The Impact of Untreated Attention-Deficit/Hyperactivity Disorder on Motor Vehicle Accidents: A Systematic Review and Meta-Analysis

INTRODUCTION: This meta-analysis quantified the dangers of driving with untreated ADHD and compares consequences for untreated drivers with ADHD to those of better publicized accident risk factors. METHODS: A systematic literature review and meta-analysis of published data was performed to determine the correlation between driving with untreated ADHD and motor vehicle accidents (MVAs). Separate analyses were performed for alcohol use and driving, excessive speed, cannabis use, sleepiness/fatigue, opioids/benzodiazepines, and cell phone use. RESULTS: Four studies showed significantly higher odds of an accident among untreated ADHD drivers versus the general population of drivers-a 93% increase [(significant pooled odds ratio (OR), 95% confidence interval (CI) for the overall effect, p < 0.001]. The odds of having an accident was increased by 85% in THC/cannabis users (significant pooled OR, 95% CI, p < 0.001); 162% increase in sleepy/tired drivers (significant pooled effect OR, 95% CI, p = 0.004); and 53% increase in opioid or benzodiazepine users (significant pooled OR, 95% CI, p < 0.001). CONCLUSION: This analysis found that MVAs occur significantly more frequently with drivers with untreated ADHD compared to the general population of drivers. Increasing awareness of accident risk among drivers with untreated ADHD and the positive impact of treating ADHD on driving highlights the importance of treating ADHD.