Doctor's orders: what makes you fit to drive?

No alcohol or drugs: “No one wants to share the road with a driver over the drink-drive limit, spaced out on cannabis or spice or manic and invincible after a line of Colombian marching powder. But what about someone who has had a pint of beer or a ‘harmless’ glass of rosé?

“Alcohol has a profound effect on driving ability as blood levels rise, particularly on reaction time, and this slowing of responses is even more marked in women. However, while your reactions may be okay at lower, legal alcohol levels, studies show that your behaviour isn’t. Just one drink disinhibits you, as it hits the controlling frontal lobe of your brain that makes you the sensible, well-behaved person you are. Hazard recognition becomes impaired and you take increased risks, like a dubious overtake. The bottom line? The safest option when driving is not to drink at all.”

Stay alert: “Rospa [the Royal Society for the Prevention of Accidents] estimates that driver fatigue is responsible for 20% of accidents on British roads, and up to a quarter of those involving a fatality or serious injury. Driving when you’re knowingly exhausted or even just a bit under par is risky, as your attention and reaction times drop. Bear in mind that fatigue can creep up on anyone if they drive long distances without a break (stop for 15 minutes every two hours, says the Highway Code).

Some groups who are particularly vulnerable to fatigue include those who snore heavily (a possible sleep-apnoea syndrome associated with daytime drowsiness) and those on sedative medication, either prescribed or over the counter. Common examples of prescribed medication include opioid painkillers (such as codeine) and some antidepressants (including mirtazapine and amitriptyline), sleeping tablets (the hangover effect) and bladder pills (oxybutynin, for example).

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“Common over-the-counter culprits include antihistamines. Modern versions are much better, but avoid older types like promethazine (Phenergan) if driving. Sleep remedies like Nytol often contain these older antihistamines, too, and so can make you drowsy the next morning.

“Caffeine helps combat fatigue and improve alertness. It’s no substitute for regular breaks, and optimal doses vary from person to person, but aim for 100-200mg (a double espresso) every three to four hours for the best effect.”


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