Counsel methadone patients on drug driving, pharmacists urged

blurred car

The omission of methadone from drug driving laws has been questioned by Drug-Safe Communities following its implication in a fatal Boxing Day crash

On December 26, a 50-year-old man who was driving home after attending a Nowra methadone clinic crossed onto the wrong side of the road and hit a car carrying the Falkholt family.

All four family members – parents Lars and Vivian and adult daughters Annabelle and Jessica – were killed as a result of the crash, with 28-year-old Jessica, an actress who had appeared in soap Home and Away, passing away in hospital three weeks after it occurred. The other driver was also killed.

Now, Drug-Safe Communities is querying why methadone patients are permitted to self-diagnose whether they are in a safe condition to drive, and encouraging pharmacists to counsel them on the dangers.

“The law says a person can have methadone in their body while they are driving but they cannot be under the influence of it,” the company said in a statement this week.

“We are asking a person whose judgement and logic is impaired by methadone to self-diagnose if they are ‘under the influence’ or not,” says Brian Lloyd, accredited trainer and principal at Drug-Safe Communities.

Jessica Falkholt, who died after a methadone-affected driver hit her parents' car.
Jessica Falkholt, who died after a methadone-affected driver hit her parents’ car. Image: Facebook

“It is comparable to asking an alcoholic if they are drunk while they drink and drive.

“When a Drug-Safe Communities field tester identifies a person with alcohol or a narcotic in their system, we are required by law to provide alternative transport to take them to a safe environment to recover, until a drug test indicates they are free of any effects.

“So it is baffling that the law permits a methadone user to drive.”

He said that while nobody can prevent methadone patients from driving, he urged pharmacists who provide methadone services to counsel them about the side-effects of the medicine, “and counsel them towards behaviours and actions that could potentially save their life, and more important the life of other innocent road users”.

He listed side-effects including anxiety, nervousness, restlessness, sleep problems (insomnia), weakness, drowsiness, dry mouth and nausea; as well as potentially: shallow breathing, hallucinations, confusion, chest pain, dizziness, fainting, fast or pounding heartbeat, and trouble breathing.

“For anyone in charge of a motor vehicle, many of these are potentially lethal,” he said.

“We know that the effects of methadone in oral form can last up to 48 hours. Its initial analgesic action is somewhere between 6-10 hours.

“Ideally therefore, we should be advising users not to drive or operate machinery of any kind for 48 hours.

“Ideally, an explanation from the pharmacist, along with a printed brochure that outlines all these details would be a great start.”

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    So we are discussing changing the laws and potentially stopping our methadone clients from being able to drive at all because of an accident involving a driver who had lost his licence a couple of times previously for bad driving. Surely bad driving contributed to the accident?

  2. Irvine Newton

    It is really important we don’t jump the gun and make judgements without knowing the facts. Properly managed methadone recipients are not “intoxicated”. They are perfectly capable of going about their normal daily lives.What we don’t yet know is the actual health staus of the driver involved in the collision.His past history suggests he may have had other influences on his ability to drive safely than his methadone maintenance dose. We don’t even yet know if he alone was responsible for the collision. No doubt a coroner’s inquest will establish all these details.
    It’s important to know that the majority of “methadone related deaths” involve people having other drugs in their blood stream at the time of the death.
    There are over 40,000 people in Australia receiving methadone and Buprenorphine at this time. The vast majority are doing well and many are involved in careers as taxi drivers, building workers etc. Many more are successfully holding down jobs in the professional world.
    Let’s not jump with inappropriate knee jerk reactions to this one terrible event. Naturally people want quick responses and action, but let’s get the facts and make good judgements and decisions.

  3. Jarrod McMaugh

    There is a big difference between the therapeutic use of a regular dose of a medication, and the recreational use of any substance that can affect driving.

    People using new medications for multiple conditions need to consider their driving; hypertension, diabetes, analgesics, depression, etc etc.

    Those who have been on steady treatment, including ORT, will not be affected when driving in any way that is comparable to drink driving.

  4. Amandarose

    There is an app called DRUID that tests impairment that is being considered in the USA as a tool to assess cannabis impairment . It may also be useful for drowsiness, other medications etc.

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