NTSB Safety Alert SA-037 - Pilots Understand Impairment Risk

Pilots: Un derstand Impairment Ri sk

Over-the-Counter and Prescription Drugs

Can Cause Impairment

The problem

 Toxicology tests of pilots involved in fatal aviation accidents increasingly show

evidence that a wide variety of over-the-counter (OTC) and prescription drugs

have been used, including drugs that are potentially impairing.

 Pilots may be using OTC or prescr iption drugs without realizing that they can

cause impairment.

 Pilot impairment reduces the safety of flight and increases accident risk.

 Pilot impairment due to t he effects of drugs is preventable.

Related ac cidents

 On May 5, 2012, a Cess na 177B impacted terrain after experiencing an

aerodynamic stall about 300 feet above the ground during a go-around. The

investigation found no preaccident anomalies with the aircraft. Postaccident

toxicology testing of the fatally injured pilot showed that the pilot had taken

diphenhydramine, an OTC sedating antihistamine commonly marketed under the

names Benadryl and Unisom. The drug’s effects and pilot impairment were

contributing factors in the accident. (ERA12FA319)

 On March 30, 2011, a Cess na 310R impacted terrain while conducting a

nonprecis ion approach to a mountain top airport that was obscured by clouds

and fog. The investigation found no preaccident anomalies with the aircraft.

Toxicological testing of the fatally injured pilot found significant amounts of

doxylamine, a sedating antihistamine, in combination with other drugs that

suggested use of an OTC cold medicine such as a Nyquil or an Ald ex product.

The drug’s effects and pilot impairment were contributing factors in the accident.

(ERA11FA218)

 On July 7, 2010, a Eurocopter AS-360-B2 helicopter flying during the day in good

visibility impacted trees and terrain. The investigation found no preaccident

anomalies with the aircraft. Toxicological testing of the fatally injured pilot showed

SA-037 September 2014, revised December 2015

the presence of numerous medications, including hydrocodone, a controlled

substance used by prescr iption as a narcotic pain medication commonly

marketed with the names Vicodin and Norco; diazepam, a controlled substance

available by prescr iption with sedative effects commonly marketed with the name

Valium; and chlorpheniramine, an OTC sedating antihistamine commonly

marketed with the name Chlor-Trimeton. The probable cause of the accident was

the pilot’s impaired judgment due to multiple medications. (CEN1 0FA424)

What can pilots do?

 Discuss EVERY medication you take regularly, including OTC, prescription, and

other drugs, with your aviation medical examiner during your medical certification

exam.

 Make sure anyone prescribing medication for you knows that you are a pilot. Ask

if the medication is safe to take before or while flying or if there is an alternative

that would be less likely to cause impairment.

 DO NOT FLY if you notice you are feeling sleepy, “out of it,” or jittery after using

any drug. These feelings mean you are probably impaired.

 For medications that have a warning abou t using caution when driving a vehicle,

the Federal A viation Administr ation (FAA) r ecommends waiting at least 5 times

the longest recommended interval between doses before flying to be sure you

are safe to fly.

o For example, if the dosing interval states, “take every 4 to 6 hours” that

means waiting 30 hours (5 times the longest dosing interval of 6 hours).

 When choosing OTC medications, read the label. If it has a warning that states,

“Use caution when driving a vehicle or operating machinery,” ask the pharmacist

if there is something else you can use that will not incre ase your risk of

impairment.

Interested in more information?

See the FAA pilot safety brochure, Medications and Flying , at

http://www.faa.gov/pilots/safety .

The NTSB safety study Drug Use Trends in Aviation: Assessing the Risk of Pilot

Impairment can be accessed from the NTSB’s Safety Studies and Special Reports

web page under report date 9/9/2014.

This NTSB safety alert and others can be accessed from the NTSB’s Safety Alerts web

page. The reports for the accidents referenced in this safety alert are accessible by

accident number from the NTSB’s Aviation Accident Database & Synopses web page.