Driving after having a full left hip replacement

[aliceBB]

As I recall from a relative in your situation, the consultant will not agree that you are fit to drive (even if you think you are) until at least 6 weeks post-op. If you drive without your consultant's 'blessing', your insurance will be invalid.

[medusa]

Is it wise to drive if you're taking strong painkillers?

 

I'm on 5 painkillers as my daily regime and I'm perfectly fine with driving as long as I'm feeling good and have rested properly.

 

I did contact the DVLA when I first got ill and asked them for the regulations which apply in the case of illness, and whether they wanted me to send my driving licence back for endorsement or whatever.

 

Their answer was that on every day you get in the car it is your personal responsibility to ensure that you are capable and safe to drive. The possession of a driving licence is only part of that, and someone who is perfectly healthy normally may be unsafe to drive on one day because they have stubbed a toe, or cut their hand, or their hayfever has caused eye inflammation which leaves them less able to see than normally. On these days it is their responsibility not to drive.

 

On the days when I'm feeling really unwell, or when my pain is really bad, I don't go out in my car. If I'm out in the car then that is because I'm rested and pain controlled enough to drive safely.

 

That is the last word from the DVLA and as they said, people don't contact their insurer every time they take a paracetamol for toothache, do they?

[JFKvsNixon]

I'm on 5 painkillers as my daily regime and I'm perfectly fine with driving as long as I'm feeling good and have rested properly.

 

I did contact the DVLA when I first got ill and asked them for the regulations which apply in the case of illness, and whether they wanted me to send my driving licence back for endorsement or whatever.

 

Their answer was that on every day you get in the car it is your personal responsibility to ensure that you are capable and safe to drive. The possession of a driving licence is only part of that, and someone who is perfectly healthy normally may be unsafe to drive on one day because they have stubbed a toe, or cut their hand, or their hayfever has caused eye inflammation which leaves them less able to see than normally. On these days it is their responsibility not to drive.

 

On the days when I'm feeling really unwell, or when my pain is really bad, I don't go out in my car. If I'm out in the car then that is because I'm rested and pain controlled enough to drive safely.

 

That is the last word from the DVLA and as they said, people don't contact their insurer every time they take a paracetamol for toothache, do they?

 

I'm not really talking about simple analgesics like paracetamol, but more along the lines of the stronger opioids.

[medusa]

I'm not really talking about simple analgesics like paracetamol, but more along the lines of the stronger opioids.

 

If you're taking them at therapeutic levels and you've been taking them for a while then they are normal to your body and while they do cause some sedation, they don't cause cognitive issues or being 'stoned'.

 

I can't take opiates, but I do take sedative painkillers. I take them mostly at night so that I'm sleeping off the worst sedative effects, I plan for nap times on longer drives, and plan break times on any drive longer than an hour or so, and I don't start out on a journey if I don't feel up to par, and having talked to my insurers and the DVLA, they are both hapy that this is me being responsible and complying with the law.

[Runningman]

I was told to wait 6 weeks after my hip replacement which I did. Started driving and no problems !

[JFKvsNixon]

If you're taking them at therapeutic levels and you've been taking them for a while then they are normal to your body and while they do cause some sedation, they don't cause cognitive issues or being 'stoned'.

 

I can't take opiates, but I do take sedative painkillers. I take them mostly at night so that I'm sleeping off the worst sedative effects, I plan for nap times on longer drives, and plan break times on any drive longer than an hour or so, and I don't start out on a journey if I don't feel up to par, and having talked to my insurers and the DVLA, they are both hapy that this is me being responsible and complying with the law.

 

If someone was pulled over by the police, for what ever reason, and they were tested for drugs, I do not believe that a valid prescription would get them off a charge of driving under the influence of drugs.

[medusa]

If someone was pulled over by the police, for what ever reason, and they were tested for drugs, I do not believe that a valid prescription would get them off a charge of driving under the influence of drugs.

 

Even the new and very strict laws only apply for prescription drugs at a level ABOVE the recommended prescription strength, so I'm afraid you are wrong with this one unless someone was visibly affected.

[JFKvsNixon]

Even the new and very strict laws only apply for prescription drugs at a level ABOVE the recommended prescription strength, so I'm afraid you are wrong with this one unless someone was visibly affected.

 

There isn't a "perspiration strength" for many people with chronic pain on opioids, as you well know, over time the dose needs increasing to give the same levels pain relief. Sometimes to the point that an individual may well receive a level of opioid that'll cause real harm to someone else.

[medusa]

There isn't a "perspiration strength" for many people with chronic pain on opioids, as you well know, over time the dose needs increasing to give the same levels pain relief. Sometimes to the point that an individual may well receive a level of opioid that'll cause real harm to someone else.

 

There's lots of evidence from studies actually, that if you're taking opiates for pain relief very few people have any amount of tolerance of action and increasing doses needed. When you see increasing doses with people who have cancer, that is because the pain is getting worse, not because of a tolerance for the painkiller.

 

I've been on the same dose of my painkillers for over a decade, including methadone, that most people think falls into this tolerance category. My dose is typically less than a tenth of that of people who use the drug recreationally.

 

The tolerance that people who use a drug recreationally experience is because they're chasing an effect on their mood and emotions, not the painkilling, and they have to increase the dose perpetually because after a few doses the euphoria effect fades.

 

The serum levels of pretty much everybody who takes these drugs as a painkiller will be very much lower than that of people who are taking the drugs recreationally, and the permitted limits in the new drug driving law are higher than the standard prescription levels of the drugs would equate to. Clearly somebody who takes such a hugely high level of Oramorph or similar would be very unlikely to be fit to drive, either due to the morphine or the illness that necessitated the morphine in the first place.

 

My comments about the lack of tolerance etc. came straight from my palliative care physician, who is the medical director of Marie Curie Cancer Care, so if he says that he's done a long term review of literature on the topic I tend to believe him, as he has no reason to lie about it.

[JFKvsNixon]

There's lots of evidence from studies actually, that if you're taking opiates for pain relief very few people have any amount of tolerance of action and increasing doses needed. When you see increasing doses with people who have cancer, that is because the pain is getting worse, not because of a tolerance for the painkiller.

 

I've been on the same dose of my painkillers for over a decade, including methadone, that most people think falls into this tolerance category. My dose is typically less than a tenth of that of people who use the drug recreationally.

 

The tolerance that people who use a drug recreationally experience is because they're chasing an effect on their mood and emotions, not the painkilling, and they have to increase the dose perpetually because after a few doses the euphoria effect fades.

 

The serum levels of pretty much everybody who takes these drugs as a painkiller will be very much lower than that of people who are taking the drugs recreationally, and the permitted limits in the new drug driving law are higher than the standard prescription levels of the drugs would equate to. Clearly somebody who takes such a hugely high level of Oramorph or similar would be very unlikely to be fit to drive, either due to the morphine or the illness that necessitated the morphine in the first place.

 

My comments about the lack of tolerance etc. came straight from my palliative care physician, who is the medical director of Marie Curie Cancer Care, so if he says that he's done a long term review of literature on the topic I tend to believe him, as he has no reason to lie about it.

 

In my job daily I'll give intravenous opioids to patients, some of whom are on long term opioids, many of them non cancer patients. It is extremely rare that these patients need a dose of painkillers that a non chronic pain patient who is on long term opioids would need, and the evidence dose back up my experience.

 

Obviously the dependance on the opioids goes a lot deeper than just a purely physical dependance, for example there is an unquestionable link between fear and pain. Quite often there is an emotional dependence on there painkillers, and they end up becoming a crutch for some.

 

As a result some long term opioid users end up having poor coping mechanisms, which in turn leads to them needing higher doses of opioids.