Abstract
Physicians establish which medicines should be administered for the benefit of patients. The system of categorization for medicines and driving developed by the International Council on Alcohol, Drugs and Traffic Safety (ICADTS) and research groups within the European project DRUID (Driving Under the Influence of Drugs, alcohol and medicines) would allow the prescribing doctor to look for safer alternatives within a specific therapeutic class. A prime and exemplificative medico-legal case of driving under the influence of psychotropic medications is presented, analyzing the responsibilities of each participant: the patient, the general and specialized physician, and the driving licensing authorities. It is necessary to establish guidelines relating to the prescription of psychoactive medications, to be shared and adopted by all of the parties involved. The point of reference is that of Personalized Medicine, a paradigm which also entails the personalization of therapy, including a careful evaluation of the social sphere and impact on the community.
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Notes
- 1.
European Monitoring Centre for Drugs and Drug Addiction. Literature review on the relation between drug use, impaired driving and traffic accidents. Lisbon: EMCDDA; Feb, 1999.
- 2.
European Monitoring Centre for Drugs and Drug Addiction. Driving Under the Influence of Drugs, Alcohol and Medicines in Europe—findings from the DRUID project. Lisbon: EMCDDA; 2012.
- 3.
Jones R, Shinar D, Walsh JM. State of the knowledge of drug impaired driving. National Highway Traffic Safety Administration; Sep, 2003.
- 4.
European Commission–Road Safety–Fitness to drive. (http://ec.europa.eu/transport/road_safety/topics/behaviour/fitness_to_drive/index_en.htm).
- 5.
See foot note 2.
- 6.
The paradox is that the Generic Recommendation written by the prescribing physician was «Prudence in driving».
- 7.
This document is a self-declaration written in the presence of a physician authorized by the State. It is filled out every ten years for drivers. In the past it was an anamnestic certificate written by Italian general practitioners, but they asked for its abrogation due to conflict of interest with professional secrecy.
- 8.
Amitriptyline hydrochloride product information: Mylan Pharmaceuticals Inc., Morgantown, WV, (PI revised 03/2016).
- 9.
Trilafon perphenazine product information: Schering Corporation 505 Kenilworth, NJ, (PI revised 04/2002).
- 10.
Lamictal lamotrigine product information: GlaxoWellcome Inc., Research Triangle Park, NC, (PI revised 05/2015).
- 11.
Flurazepam hydrochloride product information: Mylan Pharmaceuticals Inc., Morgantown, WV, (PI revised 01/2015).
- 12.
Venlafaxine hydrochloride product information: Wyeth Pharmaceuticals Inc. Philadelphia, PA, (PI revised 02/2008).
- 13.
Quetiapine Fumarate product information: Sandoz Canada Inc., QC, (PI revised 09/2015).
- 14.
In Italy the exponential increase in fatal road accidents in the face of the perceived inadequacy of the repressive system has led the Italian Parliament to introduce Law n. 41 of March 23rd, 2016, making vehicular homicide, together with road traffic injuries, a criminal offense, both of which to be punished as a result of gross negligence. The penalties of the new law are doubled compared to “general” involuntary homicide: driving a motor vehicle in a state of psycho-physical alteration resulting from the consumption of narcotic drugs or psychotropic substances is punished with imprisonment from 8 to 12 years.
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Snenghi, R., Amagliani, A. (2017). Medicines and Driving Personalized Medicine and Medical Liability. In: Ferrara, S. (eds) P5 Medicine and Justice. Springer, Cham. https://doi.org/10.1007/978-3-319-67092-8_32
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