Fitness to drive: alcohol, drugs, medication, fatigue, emotions and eyesight

By Mustafa Aybek · maker of Rijtheorie Hub · sources: RVV 1990, cbr.nl · last updated 2026-10-11

Alcohol: 0.5 per mille for experienced drivers, 0.2 for beginners

• Experienced: max 0.5 per mille (220 µg/l breath)
• Novice: max 0.2 per mille (88 µg/l breath)
• Novice = first 5 years after first licence
• Breakdown takes 1 to 1.5 hours per drink
• Coffee, showers or food do not help
• Alcohol slows reactions and narrows vision

Watch out: exceptions and pitfalls

• The novice period isn't always 5 years: if your first licence was an AM (moped) or T licence issued before you turned 18, the strict 0.2 limit applies for 7 years from that licence. Licence B via 2toDrive at 17 with no earlier AM or T licence: 5 years from your B.
• The novice rule counts from your very first licence. If you already got a moped licence (AM) at 16, part of your novice period may have expired before you obtain your car licence.
• The 0.2 limit also applies on a moped and light moped, not only in a car.
• 'Residual alcohol' the next morning is underestimated: after a heavy night you can still be well over the limit at 8 a.m.
• For a novice, a single beer or glass of wine already puts you at or over the 0.2 line; there is virtually no safe margin.
• Cyclists are also bound by 0.5 per mille, without a novice reduction (no licence is needed for a bicycle); cycling home from the pub drunk is punishable too. Light-moped riders, however, drive a motor vehicle that requires a licence: for novices the 0.2 limit applies there.
• Amsterdam trap: the 'I'll just have one on the terrace' culture and the weekend checks near the bridges, Leidseplein and Rembrandtplein catch many novices out.

Drugs and medication behind the wheel

• Drugs in Traffic Act applies since 1 July 2017
• Thresholds so low: effectively zero tolerance
• Check: saliva test, then decisive blood test
• THC detectable for days to weeks
• Combining drugs/alcohol: limit drops to 0.2
• Yellow triangle on pack = driving-impairing medicine

Watch out: exceptions and pitfalls

• A prescription does not protect you: if you drive under the influence of an impairing medicine and cannot steer properly, you are punishable.
• THC trap: coffeeshop tourists who then get into a rental car often still test positive, even the next day; smoking and driving never mix.
• The alcohol + drugs combination lowers the alcohol limit to 0.2 per mille, so even 'just one beer' suddenly becomes punishable.
• Innocent-seeming products such as strong hay-fever tablets, sleeping pills and old codeine cough syrup can impair driving.
• Laughing gas (nitrous oxide) is now banned; driving under its influence is a criminal offence.
• If unsure about a new medicine, do not drive for the first few days, because the effect is strongest while your body is adjusting to it.
• Amsterdam gotcha: around coffeeshops and after festivals many drivers unknowingly still have drugs in their blood; police can deploy targeted saliva tests.

Fatigue and the microsleep

• Microsleep: 1 to 4 seconds of involuntary sleep
• At 100 km/h you drive 100+ metres blind
• Signs: yawning, burning eyes, drifting from lane
• Power nap: coffee, then sleep 15-20 minutes
• Caffeine only kicks in after about 20 minutes
• Take a break every two hours on long trips

Watch out: exceptions and pitfalls

• Coffee is no miracle cure: it only works after about 20 minutes and only briefly; after the peak you are often even more tired.
• Open window, cold air, loud music or pinching your arm are persistent myths that do not prevent microsleep.
• Extra risk groups: shift workers, people after a night flight via Schiphol, and new parents who are sleep-deprived.
• A microsleep can occur with your eyes open, so 'I kept my eyes open' is no proof that you were awake.
• Sleep apnoea is a medical condition that affects your fitness to drive and must be reported to the CBR; untreated it hugely increases risk.
• Sleeping pills from the previous evening can still be working the next morning and secretly deepen your fatigue.

Emotions, stress and road rage

• Anger affects concentration much like alcohol
• Do not drive after a row, bad news or funeral
• Feel tension: breathe calmly, pull over safely
• Amsterdam: narrow streets, cyclists, trams, taxis
• Do not be provoked, never seek confrontation
• Giving space beats proving you are right

Watch out: exceptions and pitfalls

• Strong emotions narrow your attention just like alcohol; do not underestimate the effect of being 'just a bit angry'.
• Driving right after a funeral or just after bad news is an underestimated risk; let someone else drive if needed.
• A hands-free phone call that turns into an argument distracts you just as much, even with your hands on the wheel.
• Amsterdam cycle conflicts: do not react by honking, tailgating or shouting; one act of revenge can become a collision.
• Parents with crying children or arguing passengers in the back are heavily distracted; better to stop briefly than to drive on.
• Positive excitement too (just passed an exam, just won something) can lead to reckless driving.

Eyesight and vision requirements

• Minimum 0.5 visual acuity, glasses allowed
• Wide enough horizontal field of view required
• Glasses/lenses on licence = must wear when driving
• Test eyes regularly; vision worsens gradually
• Watch night blindness and glare from low sun
• Amsterdam: winter sun, wet rails and cobbles dazzle

Watch out: exceptions and pitfalls

• If your licence carries a glasses requirement, driving without glasses or lenses is an offence and your insurer can be difficult in the event of a claim.
• Driving with one eye (monocular vision) may be allowed, but only after an adjustment period and approval via the CBR.
• Colour blindness is usually no obstacle for an ordinary licence; you recognise traffic lights by the fixed order/position of red-amber-green.
• Progressive eye conditions (glaucoma, cataract, diabetic retinopathy) must be reported to the CBR on the Health Declaration when you renew.
• From age 75 a medical assessment is required when renewing your licence.
• Brand-new, stronger lenses or multifocal glasses can disturb your depth perception for the first few days; be extra careful then.
• Amsterdam gotcha: low sun over the canals and the IJ plus mirror-like wet tram rails cause fierce glare, precisely at junctions where cyclists cross.

Penalties, licence seizure, EMA/alcolock and refusing the breath test

• Fines, driving ban, community service up to prison
• Seizure experienced: from ~1.3 per mille (570 µg)
• Seizure novice: already from ~0.8 per mille (350 µg)
• CBR can impose EMA/LEMA course (you pay)
• Alcolock no longer a CBR measure since 2015
• Refusing = worst category, prosecution plus CBR measure

Watch out: exceptions and pitfalls

• Commonly heard but outdated: the alcolock has not been imposed as a CBR measure since 2015; do not rely on old information.
• Refusing the breath test is no escape: you are punished as if you fell into the highest category, so you are always worse off.
• You may not refuse the indicative roadside breath test, and certainly not the official breath analysis at the station; you cannot simply choose 'blood instead' at will.
• For novices all thresholds are lower: they lose their licence sooner and get a CBR measure sooner.
• You pay for the EMA/LEMA yourself (easily more than a thousand euros); if you do not complete the course, your licence is declared invalid.
• Recidivism counts: twice within 5 years at 1.3 per mille or more (or refusing) can make your licence invalid by operation of law.
• Foreign tourists with an EU or international licence do not escape: Dutch prosecution and fines apply anyway, even for a rental car in Amsterdam.

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