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The
NTSB's research indicates that abuse and misuse of prescriptions is
more prevalent than "illicit" drug use. Since 1990, there has
been a dramatic increase in the use of medications for chronic pain,
anxiety, attention deficit, and sleep disorders. Inappropriate
use of medications comes in the following forms:
- Non-medical use
is when use of the medication is not prescribed by a medical
professional and is used for the experience or feeling it causes.
- Misuse is
the incorrect use of a medication by not following prescribed dosage
levels, frequency of use, or use for a purpose other than for which it
was prescribed.
- Abuse is
when the pattern of use leads to clinically significant impairment or
distress that manifests itself in the individual’s behavior.
- Physiological
dependence is when the individual experiences increasing
tolerance for a drug and experiences withdrawal when the medication is
discontinued.
- Psychological
dependence ("addiction") is when the individual experiences an
overall loss of control, seeks medication compulsively, and continues
use of the medication in spite of negative consequences.
Somnolence
Fatigue
Impaired judgment
Hypotension
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Erratic performance
Muscle weakness
Visual disturbance
Impaired reflexes
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Dyskinesias
Headaches
Sedation
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Some medications are potentially medically disqualifying for pilots:
- Insulin – all forms, unless given exemption
- Seizure medication
- Methadone—increasingly being prescribed for chronic pain
- Modafinil—stimulant used to increase wakefulness, alertness
- Antidepressants and
Psychoactive Medication which relieve
depression and other psychological conditions
- Steroids which control bodily
functions
Medical providers may not be aware
of your status as a pilot and may not initially consider a medication
alternative that does not have disqualifying side effects.
Medications
to be Wary Of
There are hundreds of new drugs on
the market every year that have potential “impairing” effects.
Instead of trying to list the thousands of drugs that could cause
undesireable side effects, I've listed here "classes" of drugs to be
wary of.
Pain medicines: such as Codeine, Darvocet, Morphine, Vicodin,
oxycontin. This class of medications will cause Drowsiness,
Slower reaction times, Mental confusion, Anxiety, Agitation,
Dizziness, and Blurred vision.
Tranquilizers and Sedatives:
such as Ativan, Diazepam, Xanax, Halcion, and Valium. These drugs help
relieve anxiety, stress, and insomnia. This class of medications
will cause Drowsiness, Amnesia, Agitation, Dizziness, Weakness,
Unsteadiness, and Disorientation.
Muscle relaxers: such as
Flereril, Parafon Forte, Robaxin as this class of medications will
cause Drowsiness, Fatigue, Nervousness, Confusion, Dizziness, and
Visual disturbances.
Anti-motion
sickness: such as Antivert, Dramimine, and Phenergan. This class
of medications will cause Drowsiness, Restlessness, Hallucinations, and
Blurred vision.
Antihistamines: such as
Benadryl. Antihistamines reduce allergy and cold symptoms and can also
be used to treat insomnia. This
class of medications will cause Drowsiness,
Slowed reactions, & Impaired vision.
Stimulants: such as
Sudafed, ephedrine, Aderall which cause the user to be more alert. This class of medications will cause Jitteriness, Diminished concentration, False
sense of alertness, Irritability, and Post-high fatigue
 OTC
Medications
It's not just prescribed
medications,
Over-the-Counter (OTC) medications can also have disqualifying
effects. Common OTC medications types include: Pain relief/fever
reducers, Colds/Flu medications, Appetite suppressants, Bowel
preparations, Sleeping aids, and Stimulants. OTC drug
products are those drugs that are available to consumers without a
prescription. There are more than 80 therapeutic categories of
OTC drugs, ranging from acne drug products to weight control drug
products.
Side effects from OTC medications include: Agitation, Anxiety,
Blurred
vision, Breathing difficulty, Chest pain, Chest tightness, Confusion,
Dizziness, Disorientation, Double vision, Drowsiness, Disorientation,
Emotional instability, False sense of well being, Fatigue, Fever,
Hallucinations, Severe Headache, Hyperventilation, Insomnia, Light
headedness, Muscle cramps/spasms, Nausea/vomiting, Nervousness,
Palpitations, Poor coordination, Rapid or irregular heart beat,
Restlessness, Ringing in the ears, Sedation, Seizures, Severe diarrhea,
Tremors, and Weakness. This is not a complete list, this was
obtained from browsing 2 isles of medications in my local drug store.
All OTC medications require the label to describe the active
ingredients and potential side effects. Read these labels
carefully to ensure that you are medically qualified to perform safety
sensitive duties.
In the next article, we'll discuss how even OTC drugs can cause false
positives on drug tests.
"For
us as pilots, the question is: What do I do with this? Go or no go?"
—
Wolfgang Langewiesche, as quoted in Weather Flying, 1977 by Robert N.
Buck
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