Skip to main content
SpringerLink
Log in

Acute administration of oxycodone, alcohol, and their combination on simulated driving—preliminary outcomes in healthy adults

  • Original Investigation
  • Published:
Psychopharmacology Aims and scope Submit manuscript

Abstract

Rationale

Epidemiological data indicate that drivers testing positive for an opioid drug are twice as likely to cause a fatal car crash; however, there are limited controlled data available.

Objectives

The primary aim of this study was to assess the effects of a therapeutic dose range of oxycodone alone and in combination with alcohol on simulated driving performance.

Methods

Healthy participants (n = 10) completed this within-subject, double-blind, placebo-controlled, randomized outpatient study. Six 7-h sessions were completed during which oxycodone (0, 5, 10 mg, p.o.) was administered 30 min before alcohol (0, 0.8 g/kg (15% less for women), p.o.) for a total of 6 test conditions. Driving assessments and participant-, observer-rated, psychomotor and physiological measures were collected in regular intervals before and after drug administration.

Results

Oxycodone alone (5, 10 mg) did not produce any changes in driving outcomes or psychomotor task performance, relative to placebo (p > 0.05); however, 10 mg oxycodone produced increases in an array of subjective ratings, including sedation and impairment (p < 0.05). Alcohol alone produced driving impairment (e.g., decreased lateral control) (p < 0.05); however, oxycodone did not potentiate alcohol-related driving or subjective effects.

Conclusions

These preliminary data suggest that acute doses of oxycodone (5, 10 mg) do not significantly impair acuity on laboratory-based simulated driving models; however, 10 mg oxycodone produced increases in self-reported outcomes that are not compatible with safe driving behavior (e.g., sedation, impairment). Additional controlled research is needed to determine how opioid misuse (higher doses; parenteral routes of administration) impacts driving risk.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  • American Pain Society. Pain management and dosing guide. 2016. http://americanpainsociety.org/uploads/education/PAMI_Pain_Mangement_and_Dosing_Guide_02282017.pdf

  • Babalonis S, Lofwall MR, Nuzzo PA, Siegel AJ, Walsh SL (2013) Abuse liability and reinforcing efficacy of oral tramadol in humans. Drug Alcohol Depend 129(1-2):116–124

    Article  CAS  Google Scholar 

  • Babalonis S, Hampson AJ, Lofwall MR, Nuzzo PA, Walsh SL (2015) Quinine as a potential tracer for medication adherence: a pharmacokinetic and pharmacodynamic assessment of quinine alone and in combination with oxycodone in humans. J Clin Pharmacol 55(12):1332–1343

    Article  CAS  Google Scholar 

  • Bernhoft IM, Hels T, Lyckegaard A, Houwing S, Verstraete AG (2012) Prevalence and risk of injury in Europe by driving with alcohol, illicit drugs and medicines. Procedia Soc Behav Sci 48:2907–2916

    Article  Google Scholar 

  • Berning A, Compton R, Wochinger K (2015) Results of the 2013–2014 National Roadside Survey of alcohol and drug use by drivers. Traffic Safety Facts Research Note. Report No. DOT HS 812 118. National Highway Traffic Safety Administration, Washington, DC

    Google Scholar 

  • Brown TL, Milavetz G, Gaffney G, Spurgin A (2018) Evaluating drugged driving: effects of exemplar pain and anxiety medications. Traffic Inj Prev 19:S97–S103

    Article  Google Scholar 

  • Chihuri S, Li G (2017a) Use of prescription opioids and motor vehicle crashes: a meta analysis. Accid Anal Prev 109:123–131

    Article  Google Scholar 

  • Chihuri S, Li G (2017b) Trends in prescription opioids detected in fatally injured drivers in 6 US states: 1995-2015. Am J Public Health 107:1487–1492

    Article  Google Scholar 

  • Chihuri S, Li G (2019) Use of prescription opioids and initiation of fatal 2-vehicle crashes. JAMA Netw Open 2:e188081

    Article  Google Scholar 

  • Esser MB, Guy GP Jr, Zhang K, Brewer RD (2019) Binge drinking and prescription opioid misuse in the US, 2012–2014. Am J Prev Med 57:197–208

    Article  Google Scholar 

  • Ferreira DH, Boland JW, Phillips JL, Lam L, Currow DC (2018) The impact of therapeutic opioid agonists on driving-related psychomotor skills assessed by a driving simulator or an on-road driving task: a systematic review. Palliat Med 32:786–803

    Article  Google Scholar 

  • Fraser HF, Van Horn GD, Martin WR, Wolbach AB, Isbell H (1961) Methods for evaluating addiction liability. (A) “Attitude” of opiate addicts toward opiate-like drugs. (B) A short-term “direct” addiction test. J Pharmacol Exp Ther 133:371–387

    CAS  PubMed  Google Scholar 

  • Galski T, Williams JB, Ehle HT (2000) Effects of opioids on driving ability. J Pain Symptom Manage 19:200–208

    Article  CAS  Google Scholar 

  • Hayley AC, Downey LA, Green M, Shiferaw B, Kenneally M, Keane M, Adams M, Shehabi Y (2019) Driving simulator performance after administration of analgesic doses of ketamine with dexmedetomidine or fentanyl. J Clin Psychopharmacol 39:446–454

    Article  CAS  Google Scholar 

  • Hedlund J, Macek K (2018) Drug-impaired driving: marijuana and opioids raise critical issues for states. Governor’s Highway Safety Association, Washington, DC https://www.ghsa.org/resources/DUID18

    Google Scholar 

  • Irwin C, Iudakhina E, Desbrow B, McCartney D (2017) Effects of acute alcohol consumption on measures of simulated driving: a systematic review and meta-analysis. Accid Anal Prev 102:248–266

    Article  Google Scholar 

  • Jongen S, Vuurman EF, Ramaekers JG, Vermeeren A (2016) The sensitivity of laboratory tests assessing driving related skills to dose-related impairment of alcohol: a literature review. Accid Anal Prev 89:31–48

    Article  CAS  Google Scholar 

  • King AC, de Wit H, McNamara PJ, Cao D (2011) Rewarding, stimulant, and sedative alcohol responses and relationship to future binge drinking. Arch Gen Psychiatry 68:389–399

    Article  Google Scholar 

  • King AC, McNamara PJ, Hasin DS, Cao D (2014) Alcohol challenge responses predict future alcohol use disorder symptoms: a 6-year prospective study. Biol Psychiatry 75:798–806

    Article  Google Scholar 

  • King AC, Cao D, de Wit H, O’Connor SJ, Hasin DS (2019) The role of alcohol response phenotypes in the risk for alcohol use disorder. Br J Psych 5(e38):1–3

    CAS  Google Scholar 

  • Kirkpatrick MG, de Wit H (2013) In the company of others: social factors alter acute alcohol effects. Psychopharmacology (Berl) 230:215–226

    Article  CAS  Google Scholar 

  • Kress HG, Kraft B (2005) Opioid medication and driving ability. Eur J Pain 9:141–144

    Article  CAS  Google Scholar 

  • Lacey JH, Kelley-Baker T, Berning A, Romano E, Ramirez A, Yao J, Moore C, Brainard K, Carr K, Pell K, Compton R (2016) Drug and alcohol crash risk: a case-control study (Report No. DOT HS 812 355). National Highway Traffic Safety Administration, Washington, DC

    Google Scholar 

  • Lenne MG, Dietze P, Rumbold GR, Redman JR, Triggs TJ (2003) The effects of the opioid pharmacotherapies methadone, LAAM and buprenorphine, alone and in combination with alcohol, on simulated driving. Drug Alcohol Depend 72:271–278

    Article  CAS  Google Scholar 

  • Linnoila M, Hakkinen S (1974) Effects of diazepam and codeine, alone and in combination with alcohol, on simulated driving. Clin Pharmacol Ther 15:368–373

    Article  CAS  Google Scholar 

  • Martin CS, Earleywine M, Musty RE, Perrine MW, Swift RM (1993) Development and validation of the biphasic alcohol effects scale. Alcohol Clin Exp Res 17(1):140–146

    Article  CAS  Google Scholar 

  • Miceli L, Bednarova R, Rizzardo A, Samogin V, Della Rocca G (2015) Development of a test for recording both visual and auditory reaction times, potentially useful for future studies in patients on opioids therapy. Drug Des Devel Ther 9:817

    Article  CAS  Google Scholar 

  • National Center for Statistics and Analysis (2019) Alcohol-impaired driving: 2018 data (Traffic Safety Facts. Report No. DOT HS 812 864). National Highway Traffic Safety Administration, Washington, DC

    Google Scholar 

  • National Survey on Drug Use and Health, Center for Behavioral Health Statistics and Quality. Results from the 2018 National Survey on Drug Use and Health: detailed tables. Rockville (MD): SAMHSA; 2019. https://www.samhsa.gov/data/report/2018-nsduh-detailed-tables

  • Nilsen HK, Landro NI, Kaasa S, Jenssen GD, Fayers P, Borchgrevink PC (2011) Driving functions in a video simulator in chronic non-malignant pain patients using and not using codeine. Eur J Pain 15:409–415

    Article  CAS  Google Scholar 

  • Rush CR (2001) Pretreatment with hydromorphone, a mu-opioid agonist, does not alter the acute behavioral and physiological effects of ethanol in humans. Alcohol Clin Exp Res 25:9–17

    CAS  PubMed  Google Scholar 

  • Setnik B, Sokolowska M, Johnson F, Oldenhof J, Romach M (2014) Evaluation of the safety, pharmacodynamic, and pharmacokinetic effects following oral coadministration of immediate-release morphine with ethanol in healthy male participants. Hum Psychopharmacol 29:251–265

    Article  CAS  Google Scholar 

  • Strand MC, Arnestad M, Fjeld B, Morland J (2017) Acute impairing effects of morphine related to driving: a systematic review of experimental studies to define blood morphine concentrations related to impairment in opioid-naive subjects. Traffic Inj Prev 18:788–794

    Article  Google Scholar 

  • Strand MC, Vindenes V, Gjerde H, Morland JG, Ramaekers JG (2019) A clinical trial on the acute effects of methadone and buprenorphine on actual driving and cognitive function of healthy volunteers. Br J Clin Pharmacol 85:442–453

    Article  CAS  Google Scholar 

  • Tori ME, Larochelle MR, Naimi TS (2020) Alcohol or benzodiazepine co-involvement with opioid overdose deaths in the United States, 1999-2017. JAMA Netw Open 3:e202361

    Article  Google Scholar 

  • Walsh SL, Nuzzo PA, Lofwall MR, Holtman JR Jr (2008) The relative abuse liability of oral oxycodone, hydrocodone and hydromorphone assessed in prescription opioid abusers. Drug Alcohol Depend 98:191–202

    Article  CAS  Google Scholar 

  • Yadav AK, Velaga NR (2019) Laboratory analysis of driving behavior and self-perceived physiological impairment at 0.03%, 0.05% and 0.08% blood alcohol concentrations. Drug Alcohol Depend 205:107630

    Article  CAS  Google Scholar 

  • Zacny JP, Gutierrez S (2011) Subjective, psychomotor, and physiological effects of oxycodone alone and in combination with ethanol in healthy volunteers. Psychopharmacology (Berl) 218:471–481

    Article  CAS  Google Scholar 

Download references

Acknowledgments

We thank Dr. Samy-Claude Elayi for patient support, the UK Investigational Pharmacy for preparing study medication, and the staff at the University of Kentucky (UK) Center on Drug and Alcohol Research for research support: Victoria Vessels, Emily Greene, Lindy Howe, and Russell Lewis.

Funding

This study was funded by grants from the National Institute on Drug Abuse (R56 DA036635 [SLW]) and the National Center for Advancing of Translational Sciences (KL2 TR000116-04 [SB]; UL1TR001998 [UK CTSA]).

Author information

Authors and Affiliations

  1. Department of Behavioral Science, University of Kentucky, College of Medicine, Lexington, KY, USA

    Shanna Babalonis, Michelle R. Lofwall & Sharon L. Walsh

  2. Center on Drug and Alcohol Research, University of Kentucky, College of Medicine, 845 Angliana Avenue, Lexington, 40508, KY, USA

    Shanna Babalonis, Marion A. Coe, Paul A. Nuzzo, Michelle R. Lofwall, Nur Ali, Laura C. Fanucchi & Sharon L. Walsh

  3. Department of Pharmacology, University of Kentucky, College of Medicine, Lexington, KY, USA

    Marion A. Coe & Sharon L. Walsh

  4. Department of Psychiatry, University of Kentucky, College of Medicine, Lexington, KY, USA

    Michelle R. Lofwall & Sharon L. Walsh

  5. Department of Anesthesiology, University of Kentucky, College of Medicine, Lexington, KY, USA

    Paul A. Sloan

  6. Department of Internal Medicine, University of Kentucky, College of Medicine, Lexington, KY, USA

    Laura C. Fanucchi

Authors
  1. Shanna Babalonis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marion A. Coe
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paul A. Nuzzo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michelle R. Lofwall
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nur Ali
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Paul A. Sloan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Laura C. Fanucchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Sharon L. Walsh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shanna Babalonis.

Ethics declarations

All participants provided sober, written informed consent prior to participation and were paid for their participation. The study was approved by the University of Kentucky Institutional Review Board and was conducted in accordance with the Helsinki guidelines for ethical research.

Conflict of interest

The authors declare that they have no conflicts of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Babalonis, S., Coe, M.A., Nuzzo, P.A. et al. Acute administration of oxycodone, alcohol, and their combination on simulated driving—preliminary outcomes in healthy adults. Psychopharmacology 238, 539–549 (2021). https://doi.org/10.1007/s00213-020-05702-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00213-020-05702-w

Keywords

Search

Navigation