Is it safe for a methadone-maintained patient to drive a vehicle?

The public has been greatly concerned about persons using alcohol or any drugs that might impair mental function when they drive motor vehicles. However, it is clear that methadone itself does not in any way hinder persons stabilized in MMT from driving safely.

An important exception might be during the early days while starting on methadone, before the dose is stabilized. Like all opioids, methadone may impair the mental and/or physical abilities required for performing potentially hazardous tasks, such as driving or operating machinery. Patients should be cautioned accordingly.

Once stabilized on methadone maintenance, various research studies have examined important skills in MMT patients required for safe driving, such as the ability to pay close attention, reaction time, eye-hand coordination, and accurate responses in emergency situations. In some cases, driving simulators were used to test these skills. In all studies, persons maintained on adequate and appropriate methadone doses had normal functioning.

To examine “real world” driving performance, some researchers looked at reported traffic violations and accidents among methadone-maintained patients compared with others having no history of drug addiction. MMT patients did not differ in any way from other drivers of the same age.

Therefore, the research consistently shows that methadone itself is not a source of concern when it comes to driving motor vehicles. However, it should be noted, that the patients tested were well-established in MMT, receiving adequate methadone doses, and not abusing illicit drugs or alcohol. Patients going through opioid withdrawal due to insufficient methadone doses, or experiencing methadone overmedication effects, such as sleepiness or fatigue, might not perform as well.

For further discussion and references, see: Gordon NB. The Functional Potential of the Methadone Maintained Person. In: Compendium for methadone maintenance treatment by the Chemical Dependency Research Working Group of New York State OASAS (Monograph 2, 1994: page 39).