Drug-impaired driving: The hidden impairment on SA roads

12 June 2026 | From Arrive Alive


Drug-impaired driving, spanning everything from illicit substances to the cold and flu medication in your bathroom cabinet, represents just as serious a threat to road safety as other behaviours like alcohol impairment or distracted driving, but receives far less attention.

The global data is sobering:

  • Research from New Zealand found that drug-impaired drivers were involved in 79 fatal crashes in a single year, compared to 70 involving alcohol. It was their recorded instance of drugs overtaking alcohol in that country’s road fatality data.
  • In the United States, studies consistently show that drugs other than alcohol are present in roughly 44% of fatally injured drivers tested.
  • Closer to home, the Road Traffic Management Corporation identified drug use as a significant contributing factor in collisions, though accurate quantification remains a challenge given limited roadside testing capacity. 

For fleet operators, the risk includes both illicit substances and over-the-counter medication. The CEO of MasterDrive, Eugene Herbert, says: “As we enter the winter months, a significant number of employees will be managing colds and flu while continuing to drive. Many will be doing so after taking medications that carry clear drowsiness warnings.

“According to the Loughborough Sleep Research Centre and the Centres for Disease Control and Prevention, fatigued drivers account for more than 20% of all road accidents. Up to one in five fatal crashes involves a tired driver.” 

The danger of this is consistently underestimated. “Flu medication can reduce reaction time, increase drowsiness and cause nausea and dizziness. Coupled with the fatigue that accompanies illness, it can be a recipe for disaster. Various studies suggest that driving while fatigued is just as dangerous as drunk driving, but most drivers do not treat it with the same seriousness.” 

Employers also bear responsibility here. “Employees who depend on driving for an income are at greater risk of feeling pressured to remain on the road while unwell or medicated. If you are on the road most of the day, there is almost no scenario where it is safe to take flu medication. 

“Employers must have policies and alternative arrangements in place which can be anything from desk-bound duties to approved sick leave, or revised schedules. The safety of your staff and the well-being of your business may depend on it.” 

Screening for drug use, including prescription and over-the-counter medication, should form part of any serious fleet risk management programme. “Roadside testing and enforcement need to come a considerable way before official means exist to enforce drug-free driving. Until such tools are available and widely deployed, the burden falls on organisations to close the gap through policy, awareness and a willingness to treat legal drugs with the same caution as illegal ones,” says Herbert.

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