The National Transportation Safety Board has investigated many accidents in all passenger transportation modes in which the use of a licit medication by a vehicle operator has been causal or contributory. As a result, the Safety Board has previously recommended that various agencies
take certain actions to address issues pertaining to the use of medications.
In this letter, the Safety Board makes recommendations to the U.S. Department of Transportation (DOT), the modal administrations, and the U.S. Food and Drug Administration (FDA). The Safety Board is recommending that the DOT establish a list of approved medications and/or classes of medications that may be used safely when operating a vehicle, and expressly prohibit the use of any medication not on that list except in certain situations. The Board is also recommending that the DOT evaluate the applicability of similar restrictions for transportation employees in all safety-sensitive positions. The Board is recommending that the modal administrations (the Federal Aviation Administration, the Federal Motor Carrier Safety Administration, the Federal Railroad Administration, the Federal Transit Administration, and the U.S. Coast Guard) establish procedures by which modal vehicle operators who medically require substances not on the DOT’s list of approved medications may be allowed, when appropriate, to use those medications while operating a vehicle. The Board is also recommending that the modal
administrations educate vehicle operators about the potential for medications to adversely affect their ability to safely operate vehicles, and that the modal administrations that regulate vehicle operators in surface modes work with the DOT to obtain more comprehensive data on the nature and extent of medication involvement in fatal surface mode accidents. Finally, the Safety Board is recommending that the FDA establish and require the use of a clear warning label for medications
that may interfere with an individual’s ability to operate a vehicle.
This letter summarizes the Safety Board’s rationale for issuing the new recommendations.