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Medication Impact on Driving and Working

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  • It's considered an auxiliary aid,

    As long as the use of the medication doesn't substantially limit your ability to perform job-related functions or require unreasonable accomodation, the employer cannot discriminate based on the reason for or the type of medication involved.

    Also, under ADA, you're not required to disclose a disability if you're not requesting accomodation. If you don't require accommodation for issues related to your pain medication, you're not required to disclose the details surrounding your use of the medication. The only information you're required to provide is proof that your use of the medication is legal, if you test positive on an employment-related drug screening.

  • Absolutely correct-I did see all of these issues you've addressed here on the ADA website (and btw, I saw where you listed the link in another post-thank you). I'm glad that you're posting this information. There are so many members (and even guests) that are facing such struggles with their employers and I think it's imperative that they arm themselves with as much of this information as their brains can handle-for their own protection. I wish I had known more before things ended up the way they did with my own former job.

    Thank you so much for sharing your knowledge of this stuff with us. I'm sorry that you had to learn it under the circumstances that you did, however. God bless you-you're a very strong woman to have endured all you have and still have such a great attitude. You're a prime example of the type of person I look up to, and that other members here can learn from your example and knowledge/experiences. Thanks again! :)
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  • Wow, interesting post. I find i am in the position of being confused. I am in to much pain to do much driving (even with the meds). If so much stigma is applied to picking up scripts, why not go ahead and apply for disability? Whats the difference. I could care less what people say about me. If they aren't paying your bills, why bother with what they think. Im confused on the fact that if some peoples pain is so intense, how can they possibly work a 40 hour week just by taking pain meds? I find it impossible. Does this mean my meds arent strong enough? I'm on some pretty big stuff. I guess I'm lucky to have caring family and friends to help me get places when i need to go. I would never wanna jeopordize anyone elses safety because of my disability. I guess i have learned to live with my issues, and have asked those close to me to help me out. i WISH i could work a job on pain meds. If i were able to work a job and feel useful, i'd glady take a Tarc or carpool. Thanks for all the information. This was a great post. I had no idea that a person on pain meds could be given a DUI when the meds are prescribed by a doctor. I think everyone knows how their bodies respond to medications, and should make judgements that wont affect the rest of the world. I would almost bet my life that some people DO take more pain meds than needed. I used to work in a doctors office and you wouldnt believe the amount of people that come in claiming their meds were stolen or lost. What seemed to be the case alot of times, were that these people took MORE than prescribed to "get through the day". i can see this is a very touchy subject , but a great one. As far as the DUI goes, can't they tell by a blood test if you only have amounts prescribed in your system OR if you have taken more than prescribed? What constitues the DUI, just the fact that you have meds in your system? I am on extended release morphine (and i take it daily as prescribed). If i have to go to the store alone (which means im driving myself), i do it at a time of the day where i have not had to take my breakthrough meds. In my opinion, i guess people need to make the judgement call themselves. We all know after a few days on meds how our bodies will react, so i just hope everyone learns from these posts and does what they can to ensure the rest of the world is as safe as can be while those that do drive on pain meds are out there. I do agree that tylenol etc would be ok. Just talk to your doctors and pharmacists and dont drive until you are sure you can operate a vehicle safely.
  • cj062373 said:
    I find i am in the position of being confused. I am in to much pain to do much driving (even with the meds). If so much stigma is applied to picking up scripts, why not go ahead and apply for disability? Whats the difference.
    For me, the answer is simple. I don't qualify for disability because I don't have enough work credits in the correct time frame.

    I have to return to work and I have to make it through the 40-hour work week.
  • downinmyheart said:
    It goes straight to the pain and most definately not to my head. Sometimes I wish it did though!

    I think if I were not in severe pain, I would definately be more suseptible to the euphoric side effects of drugs and alcohol.

    I would be a cheaper date too! :))(
    Cheep date huh ? :X >:D< :jawdrop:
    Dang girl you got it going on. ;) B)
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  • i'm not positive this link will work, but i'll try. this is the abstract of a paper presented at the american society of anesthesiologists annual meeting in 2007. it was a follow-up study to the one i posted previously. the reference to figure 1 in the last paragraph is a graph of the results, which is located on the original abstract page.

    https://www.asaabstracts.com/strands/asaabstracts/abstract.htm?year=2007&index=3&absnum=664

    october 17, 2007
    9:00 am - 10:30 am
    room room 120

    does chronic intrathecal opioid treatment adversely affect driving skills?

    asokumar buvanendran, m.d., mario moric, ph.d., jeffrey s. kroin, ph.d., nithya venkatesan, m.d., kenneth j. tuman, m.d.
    anesthesiology, rush medical college, chicago, illinois

    introduction: intrathecal opioid, via implantable pump systems, is an acceptable tool in the treatment of intractable chronic pain (j pain symptom manage 1996; 11:71). no guidelines exist for deciding whether intrathecal opioid treatment, which is intended to reduce side effects such as sedation, impairs driving skills. this study is designed to use a driving simulator to allow us to address whether patient driving performance is affected by intrathecal opioids.

    methods: the clinical trial compared 2 groups; it opioid: 35 patients receiving chronic intrathecal opioids at morphine equivalent doses of 1-10 mg/day; control: 33 age-controlled subjects (not receiving narcotic medication). exclusion criteria were any medical condition or medication that would prevent normal driving. patients were consented (irb) to take a validated 12 min test in a driving simulator in a quiet room. a 3 min practice phase preceded the evaluation phase. the driving simulator provides assessment on several outcome measures: attention, reaction time, etc. allowing us to specifically address questions pertaining to any cognitive or behavioral differences. measures from the 2 groups were compared using student t-test, mann whitney u test, and chi-square test as appropriate (alpha=0.05). schuirmann's two-one sided t-tests (tost) of equivalence were used to statistically determine equality between the 2 groups (j pharmacokin biopharm 1987; 15:657-680). tost is the fda preferred method for clinical drug-drug interactions.

    results: there were no demographic differences between the 2 groups: controls 43.3 (1.5) y.o.; it opioid 45.4 (1.4) y.o. (mean (sem)). the variation in the lateral deviation from center line was 3.77 (0.19) feet for controls and 3.81 (0.18) feet for the it opioid group. lateral deviations for specific time periods throughout the simulation are shown (fig). a t-test of this difference was not significant (p=0.134), so the tost test of equality was performed and was significant (p<0.001) indicating both groups are equivalent. the other measure was reaction time. again there were no significant differences between the 2 groups: control 0.72 (0.04) sec, it opioid 0.69 (0.03) sec, p-value=0.617. tost test of equivalence for reaction time was p=0.008. for both measures the tost results indicated we should have been able to detect a difference if one existed, indicating similar driving performance of the two groups.<br />
    discussion: there was no difference in deviation from the center line or reaction time between patients receiving chronic intrathecal opioid medication versus normal subjects. although these results need to be confirmed with a larger number of patients and with additional measures of driving efficacy, this study can act as a guideline for discussing the issue of driving for patients taking intrathecal opioids.[figure1]



  • That is very good information to know.

    Yesterday while thinking about all of this, I did check my own employers policy regarding drug use. And they say pretty much the same thing. As long as you are not impaired from doing your job, prescribed medications are not a problem.

    I think it is imperative for all of us to be aware of all the laws and policies that apply to drug use in our lives (employment and the state in which we live).
  • weakback said:
    downinmyheart said:
    It goes straight to the pain and most definately not to my head. Sometimes I wish it did though!

    I think if I were not in severe pain, I would definately be more suseptible to the euphoric side effects of drugs and alcohol.

    I would be a cheaper date too! :))(
    Cheep date huh ? :X >:D< :jawdrop:
    Dang girl you got it going on. ;) B)
  • When I am undermedicated and in terrible pain, I do not drive. It is not safe. I have sharp, shooting pain that will just rip through my leg and out my foot. When this happens, sporadically, I could literally end up in a ditch the pain hurts so bad.

    When I am properly medicated, I do not have issues with my attention span, reflexes, etc., (as far as I know), but I still choose to rarely drive.

    When I get my meds changed or adjusted, I wait a long time to see how it will really affect me at all time of the day. My husband supports me not driving unless absolutely necessary.

    Another issue with driving is that I can't shift and adjust as needed. I can be in a pain flare for days after one short trip to town. If hubby drives, I recline the passenger seat quite a bit, keep the heated seat on to keep the muscles from spasming, etc. Can't do the reclined seat when driving. I had to drive to an appointment 2 days ago (10 minute drive) and I am still recovering. Both from the drive and having to sit in regular chairs at the doctor's office.

    My S1 nerve has acute and chronic damage and sitting is my biggest trigger. I spend the majority of my day reclined at home, keeping my weight completely off my low back.
  • Your compassion is a quick reminder of the bond we should all share here. Thank you.

    I can't comment on this too much because it is being interpreted as being off topic. I will say that yes, my brother had huge responsibility in this situation. I do not condone his actions at all and i think they are inexcusable. I think there was some misunderstanding here though. Initially he did not abuse his pain meds. It was when they no longer worked for him, and he was desperate for relief, that he added to taking street drugs along with the prescribed drugs. So much of my words have been deleted that I can see where you would think that he turned to street drugs completely. He was not using the street drugs for recreational purposes, but for pain relief. I will agree that they were responsible for this, just as we are responsible for our actions. I guess my communication skills are not what they should be, because the point has been missed here by many. I feel this information is relevant to the topic, because it illustrates teh seriousness of driving while impaired, no matter what the reason for the impairment.

    I am not feeling a need to explain the situation with my brother the person. He paid the ultimate consequences for his actions, and his 2 daughters will have to live without their father. However, I did want to clarify the situation, because it is the driving with drugs in your system that is the issue here. And that is what makes his story relevant to this topic. Thank you for your thoughtful post.

    Additionally, I want to thank you for being so responsible with how you take your pain meds. You obviously understand the seriousness of the subject.

    Cindy
    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
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