ADHD raises teens' accident risk

By AMBER CORRIN, UPI Correspondent  |  Sept. 11, 2006 at 12:15 PM
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WASHINGTON, Sept. 11 (UPI) -- Teenage drivers afflicted with attention-deficit/hyperactivity disorder face an even greater risk of car accidents, already the leading cause of death among adolescents in the United States, according to a new study at the University of Virginia Health System.

Driving collisions account for 15 teenage deaths every day in the United States, according to the National Highway Traffic Safety Administration. Coupled with the estimated 5 percent to 8 percent of American teens with ADHD, the danger increases, and experts at the university are stressing the importance of proper treatment for the condition.

"Those with ADHD, who have inattentive or impulsive tendencies, can be between two and eight times more likely to be involved in a collision," said Daniel Cox, professor of psychiatric medicine at the University of Virginia and the lead researcher of the study recently published in the American Academy of Pediatrics Journal.

Adolescent drivers with ADHD were also found to be four times more likely to be at fault in a collision and more than three times more likely to incur injuries as a result. Teen driving fatalities saw significant increases with the presence of teenager passengers and were most likely to happen in the evenings, on weekends and during the summer months.

"Historically there's been this thinking that it's good to take a break (from the medications) on weekends or in the summer, kind of a 'drug holiday.' But those 'drug holidays' are the times when people end up in the emergency room," Cox said. "If you ask when teenagers are least likely to be medicated, and then you ask when they're most likely to be in accidents, it's the same answer."

Maintaining a regular dosing schedule can save a life, confirms Alison O'Brien, a 20-year-old Reston, Va., student. O'Brien was 16 when she was lucky to survive a head-on collision one Sunday morning when she forgot to take her daily ADHD treatment.

"I was just unable to focus; that's what happens when you forget your meds. I think I just kind of fell asleep, and I lost control of the vehicle. It all happened so fast; I didn't have much of an idea of what was going on," said O'Brien, who takes 36 mg of Concerta "every day, seven days a week, all year round."

"There are a lot of things other than school you have to focus on, and those who don't realize that are at a risk," she said. "The one time I didn't take my meds, I almost died."

Of course, there are other factors involved in the dangers of adolescent driving. "There are many conditions associated with greater risk in driving mishaps; it's not unique to this diagnostic group. Other conditions can have the same effect. But what's important is the treatment available," Cox said.

The UVA study, only the most recent findings in ongoing research of ADHD and driving safety, noted different results from different ADHD treatments. Adolescent drivers with ADHD participating in the study performed best when treated with OROS methylphenidate, a controlled-release stimulant, when compared with extended-release amphetamine salts and placebo controls. OROS MPH, generic for medications such as Concerta, and se-AMPH ER, also known as Adderall XR, are commonly prescribed for patients with ADHD.

After examining the driving techniques of 35 teen drivers with ADHD, researchers found that Concerta treatments improved performance behind the wheel by decreasing off-road swerving, speeding, impulsive errors and erratic brake and speed control.

"One benefit of Concerta is that it appears to work later, even until 11 p.m.," Cox said. And while it may be a good initial treatment choice for teen drivers, those who are already receiving other treatments don't necessarily need to change prescriptions if they are responding well to their therapy.

The risks associated with ADHD, which can be broken into different types including inattentive, hyperactive and combination types, aren't limited to driving. Kids with ADHD are also more likely to become pregnant, incarcerated, intoxicated, divorced or lose their jobs, according to Cox. "ADHD is not just relevant to the classroom, although that's often where it begins. It impacts every fiber of everyday life," he said.

Participants in the controlled study included 19 boys and 16 girls with an average age of 17.8 years. In laboratory testing, adolescents were assessed at different times throughout the day and evening after an 8 a.m. dose. The drivers were examined in simulation machines, and while a "robust predictor of online driving," the next step in the research calls for a longer-running study with long-term treatment and real-life driving situations.

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