Plane & Pilot
Tuesday, July 9, 2013

Pilots Popping Pills

Use of prescription and over-the-counter medications can be problematic for pilots

While deficiencies in the safety value of the FAA's medical certification program were clearly demonstrated in the AOPA/EAA proposal to permit expanded use of driver's license medicals, a study by the FAA itself demonstrated that even the weight of the federal government can't force compliance when the target population views your program as a threat rather than a benefit.

I recently stumbled across the study, which was sponsored by the FAA's Office of Aerospace Medicine. I don't recall hearing about it when it was completed in May of 2006. The study compared medical information about pilots uncovered by the FAA's Civil Aerospace Medical Institute for the NTSB to use in its investigations with information reported by those pilots on their applications for medical certificates.

The study highlighted a segment of 387 pilots who had been killed in accidents and whose toxicological testing results showed they had been using medications. Of the 387, only 30 had reported on FAA medical applications that they were taking those medications, and only 84 had reported having the medical conditions that would require use of those medications.

In all, the study examined data on 4,143 pilots and found that, in the words of the authors, "Not surprisingly, the accuracy of required reporting of medication usage by pilots was low, with 92% of pilots either failing to report medications they were taking or reporting a different medication than what was found during toxicological analysis."

Perhaps the researchers weren't surprised at the low accuracy rate because they know pilots are aware of what can happen when the FAA focuses on a personal medical issue, even when there are no safety implications.

One of the problems consistently faced by pilots over the years has been the FAA's reluctance to issue comprehensive lists of approvals or disapprovals for specifically named medications. Pilot organizations and medical consultants have attempted to compile the encyclopedic knowledge on their own to help pilots minimize the possibility of opening a can of worms, if they happen to report on a medical application that they're taking a new prescription or over-the-counter drug.

The FAA has, to its credit, published material such as the circular OK05-0005, Medications and Flying, which lists the potential side effects of several drugs and offers general advice on over-the-counter and prescription medications. However, it doesn't name specific drugs that are okay to use when flying. Rather, it places the medical decision-making responsibility with the pilot, an endorsement of the principle on which the AOPA/EAA proposal was based.

In these accidents recently investigated by the NTSB, FAA toxicology tests reported to investigators the use of some medications that the Safety Board said contributed to the probable causes.

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