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

Psychopharmacology (Berl). 2021 Feb;238(2):539-549. doi: 10.1007/s00213-020-05702-w. Epub 2020 Nov 9.

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.

Keywords: Alcohol; Driving simulator; Drugged driving; Ethanol; Human; Impairment; Opioid; Oxycodone.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Cross-Over Studies
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Driving Under the Influence / psychology*
  • Drug Synergism
  • Ethanol / administration & dosage
  • Ethanol / adverse effects*
  • Female
  • Humans
  • Male
  • Models, Psychological*
  • Opioid-Related Disorders / psychology
  • Oxycodone / administration & dosage
  • Oxycodone / adverse effects*
  • Psychomotor Performance / drug effects*

Substances

  • Ethanol
  • Oxycodone