As part of the ongoing industry/FAA campaign to stem loss-of-control inflight (LOC-I) accidents, the FAA recently released a go/no-go list and safety briefing to help pilots determine the safe use of over-the-counter medications while flying. In releasing this long-awaited information, the FAA noted that a 2011 study from the FAA’s CAMI Toxicology Lab found that 42 percent of 1,353 pilots tested after fatal accidents were found with at least one of the drugs from the list in their system. Of those, 90 percent were flying under Part 91.
“We all know that some drugs may compromise a pilot’s ability to control the aircraft and/or adversely affect judgment and decision making. The difficulty comes for investigators in trying to quantify the known detriment that comes with various medications and the physical conditions that require their use,” the FAA said.
Also, the agency worries about pilots not disclosing medications to their aviation medical examiner. “Undisclosed treatments could hide potentially impairing drug interactions,” the agency said. “In many cases, there are other treatment options that may allow you to continue flying, but your AME [aviation medical examiner] needs to know what medications you are using.”
In addition to listing go and no-go medications, the FAA list—What Over-the-Counter (OTC) medications can I take and still be safe to fly?—provides a checklist for pilots to determine whether they are fit for flight. Pilots are advised to wait five times the dosing interval of a “no-go” medication before flying. In other words, if the medicine has a recommended four-hour interval between doses, pilots should wait 20 hours from the last dosage before flying.
These efforts stemmed from “safety enhancements”—or calls to action—that the government/industry General Aviation Joint Steering Committee (GA-JSC) issued earlier this decade to address LOC-I. In all, the GA-JSC released close to three dozen such safety enhancements aimed at LOC-I, which remains the leading cause of fatal aircraft accidents.
Among those were a couple aimed at the use of medication, including a recommendation for a “public education/outreach campaign to promote the understanding of the effects of medication” and one specifically calling on the FAA to provide an updated list of medications that should and should not be taken when flying.
Richard McSpadden, executive director of the Aircraft Owners and Pilots Association (AOPA) Air Safety Institute and co-chair of the GA-JSC, welcomed the release of the list, saying the industry has pushed for it for years. “It’s not as extensive as we’d like it to be, but at least it’s a start where pilots can go,” McSpadden added.
AMEs have this information, but “we felt this should be information that all pilots can access," said GA-JSC members Lauren Lacey Haertlein, general counsel for the General Aviation Manufacturers Association.
The NTSB has found that antihistamines were the most commonly found substances. Other top substances the NTSB found included marijuana, with an increasing incidence of positive tests, as well as hydrocodone, a legal prescription drug, according to Haertlein and GA-JSC member Peter Korns, manager of tax, operations, and workforce engagement for the NBAA, both of whom spoke at the Bombardier Safety Standdown earlier this month in Fort Worth, Texas.
While these were just samples found in pilots and not representative of how much or whether the drugs were a factor in the accident, Haertlein said it is important to have a picture of what is happening with medication use. This has implications for the information that needs to be relayed to pilots, she said.
It is particularly important given how much medication there is in the U.S., Haertlein said. The Centers for Disease Control and Prevention has found that 48.9 percent of the population uses a least one prescription drug in a 30-day period, she said, but added, “The most common thing we are seeing is over-the-counter medication.”
AOPA plans to continue to work with the FAA on expanding the list over time, the association said. Meanwhile, the association also offers its own medication database based on FAA decisions, along with a medical self-assessment course.