ADHD And Driving: ADHD TV Episode #4

1. 
   Carol P said on December 13th, 2008 at 8:34 am

   A very moving & informative message & thank you for sharing this information. Having a son who is currently learning to drive (non-adhd) and the other (adhd) who will in 1.5 years time be learning to drive this is valuable information for both of them to hear. If not for themselves directly, but also for their friends who might be on medication.

   Thank you for getting the word out there. Time to save some lives!

2. 
   Linwood Lyons said on April 9th, 2009 at 5:46 pm

   http://www.additudemag.com/adhd-web/article/619.html

   Dr Lambert says. “Does medication make a difference? If anything, the group on medication fared worse. But researchers aren’t ready to conclude that stimulant medication is of no help; the statistic may simply reflect the fact that ADHD among drivers who take medication is more severe.”

   clearly, this is not a closed discussion. (Nor does it help me decide what a good course of action might be.)

   Lin

3. 
   Mark said on October 11th, 2009 at 3:55 am

   I have severe ADHD, I have been driving since 2001, and I have only had 2 very minor accidents and no tickets. I find this video offensive. I believe that your(Dr. Cox) data is highly biased by your experience with your own son. I think if your only talking about teenagers in this video, then yea, your probably right. But, if your talking about adults, yes, our risk may be higher for getting into an accident, but I think your have blown it way out of proportion.
   Your video I think makes those of us with ADHD look like people that, if we dont take medication ( I notice you never talked about any other therapies for ADHD, ill discuss this later ) then we are almost certainly going to get into an accident and get killed or kill someone. Dr. Kenny, in one of your videos you say that if you have ADHD then you have to be an advocate, and in this post I am going to be one.
   First of all, any teen (atleast in texas) who has a drivers licence has to complete drivers ed, in which a driving instructor drives with them and teaches them to drive. If a person cannot drive a vehicle safely with them in the car, then guess what, they fail. Also, teenagers are already at a much higher risk of getting into an accident than more experienced drivers are. Id like to see some more numbers on your “study” to see how your numbers compared to the teenage norm, and the adult norm. I would also like to see how you determined these individuals were ADHD, and wernt suffering from one of the many comorbid conditions that occur such as tourettes or bipolar disorder or even something else.
   Now I would like to address the medication issue. Just for your information, I am on medication, but ive only been on it for a few months. There are alot of concerned parents who have children with ADHD who read this website. I think that you are misinforming them on this issue for 2 reasons. First of all, it is well known, and even stated by Dr Kenny himself that while meds do help, they are not the cure all of the problem, and that doesnt exclude driving. And secondly, your language seems to be that if a person (not sure if they are teen or adult) has ADHD, then if they arent taking meds they are almost certainly going to get into an accident. But if they are, as long as they are driving while the med is in effect, then they will be safe. This is wrong too. Medication doesnt teach a person with ADHD coping skills, which are ESSENTIAL regardless of whether or not the person is taking meds or not.
   As someone with ADHD, people already judge us. Concerned parents watch this video and read and write on these blogs. They are going to read this blog and get the message that if we arent medicated while driving, then we are almost certainly going to get into an accident and die or kill someone. However, if we are medicated, then its all fine. Whether or not you like it, your one of the horses pulling the bandwagon that believes all you need to do is pop a pill in the kids mouth, then its all fine and dandy. Your also driving the stereotypic idea that people with ADHD are all erratic and reckless people. Next thing I know, my car insurance will go up because of your “data”. Oh by the way, I visited your website and I noticed a big add by Shire on there, very interesting.

   PS
   Maybe I should put a big bumper sticker on the back of my pickup truck that says
   “Caution, ADHD driver, may or may not be medicated, and if not, will almost certainly get into a fatal accident according to Dr. Daniel Cox”

4. 
   admin said on October 11th, 2009 at 11:11 am

   Mark,
   Thank you for your thoughtful comments.
   I do hear what you are saying, and I can see your point.
   I believe that the research that Dr. Cox has done actually advocates for ADHD, though I understand your point that it seems quite negative.
   While there are excellent drivers with ADHD, overall, there is a higher risk of accidents and driving violations with untreated ADHD. This is a new area of research - and one which is quite important. Essentially - this research helps to find solutions for one of the highest rates of PREVENTABLE death in adolescents (i.e. motor vehicle accidents), and helps to find an approach that can lower the risk of death.
   You correctly point out that teen drivers are generally at higher risk. The concern is that when they are teen drivers, with untreated ADHD (and maybe cell phones that they are trying to text with while driving), they are at an even higher risk of problems.
   When it comes to research on driving - I must admit that I don’t know if they have done studies on alternative treatments for ADHD and their impact on driving. As medicine has the strongest “Effect size” for treating ADHD, it seems logical to at least start with this approach.
   One of the ways that I find this research very important is when I am talking to parents of a teen (who drives), if they don’t really believe in ADHD, or consider getting treatment for it to just be a ‘lifestyle’ choice, and not a real treatment - it is helpful to share that there are risks which can be quite serious - particularly in a car. That may or may not be a relevant factor for the parents/teen, but nonetheless, I consider it important to share that data - so that they can make an informed choice about treatment.
   On another point - there is growing data that the use of cell phones in cars increases risks of accidents. In my province, Ontario, a new law is coming into effect at the end of October 09 which bans the use of any ‘hand held’ device. So that one can talk on the phone with a ‘hands free’ technology - but not hold one in ones hand. This will likely have an impact to lower accidents and injuries - even though there are many people (ADHD or not) who have used cell phones in their cars for years who haven’t gotten into accidents.
   In any case - thank you for your thoughtful comments. I hope my comments help to clarify this somewhat.
   Best,
   Dr. Kenny

5. 
   Mark said on October 14th, 2009 at 3:35 am

   Dr Kenny,
   Thank you for you clarification of this issue. Let me first say that I greatly admire you and your websites. I honestly do believe you are and advocate for those of us with ADHD and I thank you for that. I first came across your website when I was considering taking straterra for my ADHD. I had just finished college, entered the real world, and almost got fired from my job as a chemist because i just couldnt stay on task. I must say that the information on this website has helped me significantly, and helped me make the transition to choose to take medication and ultimatly I am doing 100 percent better than I was before.

   That being said, I may have gotten a little carried away in my previous post because to some extent I felt like someone else was judging those of us with ADHD. But from what you have said, it seems like Dr Cox is an advocate for ADHD, it was just difficult for me to see it at the moment. This is partially because of what happened when I recently recieved a DOT physical (for a courier position at a job that I got). On the entrance form for the physical, it asked if I suffered from any psychiatric conditions “example severe depression, schizophrenia, etc”, to which I answered No to(I dont consider ADHD in the same category as those two disorders). When I got called back to take the drug test, the nurse asked me what medications I took, and when I told her straterra, she asked me what for, and I told her ADHD. She immediatly took my form, and under the psychiatric conditions, she crossed out no and wrote ADHD. I then had to wait 2 more hours for them to contact my primary physician to get a letter stating that I was taking straterra for ADHD. The nurse also told me how I could tell my new manager in such a way that would minimize the chances of him finding out that I had this condition. I felt very humiliated by this, and wondered if it was even worth getting help (to have to go though that trouble). But now I can look back and say yes, it was worth getting help.

   I think one thing this discussion brings up is drivers ed among people with ADHD. I’m not sure how the laws are in Ontario regarding drivers ed, or what age you have to be to drive, but in Texas its 16 (you can get a learners permit at 15 I think). I was 16 when I took drivers ed, and yes I did have a very hard time. I did fine on the book part, but the actually driving part with the instructor I had a very hard time with. The instructor had to work quite a bit extra with me for me to master driving the car. But I did eventually master driving a car and I have been a safe driver ever since. I have never gotten any speeding tickets, and only gotten into 2 minor accidents, one was my fault, the other was not my fault. I think it would be very interesting to see how most ADHD students fared in drivers ed school (not sure what its called in Ontario), in particular, the hands on, driving portion of the program. In Texas, the learners permit allows the junior driver to drive as long as there is a licenced driver as a passenger over the age of 18. This person/people are generally supposed to be the parents of the junior driver, and this is to teach them how to drive (im not sure if this is the case in Ontario or not, but the student doesnt have to complete the driving portion of their drivers ed). In any case, a person with ADHD has differant issues to deal with over someone who is normal. I think maybe someone should come up with a supplemental program for the ADHD begining driver that could be completed during or before or during the time the person is taking the driving part of drivers ed. This would allow the student to learn coping skills while driving and possibly address more specific issues that ADHD drivers face. Also, this could be done with the parents of the new driver or a therapist. This also helps the self esteem of the student, because they will have an easier time taking the drivers ed class.

   But anyway, thats just an idea that I thought about earlier today after reading this discussion. Thank you for you feed back and being a good advocate for us.

   Mark

6. 
   Jeff said on February 14th, 2010 at 4:23 pm

   I think I understand the concern Mark brought up. Suggesting that ADHDers need to be on medication to drive safely brings with it the notion that people with ADHD don’t have control over their actions and lack a sound personal agency, as if they were psychotic.

   Now ADHD does cause some impairment of executive functioning, but I severely doubt it’s enough to even begin to explain the increased accident statistics. People in their 70s are, by comparison, incredibly safe drivers, and yet at that age working memory, reaction time, and other executive functions have been dulling for years.

   The fact is driving safe is one of the easier task in life and ADHD adolescents are probably just more immature and thus willfully and consciously engage in unsafe actions while driving without considering the consequences. Medication probably just dulls their thrill-seeking desires so they don’t have interest in speeding, but their foot was never, ever, forced down on the gas pedal to speed and it’s incredibly easy not to do it. It’s much easier than trying to pass the 10th grade or reading war and peace or even consistently brushing and flossing twice a day.

   With that being said I’m not at all trying to contest anything pointed out in the video, but rather just want to clarify that this is a sensitive issue for many who may feel demeaned if they get the wrong impression.

7. 
   Donna said on April 18th, 2010 at 9:21 pm

   I am a mental health professional and an adult with ADHD and I have heard Dr. Cox’s lecture on driving and ADHD a few years ago. I have to say that in my case I have noticed a significant improvement in my driving abililites since I have been on extended release medication for over 5 years now. Before I was not comfortable with driving long distances as I had difficulty sustaining my concentration and would often rock the gas pedal ( slowing down at highway speeds around corners) . I no longer do that and have done many long distance drives since. Most recently I was able to drive for several extended periords in the carribbean while on vacation, where I had to have complete focus to nagivate the potholes and the winding narrow roads .
   My son also has ADHD and is now a young adult but when he was a young driver I provided him with this information which I believe was a factor in him deciding to take medications.
   I have had a recent trial of a biofeedback EEG program shaper brain and sharper memory,( as I still stuggle with executive functioning on stimulant medication). I did have some improvement in executive functioning during the 3 months I was doing the program, but it was not sustained after it was completed. I have the program and plan to attempt another trial ( via computer 4 times a week ) so for now the jury is still out.
   I did think the comment about Alternative treatments and driving was a valid one though as I would never want to see people with ADHD compelled in the future to take medications in order to drive without adequate research into the effects of alternative treatments on driving.

8. 
   J said on May 15th, 2010 at 6:44 am

   I’m 24 with ADHD and I have never completed my full license. I take extended release Dexedrine and when I was learning to drive I never knew if it was better to take a full dose or not. Obviously my focus was much better, but I was a nervous learner to begin with and when I took my normal dose I felt completely overwhelmed with fear. I felt like I was having a panic attack and that I would definitely crash the car. I failed my exit test and let my learners permit expire. I just don’t trust myself to drive with ADHD whether I’m medicated or not at this point. I wonder if it has anything to do with Dexedrine being very similar to Adderall since it was mentioned it could have adverse effects. It the most helpful ADHD drug I’ve tried but driving with it seems impossible for me.

9. 
   Maggie Jones said on November 9th, 2010 at 9:46 am

   I myself am a mother of an ADHD son and do agree with some of the points in this discussion. Although the video explains that ADHD individuals are more likely to get in an accident while driving and unmedicated, there are quite a few other ways to treat ADHD and there are pre-requisites to getting a driver’s license which include a road test. Thank you for the information however Dr.Kenny.

10. 
    ADHD and Driving | ADD ADHD Blog.com said on December 11th, 2008 at 11:24 am

    [...] To watch this interview, visit ADHD and Driving. [...]

11. 
    Teen Mental Health Blog » Blog Archive » ADHD and Driving said on February 10th, 2009 at 1:50 pm

    [...] Check out this video on ADHD and Driving by Dr. Kenny Handelman on http://www.adhd.tv [...]

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