Truck drivers are struggling with extreme fatigue, isolation and high rates of depression, leading many to self-medicate with alcohol and stimulants to keep working, according to a study by Gruber Law.
The report utilized data from the Federal Motor Carrier Safety Administration, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Substance Abuse and Mental Health Services Administration, American Addiction Centers, RPM Moves, and peer-reviewed research. The firm also conducted surveys with more than 3,000 long-haul and regional drivers from 2019 to 2023.
According to the report, a key concern is lack of sleep, with nearly half of truck drivers sleeping less than six hours a night, which has increased 6.5% since 2019. With drivers sleeping fewer than five hours, crash risk also triples, which the report pointed out as similar to 0.08 Blood Alcohol Concentration (BAC) impairment.
Sleep-deprived drivers are as impaired as legally drunk motorists, the report said.
Fatigue is now a leading factor in one out of every five truck crashes, up from 15% in 2019.
“The trucking industry is running on burnout,” said David Gruber, attorney, founder and CEO of Gruber Law. “When drivers are overworked, unsupported and emotionally exhausted, crashes happen. Addressing mental health isn’t optional; it’s a safety mandate.”
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The report also pointed to mental health challenges. Between 2019 and 2023, depression prevalence among drivers was three times higher than the national workforce. More than one-third report severe loneliness, with drivers experiencing clinical symptoms of burnout while navigating long hours and high stress environments. Loneliness amongst truck drivers is also 67% higher than general workforce.
Even more alarming, only 15.4% of truck drivers have access to mental health support, indicating a lack of care and support for high-risk jobs.
Alcohol and amphetamine use is also high at 91% and 82.5%, respectively. Drivers are abusing substances to self-medicate untreated mental health issues.
Another study by the Journal of Occupational and Environmental Medicine found that 51% of long-haul truck drivers smoke, compared to just 19% of the general U.S. working population. The study linked smoking to higher rates of chronic bronchitis, COPD and lung cancer among truckers, suggesting that mental health struggles may drive unhealthy coping mechanisms.
Research from the CDC indicates that stress, isolation and a sedentary lifestyle contribute to these high smoking rates, highlighting the deep connection between mental health and substance use in the industry. These findings emphasize the urgent need for better mental health support and resources for truck drivers to reduce substance abuse and improve overall wellbeing in the workforce.
Although regulations like FMCSA's guidelines on hours of service and fatigue management address some aspects of truck drivers' mental health, there may still be gaps that need improvement. In recent years, lawmakers have introduced legislation aimed at tackling these challenges, such as the Truck Parking Safety Improvement Act, proposed in Congress, which seeks to reduce driver fatigue and stress by addressing the shortage of safe parking spaces.
From a legal standpoint, as fleet companies are responsible for ensuring a safe working environment, Gruber, recommended several key actions fleet operators can take:
- Formalize mental health policies: Companies should establish documented mental health and fatigue management policies. This includes protocols for drivers to report emotional distress and guidelines for supervisors on how to respond appropriately.
- Provide access to mental health resources: Employers should offer confidential access to counseling, Employee Assistance Programs (EAPs) or teletherapy services. Demonstrating that support systems are in place can protect carriers from liability claims in the event of an incident.
- Comply fully with FMCSA and OSHA standards: Strict adherence to Hours-of-Service (HOS) regulations is critical. Violations of HOS or evidence that a company knowingly encouraged unsafe driving schedules can serve as direct proof of negligence.
- Invest in ongoing training and safety documentation: Regular training on stress management, fatigue awareness and safe driving habits should be mandatory. Maintaining records of participation shows the company has taken reasonable steps to reduce foreseeable risks.
- Ensure non-retaliation and ADA compliance: Drivers must feel safe disclosing mental health concerns without fear of punishment. Employers must also be careful not to violate the Americans with Disabilities Act (ADA) by failing to accommodate drivers with diagnosed mental health conditions.
- Respond to warning signs with action: If a driver displays signs of chronic fatigue, substance use or emotional instability, the employer must intervene. Failure to act after red flags have been raised may be interpreted by courts as deliberate negligence.
