Driving and Brain Injury - Fact Sheet

For many people with acquired brain injury, returning to driving represents a major goal. The inability to drive can lead to a loss of independence, self-reliance and mobility within the community. Various effects of acquired brain injury may interfere with a person’s ability to learn to drive or return to driving after an accident.

The cognitive, perceptual and physical problems which may impair your driving skills include:

An individual with one or more of the problems outlined above may still be assessed as capable of driving while another individual with a set of different problems or circumstances may not pass a driving assessment. Particular types of impairment (e.g. sensory and motor) can be compensated for by specialised vehicle modifications. For example, an individual with left-sided hemiplegia may be able to drive using a modified vehicle adapted for right-sided functioning.

Assessment and licencing

The assessment of driving skills and safety is extremely important due to the risk of accidents. Some people may be advised not to drive after the accident and this decision may be reviewed following a period of recovery and re-assessment. The decision about whether a person can drive may be made by a number of people determined by the legislation in your state.

Because each state has different legislation, it is necessary to contact the licencing authority in your state to find out the requirements for returning to driving following any major injury or diagnosis, such as a brain injury or the development of epilepsy. You may even have you licence confiscated by the hospital upon admission. For example, in Queensland you are required to notify Queensland Transport as soon as you become aware of a medical condition which may impact upon your ability to drive.

In the circumstances where a driving assessment is not compulsory it is recommended that individuals and family members get advice regarding the need for a driving assessment from a doctor, preferably a specialist such as a neurologist or neurosurgeon. Some individuals make their own judgment that they are not safe enough to drive. This can sometimes be because they have developed high levels of anxiety about driving or being in a car as a result of a previous accident.

Self-care

Some general tips for making driving safer and more enjoyable for people who are able to drive involve making some simple decisions before getting in the car:

Driver rehabilitation or retraining programmes are often available. Such programmes may be conducted by major rehabilitation hospitals, community-based rehabilitation services, driver training schools or road and transport associations. Individuals are encouraged to contact different places to enquire about features of the programme, referral and eligibility requirements.

Alternatives

Buses, trains and taxis are all alternatives to driving yourself, as is asking a mate or a family member for a lift. However, trains and buses can be inconvenient as well as hostile places if you have a visible disability or find it difficult to cope with crowds, and taxis very quickly become very expensive.

Some other options include:

If you have a pensioner concession or health-care card, you should check for discounts every time you buy tickets or request any service. The savings can be substantial.

Medications and driving

Medication can have a positive or negative effect on driving ability. Some people, such as epileptics, may not be able to drive at all without medication. A driver with untreated depression is at high risk due to decreased concentration and slower decision making. However, treatment may also carry a risk – 10 milligrams of diazepam can produce more driving impairment than a blood alcohol concentration of 0.10; twice the legal limit in Queensland.

Drugs that slow you down also reduce your ability to make decisions and process information rapidly. People taking painkillers which contain codeine or propoxyphene may experience sedation and mild impairment. Even over-the-counter drugs can reduce driving ability. Antihistamines can cause drowsiness and poor concentration. Tranquilizers or cold remedies, such as cold tablets, cough syrup, and sleeping pills, can reduce driving ability.

Most people do not discuss their over-the-counter drugs with their doctor. Combinations of drugs can produce unexpected side effects and bad reactions. If you have more than one doctor prescribing medications without knowing what the others are prescribing, or if your doctor does not know about the over-the-counter drugs you are taking, you could be in danger.

Alcohol has a powerful impact on the body, physically and psychologically. With age, tolerance for alcohol decreases steadily, and the body processes it less efficiently. Combining alcohol with medications is risky whether or not you are behind the wheel. For instance, it can lead to falls. The only safe practice is to avoid alcohol completely if there is any chance that you will have to drive.

Impaired driving, whether due to medications, alcohol or a combination, is not only dangerous and socially unacceptable; It is also a criminal offence in Queensland. It is also a significant problem. In September 1998, Queensland Transport surveyed 400 Queensland residents about their attitudes towards road safety, including driving behaviours. Of those surveyed:

Driving is a complicated task, so don't let yourself be impaired by any kind of medication, including over-the-counter drugs and herbal or alternative remedies.

Should you choose to drive whilst impaired by a prescription medication you are committing an offence

Further information