Self-Reported Opioid Use and Driving Outcomes among Older Adults: The AAA LongROAD Study
DOI: 10.3122/jabfm.2020.04.190429
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Summary
This study investigates the relationship between self-reported opioid use, pain levels, and driving outcomes among older adults, addressing the clinical tension between managing chronic pain and maintaining driving safety. While opioids are critical for pain mitigation, they can impair driving ability, particularly in older populations who face unique risks such as polypharmacy and comorbidities. The research aims to determine the prevalence of opioid use in this demographic and assess its association with self-reported driving behaviors, including self-regulation, perceived ability, and crash involvement. The analysis utilized baseline cross-sectional data from the AAA Longitudinal Research on Aging Drivers (LongROAD) study, involving 2,990 cognitively intact drivers aged 65 to 79 years. Participants were recruited from five U.S. sites and completed baseline questionnaires and “brown-bag” medication reviews. Opioid use was identified via self-report, with doses calculated in morphine milligram equivalents (MME). Driving outcomes were measured through self-reported metrics, including driving ability, comfort, self-regulated driving reduction, lapses/errors/violations, and crashes or police actions in the past year. Statistical models adjusted for demographics, socioeconomic factors, health care utilization, and physical function to isolate the effects of opioid use. Among the participants, 5.7% (n=169) reported current opioid use, with a median daily dose of 20 MME. Opioid users reported significantly higher pain levels than non-users. In unadjusted and partially adjusted models (controlling for age, gender, race, and ethnicity), opioid users were significantly more likely to report self-regulated driving reduction and lower self-rated driving ability. They also reported a higher, though not statistically significant, rate of crashes or police actions. However, in fully adjusted models that accounted for hospitalization, impaired physical function, income, and education, these associations became nonsignificant. Notably, in the fully adjusted model, opioid users reported fewer driving lapses and higher driving comfort than non-users, though the differences were small. The findings suggest that the observed associations between opioid use and reduced driving performance are likely confounded by the underlying painful medical conditions and socioeconomic factors rather than the medication itself. The study highlights that older adults using opioids may self-regulate their driving to mitigate perceived risks. The authors conclude that clinicians should continue to discuss the risks and benefits of opioids with patients, emphasizing the importance of avoiding driving immediately after initiation or dose changes. Future research is needed to disentangle the effects of opioids from the effects of pain and to examine objective driving measures.
Key finding
The association between opioid use and self-reported driving reductions or lower driving ability disappears after adjusting for physical function and other health-related confounders.
Methodology
survey
Sample size: 2949
Provenance
The full processing record for this entry. Every stage of this paper's journey through the pipeline is logged — what ran, with which tool and model, how many attempts it took, and when it last completed. Discovered via author_sweep_intake on 2026-05-27 (2 acquisition events logged).
| Stage | Outcome | Tool | Model | Prompt | Attempts | Completed |
|---|---|---|---|---|---|---|
| discover | success | author_sweep | — | — | 3 | 2026-05-28 |
| archive | success | canonical_url | — | — | 1 | 2026-06-06 |
| extract | success | cached | — | — | 3 | 2026-06-10 |
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| embed | success | embed | Qwen/Qwen3-Embedding-8B | — | 1 | 2026-06-04 |
| enrich | skipped | — | — | — | 3 | 2026-06-04 |
| promote | success | — | — | — | 1 | 2026-06-04 |
| summarize | success | llm | qwen3.6-27b-prismaquant | summ-v5 | 2 | 2026-06-10 |
| tag | success | vector_similarity | — | — | 15 | 2026-06-11 |
| verify | success | — | — | — | 2 | 2026-06-10 |
Summary generated by qwen3.6-27b-prismaquant on 2026-06-10; verification: verified.
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