Adult ADHD and Driving: What the Research Shows

Short answer

According to studies indexed in PubMed, adults with ADHD appear to have, on average, an increased risk of traffic crashes compared with adults without ADHD. The increase is not the same for everyone and is influenced by factors such as symptom severity, anxiety, alcohol use, age and driving habits. ADHD does not mean that someone cannot drive. The research evidence applies to groups of people and does not predict what will happen to an individual.

Why this matters

Driving requires sustained attention, quick decision-making and control of impulsivity. These are functions that can be affected in ADHD. Many adults wonder whether the diagnosis affects their safety on the road. This article summarises what the literature reports and points out what is not known.

What the studies found about risk

• A Dutch study of 330 adults with ADHD and 330 controls (cross-sectional, self-report questionnaires): the diagnosis was associated with a higher likelihood of 3 or more traffic crashes (OR = 2.72). Anxiety, hostility and alcohol also played a part in the results. (Bron et al., 2018)

• A study with continuous recording of real-world driving in 3,226 drivers: crash risk rose by about 5% for each increase in the symptom severity score. In the group with self-reported ADHD the rate ratio was 1.46 and in the group with depression 1.34, that is, similar. This suggests that part of the risk may be related to difficulty concentrating more generally. (Aduen et al., 2018)

• A study of drivers aged 65-79: those who reported ADHD had a higher frequency of reported crashes (adjusted rate ratio 1.74). ADHD was defined by self-report, so there are limitations. (Liu et al., 2023)

• A study of adolescents and young adults (up to 25 years old): among those who held a driving licence, the risk of a first crash was 1.36 times higher in the ADHD group. In addition, young people with ADHD obtained a licence less often and at an older age. (Curry et al., 2017)

• A study using video recording of driving in young adults: in the ADHD group, more events of impulsive, risky or distracted behaviour were recorded. (Merkel et al., 2013)

Factors that appear to influence risk

• Symptom severity: risk appears to increase as severity increases (Aduen et al., 2018).

• Co-occurring problems: anxiety, hostility and alcohol use were associated with worse outcomes in the Dutch study (Bron et al., 2018).

• Executive functions: in adolescents with ADHD, more impulsivity errors on a Go/No-Go task were associated with more long glances away from the road in a simulator. The study concerns adolescents, so applying it to adults is uncertain. (Lynch et al., 2023)

• Family environment and road-safety attitudes: in students (4,392 participants), certain aspects of communication around safe driving appeared to influence the relationship between ADHD symptoms and dangerous driving. Results were mixed. (Burns et al., 2022)

What we know about treatment and driving

The literature is not uniform. A systematic review of 15 randomised studies (up to 2013) concluded that, in general, stimulants at therapeutic doses were associated with improved driving performance (in a simulator or a car), with more consistent improvement in adolescents and young adults, while results for atomoxetine were conflicting (Gobbo & Louzã, 2014). A more recent double-blind crossover study in 44 young adults found similar simulator performance between two medications (Madaan et al., 2024). In contrast, a retrospective study of adolescents in the US Medicaid programme did not find statistically strong evidence that medication use is associated with fewer crashes or violations (Winterstein et al., 2020), and in Aduen’s study the usual treatment regimen did not reduce risk. Overall, the data on real-world crash risk are weaker than the data on simulator performance. This article is not a treatment recommendation: every treatment decision belongs to the treating physician.

Limitations of the studies

• Many studies rely on self-report (of ADHD or of crashes), which can distort the results.

• Most studies are conducted in the US and northern Europe. No Greek data were found in the relevant search.

• Correlations do not prove causation.

Frequently asked questions

Can an adult with ADHD drive?

ADHD on its own does not rule out driving. Studies show a statistically increased risk at group level, not an individual prediction. The risk appears to differ depending on symptoms and co-occurring problems.

Does medication affect driving?

The literature shows mixed findings, mainly from simulators and small studies. The relationship with driving should be discussed with the treating physician.

Do anxiety or depression play a role?

In the studies mentioned above, anxiety and hostility were associated with worse outcomes in ADHD. In one study, depression was associated with a similar increased risk.

Does the same apply to older adults?

One study of drivers aged 65-79 showed an increased risk, but it relied on self-reported diagnosis.

When should I ask for an assessment?

If inattention or impulsivity affects daily life, including driving, a conversation with a specialist is worthwhile.

Sources

1. Bron TI, et al. Risk factors for adverse driving outcomes in Dutch adults with ADHD and controls. Accid Anal Prev. 2018;111:338-344. https://doi.org/10.1016/j.aap.2017.12.011 (PMID 29274569)

2. Aduen PA, et al. ADHD, depression, and motor vehicle crashes: A prospective cohort study of continuously-monitored, real-world driving. J Psychiatr Res. 2018;101:42-49. https://doi.org/10.1016/j.jpsychires.2018.02.026 (PMID 29547761)

3. Liu Y, et al. Motor Vehicle Crash Risk in Older Adult Drivers With Attention-Deficit/Hyperactivity Disorder. JAMA Netw Open. 2023;6(10):e2336960. https://doi.org/10.1001/jamanetworkopen.2023.36960 (PMID 37792374)

4. Curry AE, et al. Motor Vehicle Crash Risk Among Adolescents and Young Adults With Attention-Deficit/Hyperactivity Disorder. JAMA Pediatr. 2017;171(8):756-763. https://doi.org/10.1001/jamapediatrics.2017.0910 (PMID 28604931)

5. Merkel RL, et al. Comparison of On-Road Driving Between Young Adults With and Without ADHD. J Atten Disord. 2013;20(3):260-269. https://doi.org/10.1177/1087054712473832 (PMID 23400213)

6. Lynch JD, et al. Executive Functioning as a Predictor of Adverse Driving Outcomes in Teen Drivers With ADHD. J Atten Disord. 2023;27(14):1650-1661. https://doi.org/10.1177/10870547231197210 (PMID 37688481)

7. Burns AB, et al. ADHD and dangerous driving in emerging adults: The moderating role of family climate for road safety. Accid Anal Prev. 2022;178:106819. https://doi.org/10.1016/j.aap.2022.106819 (PMID 36174249)

8. Gobbo MA, Louzã MR. Influence of stimulant and non-stimulant drug treatment on driving performance in patients with attention deficit hyperactivity disorder: a systematic review. Eur Neuropsychopharmacol. 2014;24(9):1425-1443. https://doi.org/10.1016/j.euroneuro.2014.06.006 (PMID 25044052)

9. Madaan V, et al. A Randomized, Phase 3, Double-Blind, Crossover Comparison of Multilayer, Extended-Release Methylphenidate (PRC-063), and Lisdexamfetamine in the Driving Performance of Young Adults With ADHD. J Atten Disord. 2024;28(6):947-956. https://doi.org/10.1177/10870547241226634 (PMID 38404033)

10. Winterstein AG, et al. Medication Use for ADHD and the Risk of Driving Citations and Crashes Among Teenage Drivers: A Population-Based Cohort Study. J Atten Disord. 2020;25(11):1511-1518. https://doi.org/10.1177/1087054720915768 (PMID 32338114)

This article is general information. It does not replace medical advice. In an emergency, call 112 or go to the emergency department of the nearest hospital.

Author: Dr. Georgios Mylonas, Psychiatrist – Psychotherapist. Last updated: 29 October 2026.