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This systematic review fills the currently unmet need in understanding the effects of METH and MDMA on motor vehicle driving performance (MVP) and provides insight into the forensic community. A PubMed search on September 24, 2020, for experimental and observational studies, which evaluated the impact of METH and MDMA on MVP was performed. After a review of 208 abstracts, 103 were considered potentially interesting and full texts were obtained. After the exclusion of non\u2010English articles, review articles, single case reports, and articles which did not evaluate METH or MDMA on MVP, a total of nine experimental studies, 10 traditional observational studies, and 35 case series were included. The clinical rigor of experimental studies was evaluated using the Jadad scale. Experimental studies often demonstrated no significant MVP safety signals for METH or MDMA use, which was contrary to the overwhelming MVP safety risks found in observational studies. Common driving behaviors while using METH or MDMA include: errors in judgment, traveling at high speeds, failure to stop, merging inappropriately, lane weaving, and crashes. Limitations of experimental studies that led to dissimilar MVP outcomes from observational studies include: the common use of driving simulators, as opposed to actual driving examinations, and doses of METH or MDMA administered may not be representative of blood concentrations seen in observational studies. This systematic review has no funding source and was not registered.<\/jats:p>","DOI":"10.1111\/1556-4029.15179","type":"journal-article","created":{"date-parts":[[2022,11,22]],"date-time":"2022-11-22T04:46:17Z","timestamp":1669092377000},"page":"22-34","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effects of 3,4\u2010methylenedioxymethamphetamine and methamphetamine on motor vehicle driving performance: A systematic review of experimental and observational studies"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9889-7260","authenticated-orcid":false,"given":"Ian R.","family":"McGrane","sequence":"first","affiliation":[{"name":"Skaggs School of Pharmacy, College of Health University of Montana  Missoula Montana USA"},{"name":"Department of Pharmacy Providence St. Patrick Hospital  Missoula Montana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9114-5624","authenticated-orcid":false,"given":"Nathan C.","family":"Ramsbacher","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Providence St. Patrick Hospital  Missoula Montana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8550-4846","authenticated-orcid":false,"given":"William C.","family":"Rook","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University Hospitals Cleveland Medical Center  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4752-1914","authenticated-orcid":false,"given":"Faddy A.","family":"Omar","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Holy Rosary Healthcare  Miles City Montana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,21]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Substance Abuse and Mental Health Services Administration (SAMHSA).NSDUH detailed tables table 6.27B.2018[cited 2022 Jun 9]. 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