The Flight Safety Foundation Corporate Aviation Committee held a workshop in October about instituting a pilot-friendly drug- and alcohol-abatement program in corporate flight departments. According to Dr. Quay Snyder, president of Aurora, Colo.-based Virtual Flight Surgeons, the outcome of the meeting was that there will be a publication on how to institute such a program, a presentation at an upcoming Corporate Aviation Safety Seminar and a seminar at the next NBAA meeting.
Snyder, who is involved with the development of the program, is also a NATCA aeromedical advisor and ALPA/APA associate aeromedical advisor. The subject is timely due to recent negative industry-related events that have been highly publicized in the media.
According to the FAA, substance abuse is defined as using “alcohol [excessively]; other sedatives and hypnotics; anxiolytics; opioids; central nervous system stimulants such as cocaine, amphetamines and similarly acting sympathomimetics;
hallucinogens; phencyclidines or similarly acting arycyclohexyamines; cannabis; inhalants; and other psychoactive drugs and chemicals.”
The potential consequences of substance abuse are an adverse effect on the individual’s physical and mental health; relationships with others; aviation safety; loss of both medical and pilot certificates; loss of employment; and potential legal problems. For the flight department the consequences of a single employee with a substance-abuse problem can range from public embarrassment for the company to loss of life and equipment. It is not an understatement to say one pilot with a substance-abuse problem has the potential to put a company out of business.
On the other hand, companies that identify individuals with a substance-abuse problem and proactively work with them are rewarded for their efforts. “Flight department programs to identify chemical abuse–coupled with strict, supportive rehabilitation and job recovery policies–have proved successful with a substantial return-on-investment for individuals and companies,” Snyder said.
According to Snyder, between 1990 and June 1998 there were 69 alcohol-related fatal aircraft accidents involving aircraft with an mtow greater than 12,500 pounds. Of the 113 crewmembers involved, 15 had blood-alcohol concentrations exceeding the FAA limit of 0.04 mg/dl. “Certainly a larger number of pilots have flown while impaired but were not involved in fatal aircraft mishaps,” he said. A seven-year study by the FAA Civil Aeromedical Institute on alcohol and flying found approximately 12 percent of all pilots in fatal general aviation accidents had measurable levels of alcohol in their blood at the time of their death.
Snyder said research shows only a little over 15 percent of the adult U.S. population does not consume alcohol for various reasons. Alcoholics in remission are not included in that number. He went on to say that 50 to 60 percent of the population are social drinkers characterized by the ability to stop drinking at will. “Although this behavior does not meet the criteria for abuse or dependence,” he said, “people with genetic predisposition for addiction may be in the early stages leading to future abuse/dependence. The late stage of alcohol use is dependence, characterized by an inability to stop, compulsive use and continued use despite adverse consequences.” Snyder stresses that the last stage of alcohol dependence can lead to serious medical problems and possibly death. “Alcoholism is a progressive, fatal disease if left untreated,” he said.
Statistically, drug and alcohol abuse affects the pilot population in the same proportion as other professional occupations–approximately 8-to 10 percent. The major concern is that most abusers are undiscovered and even unreported. Snyder pointed out that many people simply don’t understand that they are unable to control their consumption. They have convinced themselves that they can stop anytime they want, such as when they are flying.
“Abuse and dependence problems are not a weakness in character nor a primary amoral behavior,” Snyder told AIN. “Don’t confuse that with the fact that the behavior itself may be bad, illegal or compromise safety. Not only are they unable to control their behavior, but worse yet they are not able to recognize their problem despite obvious clues. They can’t ask for help because they don’t believe there’s anything wrong.”
The FAA defines substance dependence in 14 CFR 67.107, 67.207 and 67.307 as “a condition in which a person is dependent on a substance other than tobacco or ordinary xanthine-containing beverages (e.g., caffeine) as evidenced by increased tolerance, manifestation of withdrawal symptoms, impaired control of use or continued use despite damage to physical health or impairment of social, personal or occupational functioning.”
But how does that manifest itself in individual situations? Snyder said there are many signs to watch for. “Simply walking or driving with a blood alcohol content of 0.20 mg/dl shows an increased tolerance to alcohol. Signs of the DTs, a fast heart rate and irritability are all manifestations of withdrawal,” he said.
“Another good indicator is binge drinking (more than five drinks at a time) or the need to have an ‘eye opener’ anytime. Other indicators can include an individual who persists in drinking even after having abnormal liver tests, incidences of domestic abuse while under the influence, and the use of sick leave due to hangovers or blackouts.”
The key to the diagnosis of any substance abuse is what Snyder refers to as the three Cs: loss of control, compulsive use and continued use despite adverse consequences.
Contrary to common belief, a history of substance abuse does not have to mean the end of a flying career. The stigma is in not seeking help, being treated and recovering. The FAA’s current policy on alcoholism is to think of it as similar to cancer, diabetes, heart disease and HIV. “The FAA fully supports pilots identified with chemical-abuse diagnoses who successfully recover and maintain company involvement,” Snyder said. “The FAA recognizes the value of education, intervention, treatment and return to flying duties for pilots afflicted by this common, progressive, fatal, but treatable, disease.”
Snyder said the key to a successful drug- and alcohol-testing program is training. Periodic, random drug testing catches some substance abusers, but the majority are identified by trained supervisors, peers and self reporting. For further information contact the Flight Safety Foundation (www.flightsafety.org).