CNS Drugs

, Volume 24, Issue 8, pp 639–653 | Cite as

The Relationship between Benzodiazepine Use and Traffic Accidents

A Systematic Literature Review
  • Beitske E. SminkEmail author
  • Antoine C. G. Egberts
  • Klaas J. Lusthof
  • Donald R. A. Uges
  • Johan J. de Gier
Review Article


In many countries, benzodiazepines are the most commonly used and misused psychoactive medicinal drugs. Results of epidemiological studies investigating the association between benzodiazepine use and traffic accidents seem to be inconclusive or inconsistent at first sight. However, the outcome of epidemiological studies may be influenced by several methodological factors like study design, study population, exposure measurement, outcome definitions and possible confounders.

Our objective was to conduct a systematic literature review of epidemiological studies that investigated the association between benzodiazepine use and traffic accidents, including related outcomes like culpability and injury or accident severity. We searched EMBASE, PubMed and Forensic Science Abstracts 3/0 (FORS®) for references included in these databases at 1 June 2009 using the term ‘benzodiazepines’ in combination with ‘driving performance’ or ‘accident risk’ or ‘traffic accident’. For inclusion in this review, the study design had to be comparative, include road users involved in accidents and provide specific data about benzodiazepines. Sixty-six studies were included in the review. The study populations varied from the general (driving) population, accident-involved road users with or without injury and persons admitted to a hospital to fatally injured accident-involved drivers. Exposure assessment was performed by using toxicological results, prescription data or questionnaires.The divergent study populations and comparison groups and the variety of methods used to express the outcome of interest hampered comparison between results.

Evidence is growing that exposure to benzodiazepines is related to increased accident risk. The literature indicates that the greatest accident risk is associated with the use of long half-life benzodiazepines, increasing dosage and the first few weeks of use of benzodiazepines. Clear evidence of increased culpability associated with benzodiazepine use is scarce. More research has to be done to elucidate the relationship between benzodiazepine use and injury severity.


Traffic Accident Zolpidem Zopiclone Standardize Incidence Ratio Blood Alcohol Concentration 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review.

Supplementary material

40263_2012_24080639_MOESM1_ESM.pdf (227 kb)
Supplementary material, approximately 232 KB.


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Copyright information

© Adis Data Information BV 2010

Authors and Affiliations

  • Beitske E. Smink
    • 1
    Email author
  • Antoine C. G. Egberts
    • 2
    • 3
  • Klaas J. Lusthof
    • 1
  • Donald R. A. Uges
    • 4
    • 5
  • Johan J. de Gier
    • 6
  1. 1.Department of ToxicologyNetherlands Forensic InstituteThe Haguethe Netherlands
  2. 2.Department of Pharmacoepidemiology and PharmacotherapyUtrecht Institute for Pharmaceutical SciencesUtrechtthe Netherlands
  3. 3.Department of Clinical PharmacyUniversity Medical CentreUtrechtthe Netherlands
  4. 4.Department of Pharmacy, Toxicology and Forensic MedicineUniversity Medical Center GroningenGroningenthe Netherlands
  5. 5.Department of Analytical Biochemistry, Groningen Research Institute for PharmacyUniversity of GroningenGroningenthe Netherlands
  6. 6.Department of Pharmacotherapy and Pharmaceutical Care, Groningen Research Institute for PharmacyUniversity of GroningenGroningen

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