Driving while ADHD

Statistically, people with Attention-Deficit/Hyperactivity Disorder are more dangerous drivers. But does that make it the government’s business?

Should people with ADHD be allowed to drive? That’s the question behind recent outrage over requirements in the UK that those with the disorder report their condition to Driver and Vehicle Licensing Agency, the British version of the DMV.

The rule itself is a long-standing one, first reported by the British newspaper Express in December 2017: People who have Attention-Deficit/Hyperactivity Disorder must tell the DVLA about their condition or risk paying the UK government a £1,000 fine ($1,318). Having ADHD doesn’t keep Brits from getting a license, and there’s no indication as to what the UK government does with this information, leaving many wondering why the diagnosis even matters.

Originally, as Luke John Smith reported in the Express, the change occurred after seven people died in 2016 due to wrecks caused by “uncorrected, defective eyesight.” More than 100 conditions were added to the UK’s must-tell list, including — logically enough — glaucoma, night blindness, and similar vision problems. But the list also incorporated other conditions with driving implications that aren’t so clear, such as cancer, previous cesarean sections, autism, and ADHD.

For more than a year, the requirement went relatively undetected, but on March 3, a petition went up on Change.org requesting that the DVLA revise its requirement from requiring disclosure across the board to “only if there is evidence [autism or ADHD is] affecting someone’s driving.” The petition claims that having Attention Deficit actually makes you a better driver, because people with ADHD are often able to hyperfocus, zoning in on one single thing to the detriment of everything else around them.

The problem is that multiple studies show the petition is incorrect. On the whole, driving with ADHD is dangerous. Before they turn 26, people with the disorder are 36 percent more likely to be in car accidents than non-ADHDers. For those who’ve only had their licenses a month, the numbers are higher: ADHDers crash 65 percent more often than new drivers without the disorder.

ADHD is a neurological condition caused by the underproduction of dopamine and norepinephrine, two brain chemicals that regulate focus. Its main symptoms are inattention, hyperactivity, and impulsivity. The latter may be why they get more speeding tickets. In fact, our driving habits are so bad across the board that research suggests doctors should actually use driving patterns as an ADHD diagnostic tool. Add in the fact that accidents are the most common cause of death for people with ADHD and DVLA’s requirement starts to sound less and less insane.

I have ADHD, and in my twenties, I went through a five-year period in which I was involved in four wrecks. But just because you’re in an accident doesn’t mean it was your fault; having ADHD can work against you in more insidious ways. In my worst wreck, a woman on her phone ran a stoplight. She hit me square in the driver’s side door, sending me into a spin that only ended because my car slammed into a pole. The impact knocked my glasses off my face and out of the vehicle. Paramedics had to cut me out, not just because of the mangled metal around my body, but because I was temporarily paralyzed.

The woman who hit me was on her phone and ran a red light — my missing neurotransmitters had nothing to do with it. But when she sued, claiming I ran the light, her attorney used my ADHD against me. If I’d been off my meds, he would have claimed I was driving distracted. But I took Ritalin, so he claimed I was driving under the influence instead. Either way, I was damned.

Now those with ADHD in the UK find themselves in a similar paradox. In “Drug Driving,” a March 2014 report questioning the impact of prescriptions on driving, the UK Department of Transport expresses concern about amphetamine and dexamphetamine, commonly known as Adderall, as well as lisdexamfetamine, or Vyvanse. Too high a dose could impair driving. Don’t take enough, though, and the report says we “represent an increased road safety risk.”

For some, the research again shows the British government might be right to try and regulate people with this condition: Medicated, men with ADHD are 58 percent less likely to have “serious transport accidents,” adding that nearly half of the accidents study subjects had been involved in could have been avoided had the drivers taken medication. But for women, the same research shows prescriptions don’t make a driving difference, either because ADHD manifests differently in female patients or because these studies traditionally don’t include us.

Dangerous or not, not letting those with ADHD drive is an even worse predicament. One in every three ADHD Americans is unemployed; 85 percent of unemployed Brits have the disorder. What happens if you take away our ability to get to work? We’re already more than 40 percent likely to live in poverty, unemployment aside. If we have to start declaring our diagnoses, could insurance providers increase premiums to a point we can’t afford? Not to mention the even more important question: Why is it the government’s business any way? As Cardiff neurodiversity advocate Kat Williams tweeted, “autism and ADHD are from birth and lifelong, so we passed our tests with them.”

If the British government wants to ensure its roads are safe, it’s their responsibility. And whether we cause the wrecks we’re in or not, driving is simply more dangerous when you have ADHD. But to Williams’s larger point, it isn’t any more or less dangerous than when the government gave you a license to begin with.

Terena Bell is a journalist in New York City.