Driving With Adult ADHD

Drivers With ADHD at Increased Risk of Serious Car Crash Injury

Safe driving requires self-control and the ability to pay attention, to stay focused, and resist distractions -- all areas that can be challenging for many adults with ADHD.. Photo © Carol Kohen

Research has shown that teenagers and adults with attention deficit/hyperactivity disorder (ADHD) tend to be at an increased risk for driving impairments. This is not surprising given the core symptoms of ADHD – including problems with distractibility, hyperactivity, and impulsiveness – which can impede safe driving and can often lead to very serious accidents.

A recent study, “Serious Transport Accidents in Adults With Attention-Deficit/Hyperactivity Disorder and the Effect of Medication,” published in JAMA Psychiatry (online January 29, 2014) found that drivers with ADHD had a 45% to 47% increased rate of serious transport accidents (defined as serious injury or death) compared to drivers without ADHD, in both men and women.

In this study investigators also explored the extent to which ADHD medication influences risks among subjects with ADHD. They found that ADHD medication use was associated with reduced rates of accidents among male drivers with ADHD.

Reducing Driving Risks Associated With ADHD

Many drivers with ADHD find they have difficulty maintaining vigilance and keeping their mind focused while on the road. Distractions within the car (cell phone, radio, passengers) and outside the car (road construction, “rubber necking” while driving by accidents, general points of interest alongside the road) can make it even more challenging to stay focused. Impulsive errors and reactions, as well as slower and delayed reactions, can also heighten risks for drivers with ADHD. Stimulation seeking behaviors (driving at high speeds, taking curves aggressively, any risk taking behaviors) can further impede safety. Even impatience while driving, which can sometimes escalate to angry reactions including road rage, seems to be more prevalent in adults with ADHD.

5 Driving Safety Strategies to Follow

Below are five strategies to consider to reduce driving risks associated with ADHD:

1. ADHD Medication

Medication has been shown to be effective in improving driving performance in adults with ADHD. If you have been prescribed medicine to help manage symptoms of ADHD, it is important that you be diligent about taking your medicine on a schedule that ensures you have adequate levels of medicine in your bloodstream when you are most likely to be driving (for example in the morning to work and during the late afternoon route home).


2. Reduce Distractions

Remove all potential distractions from within the car. Turn off cell phone and put it out of reach so that you aren’t tempted to use while driving. Do not eat while driving. Only adjust the radio, heat/air conditioning, mirrors, etc. while car is stopped. Let passengers know what is most helpful for you to maintain focus. It may be that you prefer not to engage in conversations while the vehicle is moving.

3. Manual Transmission

Consider whether you are a more attentive driver when using a manual transmission, as opposed to an automatic. Use of a manual transmission has been demonstrated to be associated with greater arousal. Adults (and children) with ADHD tend to be more productive and focused when an activity is involving and engaging. For some people with ADHD shifting gears manually while driving provides a positive level of stimulation that is helpful in maintaining focus.

4. Never Drink and Drive

Never drink alcohol and drive. Adults with ADHD are more adversely affected in their driving by even low doses of alcohol than drivers without ADHD.

5. Buckle Up

Always wear your seatbelt. Make this part of your routine as soon as you get in the car. If you need to put a brightly colored sticky note on your dashboard as a reminder, do so.

Additional Reading:
Understanding Symptoms of Adult ADHD
10 Things NOT to Say to Someone With ADHD
Could You Have Adult ADHD?


Zheng Chang, PhD; Paul Lichtenstein, PhD; Brian M. D’Onofrio, PhD; Arvid Sjölander, PhD; Henrik Larsson, PhD – “Serious Transport Accidents in Adults With Attention-Deficit/Hyperactivity Disorder and the Effect of Medication - A Population-Based Study,” JAMA Psychiatry. doi:10.1001/jamapsychiatry.2013.4174, Published online January 29, 2014.

Cox DJ, Punja M, Powers K, Merkel RL, Burket R, Moore M, Thorndike F, Kovatchev B - “Manual Transmission Enhances Attention and Driving Performance of ADHD Adolescent Males Pilot Study,” Journal of Attention Disorders, 2006 Nov;10(2):212-6.

Russell A. Barkley, PhD - Taking Charge of Adult ADHD, Guilford Press 2010.

Craig Surman, MD and Tim Bilkey, MD – Fast Minds: How to Thrive If You Have ADHD (Or Think You Might), Berkley Books 2013.

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