Following the introduction of a new drug driving law, head of pharmacy services at the NPA, Leyla Hannbeck, outlines what pharmacy teams and patients need to know

A new drug driving law, which came into effect in England and Wales on 2 March this year, makes it an offence to drive, attempt to drive or be in charge of a motor vehicle with a specified controlled drug in your body, in excess of a specified limit. The legislation is also due to be enforced in Scotland once it is approved by the Scottish Parliament, and the introduction of a similar offence is under consideration in Northern Ireland. To help pharmacy teams understand the new legislation, the NPA has produced a series of resources providing legal and practical guidance. It is important for pharmacy teams to be able to explain these new drug driving rules to their patients.

What drugs are included in the new legislation?

There are 16 controlled drugs (CDs) listed in the new drug driving offence, with specified allowable blood limits. The specified CDs include commonly abused drugs (where the specified limits are low), as well as some commonly prescribed CDs (where the specified limits are set above those likely to be found if patients are prescribed the drug within the usual therapeutic dose range). The commonly abused drugs specified include cocaine, cannabis, ketamine, LSD, methylamphetamine, ecstasy and heroin. The other group specified includes the licenced medicines clonazepam, diazepam, lorazepam, oxazepam, temazepam, morphine, methadone and the unlicenced drug flunitrazepam.

How will this affect existing legislation?

Currently, in accordance with Section 4 of the Road Traffic Act 1988, it is already an offence to drive while impaired by drugs. This offence will remain in force alongside the new drug driving offence.

Will patients who take drugs that may be metabolised into one of the specified drugs be affected by this new drug driving offence?

Yes. The new offence will also apply to patients taking a drug that can be metabolised into one of the specified drugs. For example, codeine is metabolised into morphine. Patients should be advised accordingly.

My patient has been prescribed quite a high dose of a CD. What will happen if their blood levels are over the specified limit?

Sometimes a patient can be prescribed controlled drugs at doses which are higher than normal. In this case, where the levels of drug in the patient’s blood may exceed those specified by the new rules, the drug driving legislation provides a statutory “medical defence”. This is only if the specified drug was taken according to the prescriber’s instructions and/or the information in the patient information leaflet (PIL), and driving is not impaired. It is important for patients to remember, however, that the statutory medical defence cannot be used if driving is impaired due to drugs, regardless of whether they are prescribed or not.

What should I advise my patients to carry with them if they are driving and legitimately taking one of the specified drugs?

Patients should be advised to carry a form of evidence that will provide proof that the medicine has been taken as prescribed by a healthcare professional or purchased over the counter and has been taken in accordance with the patient information leaflet (PIL).

Will the police be testing drivers who are suspected of driving while over the set limits for the specified CDs?

Yes. The police will be allowed to test and prosecute drivers who are suspected of driving while over the set limits for the specified CDs. Initially, a roadside test using saliva will be carried out to determine whether the driver has taken one of the specified CDs (or one that may be metabolised into one of these drugs). Drivers who test positive for the saliva test may then be requested to provide a blood sample which will be used to identify whether their blood level of the drug is above the new legal limit.

What should I advise my patients about deciding to drive or not?

Your patient should not drive if their medicine causes drowsiness, dizziness, loss of concentration or visual disturbances and/or if their ability to drive could be impaired for any reason. They should also avoid driving if they are starting a new medicine or if changing doses as this could temporarily increase the risk of impaired driving. In all cases, the decision about whether to drive or not remains the driver’s responsibility. NPA members can access drug driving resources, including a factsheet, patient counselling tool and FAQs at: www.npa.co.uk/Knowledge-Centre/Legal-Ethical/Drug-Driving. Members can also phone the NPA Pharmacy Services team on: 01727 891800.