they can cause dizziness, blurred vision and even psychoactive effects similar to that of illicit drugs.
Below are some examples of medicines (in generic names) that could affect driving skills. The more common ones perhaps are antihistamine drugs, especially the "older" types that cause sedation; for example chlorpheniramine, diphenhydramine and promethazine. The "newer" type is, however, less of a sedative, through some can still affect individuals, for example, cetirizine.
Drugs used for common cold could also have these effects. For example, pseudoephedrine and phenylpropanolamine (with-drawn from the market recently). In large doses, they could also act on the brain, and alter mood.
Another type is anti-hypertensive drugs used to lower blood pressure. Some can cause sedation (for example, beta-blockers and ACE inhibitors) dizziness. So also anti-diabetic drugs, especially when there is too much lowering of blood sugar (hypoglycaemia). It can make people lethargic.
Anti-gout drugs like allopurinol can also cause drowsiness. Others with more prominent effects on driving are those that affect the brain. Some examples include: Antipsychotic drugs. These are groups of drug used to treat a mental illness called "psychosis".
They can cause sedation at the beginning, despite the overall beneficial effects on mood and mental status. Example, haloperidol, chlorpromazine and trifluroperaziof. They can also cause sedation at the initial stage of treatment.
Benzodiazepine is another class of drug that acts on the brain. For example, diazepam, nitrazepam and clonazepam. The drug generally suppresses the brain function hence, can induce dizziness, even sleepiness. Indeed one of their major uses is a sleeping pills.
The above examples are not exhaustive, but suffice to demonstrate that medicines can unknowingly affect driving skill. Since such medicines are more accessible, one suspects that many more would be using them while driving.
In other words, to avoid road accidents arising from the use of such medicines, patients should be advised about the dangers of driving or even operating dangerous machinery. Generally, this is enhanced by the use of cautionary and advisory labels secured to the medicine's container.
The label reads: "This medicine may cause drowsiness and may increase the effects of alcohol. If affected do not drive a motor vehicle or operate machinery".
Unfortunately, this is not the case in Malaysia. Drugs are generally poorly labelled, depriving the users of vital precautionary information that could save lives.
Thus, if the intention is to make driving safer, it is not the traffic policemen alone who is involved; health professionals, too, must properly label and educate the consumers. Otherwise we are only looking at the tip of the iceberg.
Recommended websites: http://www.dmv.ca.gov/pubs/matured/dl663pt2.htm
