Meeting abstract

https://doi.org/10.24869/spsih.2026.280

When a Therapeutic Diazepam Concentration Does Not Provide the Answer: A Forensic Case Report

Lucija Kljaić ; “Dr Juraj Njavro“ National Memorial Hospital, Vukovar, Croatia *
Anamarija Petek Erić ; Clinic for Psychiatry, University Hospital Centre Osijek, Osijek, Croatia; Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Melita Jukić ; “Dr Juraj Njavro“ National Memorial Hospital, Vukovar, Croatia; Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Josipa Ivanušić Pejić ; Clinic for Psychiatry, University Hospital Centre Osijek, Osijek, Croatia
Valentin Kordić ; Clinic for Psychiatry, University Hospital Centre Osijek, Osijek, Croatia; Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia

* Corresponding author.

Abstract

Objectives: To present forensic‑psychiatric dilemmas
in the assessment of driving fitness in
individuals taking benzodiazepines in therapeutic
doses, and to highlight the importance of timely
informing patients about the possible impact of
medications on traffic safety. Materials and methods:
We present the case of a 25‑year‑old man
without a psychiatric history who was involved
in a traffic accident with a fatal outcome. Medical
records, toxicology findings, and the results
of forensic‑psychiatric evaluation were analyzed.
Toxicological analysis confirmed the presence
of diazepam and its metabolites in therapeutic concentrations, with a negative alcohol finding.
Results: The subject occasionally took diazepam
prescribed on an as‑needed basis for lumbosacral
pain, without an active psychiatric indication. The
exact time of medication intake could not be reliably
established, and quantitative toxicological
data were not available. Forensic‑psychiatric evaluation
did not reveal a mental disorder, cognitive
impairment, or a disorder related to the use of
psychoactive substances. After the accident, an
acute stress reaction developed, which did not require
psychopharmacological treatment. Despite
the known effects of benzodiazepines on psychomotor
functions, it was not possible to determine
with certainty whether diazepam affected
driving ability or contributed to the occurrence
of the traffic accident. Conclusion: The mere presence
of diazepam in the body does not in itself
prove functional incapacity to drive or a causal
link with a traffic accident. This case points to the
limitations of forensic‑psychiatric assessment in
the absence of precise data on dose, time of intake,
and individual response to the drug. At the
same time, it raises questions about prescribing
benzodiazepines outside psychiatric indications,
the quality of patient information regarding the
potential impact of the drug on driving ability,
and the need for clearer guidelines and documentation
of warnings about temporary reduction in
the ability to operate a motor vehicle.

Keywords

diazepam; benzodiazepines; forensic psychiatry; traffic safety; driving ability

Hrčak ID:

352965

URI

https://hrcak.srce.hr/352965

Publication date:

15.6.2026.

Article data in other languages: croatian

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