Evaluating an Individual’s Treatment Needs
Addiction Among Pilots
A Hollywood script is never too far behind a compelling story with universal appeal. It’s not surprising then that Flight (2012), starring Denzel Washington, was a box office hit due in great part to its plot. Washington played Whip, a pilot experiencing a severe alcohol use disorder. Whip drank vodka in flight one evening only to soon find himself conducting a controlled crash landing. He would have been praised for his outstanding command of the plan, but a toxicology report later revealed he was intoxicated, recasting him from hero to murderer (six lives were lost of the 102 onboard). Although his toxicology report is eventually excluded from the investigation, Whip confesses to being intoxicated during the flight and is sentenced to prison. Whip uses the incarceration to achieve sobriety and heal damaged relationships, including his relationship with his son. The movie successfully conveyed the dangers of addiction in the aviation industry.
Turning now from fiction to reality, the National Transportation Safety Board is a helpful source of information about substance use and abuse in the aviation industry.
Drug Use Trends among Pilots in the Aviation Industry
In 2014, the National Transportation Safety Board (NTSB) published a comprehensive report on drug use trends in the aviation industry. The safety study had a main goal of uncovering whether, and to what extent, drugs were involved in aviation accidents that resulted in the pilot’s death. The study considered 23 years of data and included flights with and without passengers on board. For the study’s purposes, drugs included over-the-counter (OTC) medication, prescription medications, and illicit drugs. Alcohol use was not included in the study.
The study of pilot post-mortem toxicology reports found the following:
- There was an upward trend in the use of all drugs.
- The most commonly used drug was the over-the-counter drug diphenhydramine; this is an antihistamine and common active ingredient in cold formulas and sleep medications.
- Only a small number tested positive for illicit drugs.
- Mainly over the prior 10 years, there was an increase in the percentage of pilots who tested positive for THC (the active ingredient in marijuana).
- Whether a pilot has a current medical certificate appeared relevant to drug use rates. Those with a medical certificate were less likely than those without certificates to use controlled substances. The FAA does not collect data on whether pilots have current medical certificates; however, pilots are usually expected to maintain medical certificates and airworthiness certificates.
The study is monumental for the aviation industry and directly helped to inform new aviation safety policies. This commitment to safety is reassuring to the public, but at present, Americans must still face the fact that pilots may fly under the influence without being detected. The under-detection issue makes it difficult to grasp the actual prevalence of pilots flying under the influence. But to analogize to drunk driving, according to Mothers Against Drunk Driving (MADD), a person typically drives under the influence more than 80 times before their first arrest. While it is not known if the number is similar in the aviation industry, Fox News conducted an investigation to learn more about pilot intoxication in the cockpit, which shed some light on the subject.
Fox obtained Federal Aviation Administration documents regarding pilot intoxication for its investigation.
The data revealed the following:
- The rate of pilots testing positive for alcohol had trended upward over the years.
- According to a 2015 screening, the prevalence of on-the-job intoxication is low in the aviation industry. The study performed more than 56,000 screenings for alcohol among pilots, traffic controllers, ground security controllers, pilots, aircraft dispatchers, mechanics, and aviation screeners. A total of 119 tested positive for at or above the lawful limit of 0.2 percent for this industry. However low this number, the stakes are high, and even one positive test is one too many.
- From 2010 to 2015, the FAA documents revealed that 64 pilots had received citations for violating alcohol and other drug regulations.
- In 2015, 1,546 aviation professionals (which included 38 pilots) tested positive for one out of five illicit drugs for which they were screened.
- Each month, one pilot, on average, is discovered to be over the legal alcohol limit (0.04 percent). This statistic does not appear to have been based on FAA documents but rather on the Fox investigation in general.
It may come as a surprise to the public, but it appears that pilots are not subject to mandatory sobriety tests before operating a plane. Perhaps the industry will implement this requirement in the future. On the one hand, flying is considered safe, but on the other hand, when accidents happen, they can be fatal and catastrophic. According to the FAA, when accidents do happen, human error is most often a contributing factor. Taking this fact into account, there is a heightened need to reduce the risk of human error, such as by taking steps to ensure pilot and crew sobriety.
Occupational Stressors in the Aviation Industry
There are numerous reasons why pilots and other airline personnel experience stress on the job. The time-tested saying, “You don’t know a person until you walk a mile in their shoes,” holds true for airline staff. Understanding the stress that airline staff may experience is an important step in the process of helping them with any substance abuse problems that may arise. It is also critical to bear in mind that stress cannot simply be seen as part and parcel of an airline job. Stress, left untreated, can lead to chronic conditions. Further, if stress is not reported, especially if it affects workers across the industry, there is less likelihood that management will implement needed changes.
To develop an informed perspective on pilot work stressors, and in turn how to help pilots facing substance abuse, consider the following information gleaned from an article on pilots and addiction:
- Piloting aircrafts involves intense, high-pressure, hectic work, and it demands extreme focus. The need for acute attention to detail can persist for hours, which can cause burnout in the short-term and long-term.
- Pilots are not geographically stable, which can be stressful for many.
- The work entails a high level of responsibility. Like a captain of a ship, a pilot feels responsible for all the lives on board.
- A pilot’s work schedule can seem dizzying to an average person. Pilots might have quick turnarounds and not receive an adequate amount of sleep. Pilots may also work many days in a row and do not have the comfort of the common five-day work schedule. Within one work schedule, a pilot may fly into and out of 50-plus cities, all the while having to tackle different time zones.
Airline personnel other than pilots are also at risk for facing high stress at work. There do not appear to be recent studies pertaining to this specific group, but it is helpful to consider the general effects of occupational stress.
On-the-job stress can cause airline workers (like other workers) to experience the following psychological and physical effects:
- Low morale
- Feelings of powerlessness
- Feeling a need to self-medicate with alcohol and/or other drugs of abuse
If any of the above symptoms are left untreated, more severe conditions may emerge, such as:
- Clinical depression
- Suicidal ideations and behaviors
- Violence against loved ones
- A substance use disorder
If substance abuse occurs, the best practice is to speak with a qualified professional, such as an addiction therapist or doctor at an accredited addiction treatment facility. It is especially important for airline professionals to understand that treatment services are an effective intervention at all stages of substance abuse (e.g., mild, moderate, or severe).
Airline professionals, because they are members of an esteemed profession, may experience psychological resistance to getting help. Often, these individuals have a history of being dedicated, responsible, and of service to the public. One way to overcome any psychological barriers to treatment entry is to acknowledge that it is necessary to get help in order to continue to effectively serve the public. Speaking with a counselor at a treatment center that has a program for working professionals may be particularly helpful.
Resources for Airline Professionals Experiencing Substance Abuse
Knowing how to get help is a critical early step to recovery. There are numerous resources available to airline professionals. The following is a brief selection of the many helpful options out there:
- HIMS: The Human Intervention Motivation Study (HIMS) is a substance abuse recovery program specifically for pilots. This program is sponsored by major airline companies and pilot unions. From 1974 to present, the program has provided treatment for over 4,000 pilots. The program aims to help pilots by bringing management and the FAA into the process. In this way, the program is based on cooperation and mutual support.
- Birds of a Feather International: This is a fellowship based on the Alcoholics Anonymous model and teachings. Birds of a Feather International is dedicated to pilots and airline crew members be they commercial or military, active or retired. The fellowship has an annual convention, maintains an informative website, and provides members with a newsletter.
- Unions: Unions can provide referrals and recommendations, and explain insurance coverage for treatment. There are specific unions for different types of employees within the airline professional. Employees include, but are not limited to, pilots, flight attendants, mechanics, fleet service personnel, customer service representatives, ticket agents, baggage handlers, reservation agents, air traffic control workers, and ticket agents.
- ALPA: Pilots who are members of the Air Line Pilots Association (ALPA) may contact this organization. This is the largest pilot union in the world, and it represents over 52,000 pilots.
- Association of Flight Attendants: Flight attendants who are members of the Association of Flight Attendants may contact this union for assistance.
- FAA: The FAA may be able to provide assistance and should have information on any programs that can help, such as HIMS.
- Publications: Self-educating through books and other print or online resources is always an option, but it should not take the place of speaking with a professional. Here are two book recommendations for pilots, concerned loved ones, or anyone working in the airline industry: Addicted Pilots: Flight Plan for Recovery (Dr. T’s Addiction Series Book 2) by Dr. Richard L. Travis, and Flying Drunk: The True Story of a Northwest Airlines Flight, Three Drunk Pilots, and One Man’s Fight for Redemption by Joseph Balzer.
Addiction is an entirely treatable disorder. Airline professionals are in a unique position because both loved ones and the public have a stake in their recovery. That fact may increase feelings of stress around getting help, but it need not. Compassionate, effective, and scientifically back treatment is always available to those in the airline community. The key is for an affected person to recognize the substance abuse and overcome any obstacles in the way of reaching out to a professional for help.