Cancer survivor Suellen Kirkegaard had been given six months to live when she was prescribed opioids, a group of strong, highly addictive painkillers.
asserted
she → give → painkillers
Doctors had discovered a metastatic melanoma three years after her breast cancer surgery and treatment.
asserted
Doctors → discover → surgery
Immunotherapy – then limited and expensive – offered the only hope of improving her prognosis.
asserted
Immunotherapy → offer → prognosis
“The oncologist I’d had for my breast cancer … [was able to get immunotherapy] for me on compassionate grounds,” she said.
asserted
she → have → grounds
“Otherwise, six months wasn’t a lot to look forward to.”
asserted
months → look → ?
Kirkegaard responded well to the treatment, but needed opioids to curb painful side effects; arthritis, joint pain, fatigue and regular bouts of pancreatitis.
asserted
Kirkegaard → respond → pancreatitis
“Without the pain medication, I just would not have been able to function at all,” she explained.
asserted
she → function → medication
While Kirkegaard understood opioids could be addictive, it wasn’t until she met Dr John Gillett, a Toowoomba-based palliative care doctor and Queensland University of Technology PhD researcher, that she learned about the risks associated with driving.
“
uncertain
she → understand → driving
The medications say ‘do not operate heavy vehicles’ and I’m thinking, yeah, I’m not going to be driving a truck,” Kirkegaard said.
asserted
Kirkegaard → say → truck
“It was only when he [Gillett] mentioned opioids and the capacity to drive [that it] crossed my mind.”
Nearly 3 million Australians are prescribed opioids each year.
asserted
Australians → mention → opioids
While strong painkillers such as morphine, oxycodone and fentanyl are not classed as sedatives, they can cause heavy drowsiness and fatigue.
asserted
they → class → drowsiness
Patients rely on health professionals to explain possible cognitive impairment, but through his research, Gillett found both doctors and pharmacists were failing to perform this duty of care.
asserted
doctors → rely → care
“I [spoke] to a couple of younger women who said, ‘can we drive?
asserted
we → speak → women
Can we drop the kids off to school?
asserted
we → drop → school
I’m taking these drugs, but nobody can tell me what to do’,” Gillett said.
asserted
Gillett → take → what
“They wanted to ask the question, but nobody wanted to answer.”
asserted
nobody → want → question
Reasons for the oversight were varied, Gillett explained.
asserted
Gillett → explain → oversight
In one study focused on pharmacists, many discussed the risk of impairment, but did not explicitly tell patients this related to driving, assuming they would make the connection themselves.
asserted
they → focus → connection
“No, I probably never ask if they are driving or not,” one pharmacist told Gillett, continuing that they encourage patients to “decide how impaired you are and then you decide if you think you’re right to drive”.
asserted
you → ask → patients
Another pharmacist implied that GPs bore greater responsibility to manage driving and opioid use: “I’ve even seen them drive their car and they haven’t even been able to walk in the door, so to me they shouldn’t be driving,” they said.
asserted
they → imply → me
“But the doctors will still sign off that they’re capable of driving, and I don’t know how they can do that.”
asserted
they → sign → that
Separate research exploring doctors’ role in assessing drivers found GPs gave mixed advice depending on their experience and relationship with patients.
asserted
GPs → explore → patients
Many doctors had not received consistent education on driving-impairing medications.
asserted
doctors → receive → medications
“The book is very clear on epilepsy and it’s pretty clear on diabetes, but on medication, it’s quite vague,” one senior doctor said.
asserted
doctor → ’ → medication
“I think that pushes a lot of … responsibility and guesswork back onto the GP.”
asserted
that → think → GP
Overall, Gillett found health professionals leave it up to patients to self regulate driving and initiate concerns.
asserted
professionals → find → concerns
“[Doctors are] not going to say ‘oh, I’m worried about these drugs you’re taking, but I know nothing about them’, and then pass that over to the patient,” Gillett said.
asserted
Gillett → go → patient
“That’s probably going to be worse than saying nothing.”
asserted
That → go → nothing
Gillett was recently asked to be involved in GP training on the topic of auditing driving privileges, and has written submissions on assessing fitness to drive guidelines.
asserted
Gillett → ask → guidelines
He said recent cases highlight the importance of improving education across the health sector and ensuring GPs and pharmacists give patients consistent advice.
asserted
GPs → say → advice
In 2024, bus driver Brett Button was sentenced to more than two decades in prison for the fatal crash that killed 10 people and injured 25 following a wedding in the NSW Hunter Valley the previous year.
asserted
that → sentence → Valley
Throughout the case, the court heard that Button had an opioid dependency and had taken a large amount of the painkiller Tramadol through the day of the accident.
asserted
Button → hear → accident
He admitted he was impaired as a result of the drugs, but did not believe when he got behind the wheel on the day of the crash.
asserted
he → admit → crash
“No one’s mentioned about the responsibility of doctors and pharmacists to inform [the driver],” Gillett said.
asserted
Gillett → mention → driver
Kirkegaard no longer takes opioids but agreed with Gillett’s calls for consistency and education.
asserted
Kirkegaard → take → consistency
“You lose so much with a cancer diagnosis, from your hair to your dignity, your self-image … you want your independence [and] some form of normality,” she said.
asserted
she → lose → normality
“But you don’t want to put other people at risk either.
asserted
you → want → risk
A car on the road with someone behind it that’s not fully switched on, so to speak, isn’t good either.”
Start the day with a summary of the day’s most important and interesting stories, analysis and insights.
asserted
that → switch → stories
The Aporia
