Drug Usage in Pilots Involved in Aviation Accidents Compared With Drug Usage in the General Population: From 1990 to 2005

Civil aviation pilots represent a small subsection of the general population. Therefore, one might expect to see the same types of drugs used by pilots that are found in the general population. The purpose of this study was to compare usage of both illegal drugs and abused prescription medications in pilots involved in civil aviation accidents from 1990 to 2005 with that of the general population in the United States. Comparisons included abused drugs routinely screened for by the Federal Aviation Administration (FAA) such as marijuana, cocaine, methamphetamine, and ecstasy, as well as prescription medications—barbiturates, benzodiazepines, opiates, and ketamine. The Civil Aerospace Medical Institute's (CAMI's) Forensic Toxicology Research Laboratory analyzes postmortem specimens collected from pilots involved in civil aviation accidents. Toxicological information for cases in which pilots were found positive for prescription or illicit compounds was obtained from CAMI's ToxFlo™ (DiscoverSoft Development, LLC) toxicology database. Statistics on drug usage, trends, and demographics of users in the United States were obtained from National Institute on Drug Abuse, Substance Abuse and Mental Health Services Administration, Office of National Drug Control Policy, Drug Enforcement Administration, and the Drug Abuse Warning Network (DAWN). Trends in illicit and prescription drug use in pilots of civil aviation accidents are comparable to those seen in emergency departments (ED) and community data from major metropolitan areas collected by DAWN and Community Epidemiology Work Group (CEWG). Of the 5,321 pilots involved in aviation accidents during the examined time period, there were 467 occurrences of either illicit drugs or commonly abused prescription drugs accounting for 11% of all pilots that were involved in aviation accidents. The average age of the pilots that were found positive for the compounds discussed in this study was typically older than that seen in emergency departments or in CEWG communities. Marijuana or its metabolite tetrahydrocannabinol carboxylic acid (THCA) were the most commonly seen compounds detected in pilots involved in civil aviation accidents. These compounds were seen approximately twice as often as all other drugs in the study.