What is already known on this topic?

Safe driving requires ‘situation awareness’, a combined implementation of skills and traits that include attending to the driving task, focusing on relevant hazards, and being aware of traffic and road conditions and responding appropriately.1 Deficits in attention and impulse control put patients with attention-deficit hyperactivity disorder (ADHD) at increased crash risk. Consistent ADHD medication use, ensuring therapeutic levels while driving, has the potential to reduce this risk.2

What does this paper add?

• This landmark population-based study is the first to quantify an almost 50% increased risk of serious crash injuries among adults with ADHD.

• For adult men, injuries were 58% less likely when on-medication compared with when off-medication; for motorcyclists alone, on -medication injuries were 90% less likely.

• Only 57.5% of men with ADHD had been prescribed ADHD medication. At the end of the study period, only 37.2% were on medication.

• Among women with ADHD, no evidence of reduction in crashes …