DGT crackdown: Thousands in Spain could lose their driving licence under new health rules

Nobody expects to lose their driving licence because of a medical check – but that could soon be a reality for thousands of motorists in Spain. The Dirección General de Tráfico (DGT) is tightening its rules from 2025, and drivers with certain health conditions may be refused renewal altogether.

This is not about punishment. It’s about safety. The DGT says too many road accidents are still linked to health problems that impair judgement, alertness or reaction time – sometimes without the driver even noticing.

But understandably, the question worrying people right now is: Who is on the risk list?

Why the DGT is cracking down on medical fitness

Spain already requires licence holders to undergo periodic medical checks. But the new rules take things further by including additional illnesses that could limit, restrict or completely block licence renewal.

Health conditions don’t all affect driving in the same way. Some can be easily managed with treatment. Others bring a real danger of losing consciousness, becoming disoriented or suffering sudden physical limitations – scenarios that could turn deadly when someone is behind the wheel.

That’s why the DGT has made its decision clear: If a doctor cannot guarantee safe driving, the licence will not be renewed.

Still, it’s not all bad news. The process is person-by-person, based on:
• how severe the condition is
• whether treatment is working
• how the illness is evolving
• whether the driver can adapt the vehicle

No one is written off automatically – but drivers must now prove they’re safe.

The conditions now under stricter review

The DGT has divided the main risks into several medical categories. Here’s what drivers should know:

Mental health conditions

Issues like anxiety, depression, OCD and ADHD don’t instantly remove the right to drive. But a doctor must confirm that symptoms – and any medication side-effects – are under control. If they aren’t, renewal may be temporary or refused.

Cardiovascular diseases

Anything that affects the heart rhythm or blood flow can interfere with driving reflexes. The biggest red flags are:

• Significant arrhythmias
• Heart attacks with lasting consequences
• Serious heart failure
• Use of pacemakers or defibrillators without medical stabilisation

These conditions may require frequent medical reviews before the licence is approved.

Neurological disorders

This is one of the most restrictive categories. The DGT is especially firm when:

• The driver has epilepsy (seizures and loss of consciousness are incompatible with driving)
• There is a history of stroke, particularly if mobility, vision or attention remain affected

Doctors must demonstrate that there is no ongoing risk of sudden episodes.

Endocrine disorders

This includes:

• Insulin-dependent diabetes, which may cause dangerous dips in blood sugar
• Severe thyroid disorders, which can trigger tremors, fatigue, confusion or excessive agitation

If treatment is stable, renewal is usually possible – but with closer monitoring.

Respiratory diseases

Here, the biggest concern is obstructive sleep apnoea, especially when accompanied by moderate to severe daytime sleepiness. Microsleeps at the wheel can lead to catastrophic crashes, so drivers will often be given shorter renewals linked to treatment success.

Cancer and haematological diseases

Chemotherapy and radiotherapy can lead to:

• Extreme tiredness
• Slower reactions
• Cognitive fog

When these symptoms are present, doctors may temporarily block renewal until treatment effects improve.

Motor and mobility impairments

If joints, limbs or the spine are severely affected, physical control of the vehicle may be compromised. Adapted vehicles may allow renewal — but only after specific medical and driving assessments.

What this means for drivers in Spain

If you depend on your car for work, family or independence, this new system might feel daunting. But the DGT insists the goal is fairness and prevention – not removing licences from everyone with a diagnosis.

Some drivers will keep their licence but with:

• Shorter renewal periods (1–3 years)
•  Mandatory medical follow-ups
• Required adaptation of the vehicle

Others will face a temporary ban while treatment stabilises.

And yes – in some cases, the licence simply won’t be renewed.

How to avoid unexpected bad news

The DGT’s advice is simple:

• Don’t wait until the renewal appointment
• Speak to your doctor early about your fitness to drive
• Make sure any treatment plans are documented and up-to-date
• Declare conditions honestly – failing to do so could have legal consequences

A medical report from a specialist may be the difference between keeping your independence and suddenly losing the right to drive.

Spain wants safer roads – and believes stricter medical rules are the way to get there. While the changes may come as a shock to many, the system remains personal, medical and adaptable.

There is one clear takeaway for all motorists: If your health has changed, your driving licence may soon depend on how well that condition is managed.