Some Drugs Leave You Asleep at the Wheel

Citations for driving under the influence don’t always involve alcohol or illicit drugs.

Under the California Vehicle Code, driving under the influence of a drug can also include over-the-counter or prescription medication, even something as seemingly harmless as cold medicine, if it impairs your ability to drive.

“The California Vehicle Code does not distinguish between illicit and other drugs,” says Sgt. Thomas Page of the Los Angeles Police Department. Page is one of 350 drug-recognition experts on the force specially trained to identify what substance, legal or not, is impairing a person’s performance.

“The fact that you are legally entitled to use a drug is not a defense,” Page says. Although arrests of drivers impaired from taking over-the-counter or prescription drugs are rare, he says, they do happen.

Based on his experiences, Page says, prescription or over-the-counter drugs may play a role in as many as 10% of incidents in which a driver is charged with driving under the influence. Sometimes, the medications have been mixed with alcohol, illicit drugs or both.

Last year, there were about 10,000 DUI convictions in the city of Los Angeles, says Evan Nossoff of the California Department of Motor Vehicles. About 80% of arrests lead to convictions.

In California, the DMV says, a first conviction for driving under the influence carries fines of $390 to $1,000 (plus locally imposed penalties, jail time or community service of 48 hours to six months) and could also result in a six-month license suspension or referral to a drug or alcohol treatment center.

Sometimes, people taking prescription or over-the-counter medicine simply don’t consider the side effects, say pharmacists, who are working to raise awareness. So too is a Milwaukee-based organization, Citizens Against Drug Impaired Drivers, or CANDID, which maintains a Web page to advocate drug- and alcohol-free driving (https://www.candid.org).

Among over-the-counter medicines that can cause drowsiness sufficient to impair driving ability are anti-inflammatory pain medicines such as Nuprin, Advil and Motrin (ibuprofen) and Aleve (naproxen sodium), says Vicky Binder, pharmacist-manager at Converse & Horton Pharmacy in Los Angeles. So can motion sickness remedies such as Bonine (meclizine hydrochloride) and Dramamine (dimenhydrinate).

Other big offenders, Binder and other pharmacists say, are medications with antihistamines such as Tylenol Cold (pseudoephedrine, dextromethorphan and chlorpheniramine), Benadryl (diphenhydramine) and Chlor-Trimeton (chlorpheniramine).

Don’t drive after taking an over-the-counter antihistamine, advises Leo McStroul, pharmacist-owner of Plaza West Pharmacy/Northridge Health Care Center, unless you have experience with the specific medication and don’t notice drowsiness when you take it.

The truly non-sedating antihistamines such as Claritin (loratadine) and Allegra (fexofenadine hydrochloride) are available only by prescription.

Many prescription medicines can compromise driving ability too. Besides prescription sleeping pills, anti-anxiety medicines such as Valium (diazepam) and Xanax (alprazolam) can cause drowsiness, pharmacists say. Antidepressants such as Wellbutrin (bupropion) and Zoloft (sertraline) can also make some people feel tired, Binder says, especially when they first begin the regimen.

There is great variability in how drugs affect people.

“Some people go about their business,” Binder says. “Some are adversely affected.”

Richard Kane, the pharmacist-owner of Oakdale Pharmacy in Encino, notes different reactions when people are taking Actifed, an over-the-counter decongestant and antihistamine. He can never predict, he says, who will become tired from the antihistamine and who will become “wired” from the decongestant.

So the first time you take a medication that might make you drowsy, pharmacists recommend, take it at home and stay there to monitor the side effects for the first dose or two.

How quickly a drug might affect you, McStroul says, “varies according to how long the drug stays in the system, the patient’s metabolism, other medical conditions and genetics.” Within half an hour to two hours after taking a dose, he says, you should have an indication of how your body will react to the medicine.

Whether you experience side effects from a medication may also depend on whether you take the medication regularly, says Herbert Moskowitz, president of the Southern California Research Institute, an independent nonprofit organization that studies the effects of drugs and alcohol on driving and other behaviors. Someone who takes antihistamines daily to manage allergy symptoms, for instance, would probably build a tolerance, he says, and be less likely to experience sleepiness than someone who takes the same medicine only occasionally.

Mixing over-the-counter drugs with prescription drugs--especially if each can cause drowsiness--is another bad idea, Kane says.

“Frequently it’s not the over-the-counter drug alone causing side effects but a combination of prescription and over-the-counter,” he says. Someone beginning to take an antidepressant who also takes an over-the-counter cold medicine might become very drowsy, for instance.

Ideally, Kane says, a pharmacist would notice the two drugs that cause drowsiness and warn a patient. But many patients use multiple pharmacies, he says. And most consumers don’t bother to get pharmacists’ input when buying over-the-counter medicines, although pharmacists will gladly advise them.

If you have a history of problems with any medication, you should report those to your pharmacist when considering a new over-the-counter or prescription drug, Kane says.

And if you can’t manage without medication to control symptoms of allergies or a cold, ask your pharmacist to suggest the less sedating drug, Kane says. (He suggests Chlor-Trimeton as the least-sedating over-the-counter antihistamine.) Always start with the lowest dose possible, he adds. If you’re trying to minimize drowsiness, avoid sustained-release formulas.

Times contributor Kathleen Doheny can be reached vie e-mail at kdoheny@compuserve.com.