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NTSB Study Shows Upward Trend In Drug Use By General Aviation Pilots

September 10, 2014 - In a study adopted Tuesday on the prevalence of drug use by pilots who died in crashes, the NTSB found an upward trend in the use of both potentially impairing medications and illicit drugs. Almost all of the crashes, 96 percent were in general aviation. 

"I think that the key take-away from this study for every pilot is to think twice about the medications you're taking and how they might affect your flying," said NTSB Acting Chairman Christopher A. Hart. "Many over-the-counter and prescription drugs have the potential to impair performance, so pilots must be vigilant to ensure that their abilities are in no way compromised before taking to the skies." 

The study analyzed toxicology results for 6,677 pilots who died in aircraft accidents between 1990 and 2012. None of the pilots who died in large airline accidents had recently used illicit drugs, though some had been using potentially impairing medications. 

Over the period studied, the proportion of pilots testing positive for drugs with impairment potential nearly doubled from about 11 percent to almost 23 percent. The most common impairing drug was a sedating antihistamine (diphenhydramine) found in many cold and allergy medications as well as sleep aids. 

Study authors emphasized that it could not be stated with certainty that more pilots are actually flying impaired. While the study noted that the greater use of medications pointed to an increasing risk of impairment, it stressed that further research is needed to better understand the relationship between drug use and accident risk. 


On October 14, 2009, a non-instrument rated private pilot and his passenger were killed at night under instrument meteorological conditions in a Robinson R22 Beta helicopter, N3234G. Several witnesses in the immediate vicinity of the departure location reported the weather as cold, low overcast skies with limited visibility due to light rain and mist. The National Transportation Safety Board determined the probable cause(s) of this accident to be: The pilot's impairment due to recent heavy use of methamphetamine recent use of a narcotic pain reliever, and fatigue.

Since 1990, the NTSB cited pilot impairment as a cause or contributing factor in about 3 percent of fatal accidents, a figure that was relatively stable over the study period. Importantly, the study explained that it was difficult to ascertain whether a pilot who tested positive was actually impaired at the time of the accident. However, the study did say that increasing numbers of accident pilots chose to fly after taking potentially impairing drugs, suggesting that some pilots are either unaware of the risks that such drugs present or consider such risks acceptable.



Illicit drug use was relatively uncommon among the study population, increasing from 2.4 percent of pilots who died in accidents in the 1990s to around 4 percent by 2012, largely due to increasing marijuana use. 

On March 30, 1983, Gates Learjet 25, registration N51CA was on a night check courier flight. During arrival, the indicated airspeed was well above the legal limit of 250 knots for flight below 10,000 ft. Runway 4R was selected for landing after the crew were advised that their original choice (runway 11) was noise sensitive. They were advised not to descend below 2000 ft until on final approach. 

The turn to final was completed about 1 mile from the runway at an altitude of approximately 700 ft. A steep final approach was flown with an estimated 1000 fpm rate of descent. On landing, the aircraft bounced, banked/turned to the right, then it hit the ground. Both pilots were killed. An exam of the wreckage revealed the aircraft was configured with the gear extended, the flaps down 20 degrees and the spoilers retracted. 

No evidence of a preimpact part failure or malfunction was found. Toxicology checks showed that both pilots had used or been exposed to marijuana and had co2 in their blood from smoking; use of medication (phenylpropanolamine) by copilot. Evidence of possible fatigue/stress to both. Although this flight was not a general aviation flight the NTSB did studied this case because of drug use by the pilots. 

In addition to the safety recommendations, the NTSB issued a safety alert urging pilots to consult medical professionals about the potentially impairing effects of any drug that they are taking, carefully read medication dosing instructions, and to refrain from flying if they feel impaired in any way. 

The study included 6 safety recommendations, all related to gathering better information about impairment in transportation or urging better dissemination of information on potentially impairing drugs to pilots and others. 

1. Develop, publicize, and periodically update information to educate pilots about the potentially impairing drugs identified in your toxicology test results of fatally injured pilots, and make pilots aware of less impairing alternative drugs if they are available. 

2. Require pilots who are exempt from medical certification requirements to periodically report to you their status as an active pilot and to provide a summary of recent flight hours. 

3. Develop and distribute a clear policy regarding any marijuana use by airmen regardless of the type of flight operation. 

4. Conduct a study to assess the prevalence of over the counter, prescription, and illicit drug use among flying pilots not involved in accidents, and compare those results with findings from pilots who have died from aviation accidents to assess the safety risks of using those drugs while flying. 

5. To the 50 states, the District of Columbia, and the Commonwealth of Puerto Rico: Include in all state guidelines regarding prescribing controlled substances for pain a recommendation that health care providers discuss with patients the effect their medical condition and medication use may have on their ability to safely operate a vehicle in any mode of transportation. 

6. Use existing newsletters or other routine forms of communication with licensed health care providers and pharmacists to highlight the importance of routinely discussing with patients the effect their diagnosed medical conditions or recommended drugs may have on their ability to safely operate a vehicle in any mode of transportation.

Please keep in mind that the focus of this report is on impairment type drugs not illicit drugs. In this case the NTSB refers to impairment type drugs as the drugs you would buy over the counter such as pain relieving medication, etc. Illicit drugs would be considered drugs bought on the street such as hallucinogens, cannabis, opiates, etc. Pilots need to be mindful that taking over-the-counter medication or prescription medication may, has the potential to impair performance and your ability to safely pilot an aircraft.
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