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Guidance: Drug or alcohol misuse or dependence: assessing fitness to drive

Driver Vehicle Licensing Agency

August 27
12:09 2024

?- 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 use disorders

DVLA have 2 standards for alcohol use disorders. These standards are for:

  • persistent alcohol misuse and alcohol dependence without high-risk features
  • alcohol dependence with high-risk features

The high-risk features are:

  • alcohol withdrawal seizures (not alcohol associated seizures)
  • medication assisted alcohol withdrawal needed or required

The presence of these high-risk features is used to identify individuals with a physiological dependence on alcohol who are at an increased risk of relapse into dependant drinking.

Guidance on diagnosis of alcohol use disorders can be found in the Internal Classification of Diseases (11th revision) produced by the World Health Organisation, relevant codes 6C40.2 and 6C40.1, or the Diagnostic and Statistical Manual of Mental Disorder (DSM-5) for alcohol use disorder, relevant code FS10.20.

For both Group 1 (card or motorcycle) and Group 2 (lorry or bus):

  • licensing may require satisfactory medical reports from a doctor
  • DVLA may need to arrange independent medical examination and blood tests

Persistent alcohol misuse

Group 1
car and motorcycle
Group 2
bus and lorry
Persistent alcohol misuse including alcohol dependence without high-risk features, 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
?- 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

Definition of controlled drinking

Controlled drinking means drinking at a level and in a manner which their clinician confirms acceptably controls their alcohol use disorder and their alcohol use is unlikely to impact on personal, social, and work responsibilities.

Alcohol dependence

Guide to definition of dependence

Group 1 Car and motorcycle Group 2 Bus and lorry
Dependence confirmed by medical enquiry with high-risk features. ?- 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 require ongoing abstinence for at least 3 years from the onset of abstinence which will be monitored by DVLA
?- 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 require ongoing abstinence for at least 5 years from the onset of abstinence which will be monitored by DVLA
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.

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

  • there is no toxicological evidence of drug misuse

  • there is no adverse effect from treatment likely to affect safe driving

  • there is no alcohol misuse or dependence

  • there should be no other disqualifying conditions (as specified in the

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