We talk about legislation impeding pain management, but one area does not get discussed and that is the ability to drive legally in a state (which I think comes under state policies). A recent discussion on another list serve was very interesting. My state, Maine, says you cannot drive impaired which is okay as after you are on opioids for a while you become tolerant of most side effects (note that is not usually the case with antiseizure medication). Massachusetts says you cannot drive when taking opioids, period, so your medications make it so you can work and now you can’t get there. Another state states if you are potentially impaired (so you can’t drive with pain or without it?) you can’t drive (that also includes a cast on any extremity). I see this as a huge problem preventing people with pain from being fully functional. Also there is an assumption here that opioids are the bad guys when it may be some other medication or disease process. Does any actually say you cannot drive when fatigued or sleepy? Your thoughts.?