Cognitive and psychomotor impairment from the use of opioid analgesics: Effects on driving and occupational activities

Given the widespread use of opioids for the treatment of pain, the potential cognitive and psychomotor effects of these medications are a significant concern. Cognitive and psychomotor impairment has been demonstrated following the administration of opioids to opioid-naive patients. These impairments could adversely affect safe driving and the safe performance of certain occupational activities. Thus, patients treated for acute pain with opioids should not drive or perform occupational activities requiring a high level of cognitive or psychomotor function. However, tolerance to the cognitive and psychomotor effects of opioids usually develops rapidly. The vast majority of studies indicate that opioid-maintained patients demonstrate no impairment of psychomotor function or driving-related skills. Therefore, patients treated for chronic pain who have been stabilized on long-term opioid therapy should not necessarily be restricted from driving or occupational activities. Professional guidelines and government regulations should be based on the currently available scientific evidence.