Driver Vehicle Licensing Agency
| ?- Must not drive | ! - May continue to drive subject to medical advice and/or notifying DVLA | ?- May continue to drive and need not notify DVLA |
Alcohol misuse
Guide to definition of misuse
There is no singular definition to embrace all the variables within alcohol misuse but DVLA offers the following:
A state that causes, because of consumption of alcohol, disturbance of behaviour, related disease or other consequences likely to cause the patient, their family or society present or future harm and that may or may not be associated with dependence.
The relevant classification code for alcohol misuse is World Health Organization F10.1 (ICD-10).
| Group 1 car and motorcycle | Group 2 bus and lorry | |
|---|---|---|
| Persistent alcohol misuse confirmed by medical enquiry and/or evidence of otherwise unexplained abnormal blood markers | ?- Must not drive and must notify DVLA. Licence will be refused or revoked until after: ? a minimum of 6 months of controlled drinking or abstinence, and ? normalisation of blood parameters | ?- Must not drive and must notify DVLA. Licence will be refused or revoked until after: ? a minimum of 1 year of controlled drinking or abstinence, and ? normalisation of blood parameters |
Definition of controlled drinking
Drinking within government recommended health guidelines (currently 14 units per week).
Alcohol dependence
Guide to definition of dependence
There is no singular definition to embrace all the variables within alcohol dependence but DVLA offers the following:
A cluster of behavioural, cognitive and physiological phenomena that develop after repeated alcohol use, including:
- a strong desire to take alcohol
- difficulties in controlling its use
- persistent use in spite of harmful consequences
- and with evidence of increased tolerance and sometimes a physical withdrawal state
Indicators may include any history of withdrawal symptoms, tolerance, detoxification or alcohol-related seizures.
The relevant classification code for alcohol dependence is World Health Organization F10.2 (ICD-10).
| Group 1 Car and motorcycle | Group 2 Bus and lorry | |
|---|---|---|
| Dependence confirmed by medical enquiry Also refer to alcohol related seizure below | ?- Must not drive and must notify DVLA. Licence will be refused or revoked until a minimum of 1 years abstinence from alcohol consumption has been attained. Continued licensing will thereafter require ongoing abstinence. | ?- Must not drive and must notify DVLA. Licence will be refused or revoked until a minimum of 3 years abstinence from alcohol consumption has been attained. Continued licensing will thereafter require ongoing abstinence. |
| For both driving groups: ? licensing will require satisfactory medical reports from a doctor ? DVLA may need to arrange independent medical examination and blood tests ? referral to and the support of a consultant specialist may be necessary |
Alcohol-related disorders
| Group 1 car and motorcycle | Group 2 bus and lorry | |
|---|---|---|
| Examples ? hepatic cirrhosis with chronic encephalopathy ? alcohol induced psychosis ? cognitive impairment | ?- Must not drive and must notify DVLA. Licence will be refused or revoked until: ? recovery is satisfactory ? any other relevant medical standards for fitness to drive are satisfied (for example, Chapter 4, psychiatric disorders) | ?- Must not drive and must notify DVLA. Licence will be refused or revoked until recovery is satisfactory. |
Alcohol-related seizure
The relevant standards for any associated alcohol dependence should be applied.
Seizures associated with alcohol use may be considered provoked in terms of licensing (for details see neurological disorders and Appendix B).
Drug misuse or dependence
The relevant classification codes for drug misuse or dependence are World Health Organization F11 to F19 inclusive (ICD-10).
The below requirements apply to cases of single-substance misuse or dependence, whereas multiple problems including with alcohol misuse or dependence are not compatible with fitness to drive and licensing consideration, in both groups of drivers.
| Group 1 Car and motorcycle | Group 2 Bus and lorry | |
|---|---|---|
| Drug group ? cannabis ? amphetamines (but see methamphetamine drug group below) ? ecstasy (MDMA) ? ketamine ? other psychoactive substances, including LSD and hallucinogens | ?- Must not drive and must notify DVLA with persistent misuse or dependence. Medical enquiry confirming the problem will result in licence being refused or revoked: ? for a minimum of 6 months, which must be free of misuse or dependence Relicensing may require an independent medical assessment and urine screen arranged by DVLA. | ?- Must not drive and must notify DVLA with persistent misuse or dependence. Medical enquiry confirming the problem will result in licence being refused or revoked: ? for a minimum of 1 year, which must be free of misuse or dependence Relicensing will usually require an independent medical assessment and urine screen arranged by DVLA. |
| Group 1 Car and motorcycle | Group 2 Bus and lorry | |
|---|---|---|
| Drug group ? opiates (for example, heroin, morphine) ? opioids (for example, codeine) ? benzodiazepines ? synthetic benzodiazepines ? synthetic cannabinoids ? methadone (note on compliance above) ? cocaine ? methamphetamine Methadone/buprenorphine programmes - see guidelines below. | ?- Must not drive and must notify DVLA with persistent misuse or dependence. Medical enquiry confirming the problem will result in licence being refused or revoked for a minimum of 1 year, which must be free of misuse or dependence. Relicensing may require an independent medical assessment and urine screen arranged by DVLA. | ?- Must not drive and must notify DVLA with persistent misuse or dependence. Medical enquiry confirming the problem will result in licence being refused or revoked for a minimum of 3 years, which must be free of misuse or dependence. Relicensing will usually require an independent medical assessment and urine screen arranged by DVLA. |
Note on methadone/buprenorphine treatment programmes
Group 1
Applicants or drivers complying fully with a consultant or appropriate healthcare practitioner supervised oral methadone maintenance programme may be licensed subject to favourable assessment and normally annual medical review. Applicants or drivers on an oral buprenorphine programme may be considered applying the same criteria. There should be no evidence of continuing use of other substances including cannabis.
Application may be considered when all of the following conditions can be met:
-
stable on the programme for a minimum of 1 year
-
the treatment programme is supervised by a consultant or specialist GP
-
the treatment is for management of opiate dependence
-
oral/sublingual treatment only (not parenteral) but subcutaneous long-acting buprenorphine or naltrexone implants may be considered
-
there has been compliance with the programme (adherence to prescription and appointments, and toxicology testing with sustained stability)
-
no non-prescribed psychoactive drug use during the programme or extra use of prescribed drugs such as methadone, buprenorphine, benzodiazepines
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there is no toxicological evidence of drug misuse
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there is no adverse effect from treatment likely to affect safe driving