Alcohol & Drug Use: Roadmap to Certification
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1 Alcohol & Drug Use: Roadmap to Certification Daniel Danczyk, MD, MPH HIMS Psychiatrist / AME / ANG FS / Private Pilot Civil Aviation Medical Association Annual Meeting, Greensboro September 15, MFMER slide-1
2 Disclosure Information Financial: Prior consulting for JetBlue (2013) No off-label med use and/or investigational 2016 MFMER slide-2
3 Objectives Review FAA definitions regarding addiction Differentiate the deferral criteria Understand the HIMS addiction protocol specifications 2016 MFMER slide-3
4 Agenda Introduction where did it all start? Definitions.. And more! Deferral criteria Getting your airman there Conclusion 2016 MFMER slide-4
5 Human Intervention Motivation Study (HIMS) Himsprogram.com 2016 MFMER slide-5
6 Occupational Alcohol Addiction Treatment Program (1970s) Drugs of Abuse 4 SSRIs (2010) HIMS today (2016) Alcohol / Drug Monitoring SSRI Protocol 2016 MFMER slide-6
7 What is disqualifying? Specifically disqualifying All Classes: 14 CFR (a)(b), (a)(b), and (a)(b) Substance dependence (a) Substance abuse (b) 2016 MFMER slide-7
8 FAA: SUBSTANCE includes Alcohol, PCP, sedatives and hypnotics, anxiolytics, marijuana, cocaine, opioids, amphetamines, hallucinogens, and other psychoactive drugs or chemicals 2016 MFMER slide-8
9 FAA Def n of Substance Abuse Physically hazardous to situation (+) drug test Etoh 0.04 Refusal to submit to DoT Etoh/drug test Misuse that the Federal Air Surgeon finds 2016 MFMER slide-9
10 FAA: Definition of Misuse Makes person unable to safely perform duties OR exercise airman certificate privileges May be reasonably be expected (for duration of med cert) to make person unable to Based on case hx and medical judgment 2016 MFMER slide-10
11 Old DSM IV Substance Abuse Criteria Failure to fulfill major role obligations at work, school, or home Situations in which it is physically hazardous Related legal problems Persistent or recurrent social or interpersonal problems 2016 MFMER slide-11
12 FAA: Substance Dependence A condition in which a person is dependent on a substance, other than tobacco or ordinary xanthine-containing (e.g., caffeine) beverages, as evidenced by. (1 or more of the following) 2016 MFMER slide-12
13 FAA: Substance Dependence (cont.) Increased tolerance Withdrawal symptoms Impaired control of use Damage to physical health Impairment of social / personal / occupational functioning 2016 MFMER slide-13
14 Deferral Criteria Obtain a detailed history to 18n or 18o The Examiner MUST defer issuance of a certificate if there is doubt concerning an applicant's substance use ANY history of alcohol / substance dependence defer If in doubt, DEFER! 2016 MFMER slide-14
15 What are Motor Vehicle Actions??? 2016 MFMER slide-15
16 FAA: Motor Vehicle Actions DWI / DUI / OWI Arrest / conviction / admin action Affecting driving privileges Involved alcohol or drugs Attendance at rehab / educ program Any licence actions including test refusal Educational safe driving program for multiple speeding convictions 2016 MFMER slide-16
17 What to do, when to issue, when to defer?? Obtain detailed history of use & all Etohrelated incidents Obtain court/ arrest records past 5 years Includes military records Forward to AMCD Document Block 60 Advise the airman on reporting req t 2016 MFMER slide-17
18 Reporting of Motor Vehicle Actions 8500 history does not alleviate airman s reporting req t of FAA requires reporting within 60 days of occurrence Airman must report it to: SECURITY AND INVESTIGATIONS DIVISION AMC-700 P.O. BOX OKLAHOMA CITY, OK AKA the (Civil Aviation) Security Division 2016 MFMER slide-18
19 Must defer specific criteria Inability to review court / arrest records within 14 days of exam BAC 0.15 Blood alcohol test refusal Motor vehicle actions w/in following: One in past 2 years, + any other ever Two within past 10 years Three in lifetime If in doubt. DEFER! 2016 MFMER slide-19
20 AME may issue IF (no doubt exists of alcoholism) (no hx of abuse or dependence) NONE of specific deferral criteria met Most recent incident 5 years ago Your hx / exam / record review does not indicate possible abuse/dependence Most recent incident > 5 years ago Your hx / exam does not indicate a possible abuse / dependence 2016 MFMER slide-20
21 HIMS Protocol Specifications FAA will require additional documentation: Personal statement State driving record x 10 years Court records / arrest reports HIMS Evaluation Psychiatric evaluation Addiction psychiatrist OR HIMStrained Neuropsychological evaluation HIMS-trained Neuropsychologist 2016 MFMER slide-21
22 SUMMARY FAA CERTIFICATION AID DRUG / ETOH RE-CERT HIMS AME Lab testing Psychiatry History Report Aftercare Chief Pilot Peer Pilot Additional providers 2016 MFMER slide-22
23 2016 MFMER slide-23
24 2016 MFMER slide-24
25 Alcohol & Drug Use: Roadmap to Certification Definitions, rules & regulations! What is addiction and how does the FAA define it? Abuse / dependence specifically DQ ing Defining a motor vehicle action Strict criteria to issue (if possible) & defer If in doubt, defer!! Understanding HIMS pathway Preparing your airman for it Huffingtonpost.com 2016 MFMER slide-25
26 Questions & Discussion 2016 MFMER slide-26
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