resuming basic med after 2 years, discontinued meds

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Basic Guy

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Basic guy
flew for several years BM. developed advanced RA that became very painful. Stopped flying 3 years ago while trying non approved meds. primarily gabapentin. Gapapentin worked pretty well until recently started noticing some cognitive issues. I also started taking Kratom back then. Between the two I felt very little pain. Kratom during the mornings and Gaba at bedtime.
I curtailed my flying because i knew gabapentin was forbidden. Kratom didn't come up on the medication list. I know better now :( Anyway I lost interest in flying.
I have a couple of questions. one is a real concern.
I decided that I would like to continue flying and I needed to discontinue these medications. or medication and supplements "kratom".
Upon discontinuation gabapentin I found it was difficult. Didn't see it coming. Kratom was not much of an issue. Some RLS.
My life long Dr retired and i needed to find a new Dr to advise me how to go about stopping these things. He stated i was addicted and had to start a taper program. he. put me on Clonidine and pramipexole for RLS. Both work wonderful

My main concern is the question on the Basic medical form about ever been diagnosed with addiction. Im not a drinker nor have I ever used illegal drugs or have used any opioids in the last 5 years. "prescription only"
What do I check? I know my basic med files are kept with me but in the event of any insurance claim or FAA investigation I might be in a bit of trouble if i check that wrong.

Second question is time off these meds to resume my flying?

What is considered discontinued? The last time i received a new script of gaba my RA doctor sent in a refill for 180 days. Is it 30 days after the script runs out or a period of time i discontinue? Its been 32days off Gabapentin and 15 off kratom.
 
“Upon discontinuation gabapentin I found it was difficult. Didn't see it coming. Kratom was not much of an issue. Some RLS. My life long Dr retired and i needed to find a new Dr to advise me how to go about stopping these things. He stated i was addicted and had to start a taper program. he. put me on Clonidine and pramipexole for RLS. Both work wonderful.”


You do not qualify for BM after a clinical diagnosis of substance dependence within the previous 2 years, as defined in §67.307(a)(4) of 14 Code of Federal Regulations

67.308(a)(4) Substance dependence, except where there is established clinical evidence, satisfactory to the Federal Air Surgeon, of recovery, including sustained total abstinence from the substance(s) for not less than the preceding 2 years. As used in this section—
(i) “Substance” includes: alcohol; other sedatives and hypnotics; anxiolytics; opioids; central nervous system stimulants such as cocaine, amphetamines, and similarly acting sympathomimetics; hallucinogens; phencyclidine or similarly acting arylcyclohexylamines; cannabis; inhalants; and other psychoactive drugs and chemicals; and
(ii) “Substance dependence” means 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—
(A) Increased tolerance;
(B) Manifestation of withdrawal symptoms;
(C) Impaired control of use; or
(D) Continued use despite damage to physical health or impairment of social, personal, or occupational functioning.
 
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If there are any light sport aircraft available for rent nearby, that would be an option while waiting for the two-years to run out.
 
Clip4 said:
“Upon discontinuation gabapentin I found it was difficult. Didn't see it coming. Kratom was not much of an issue. Some RLS. My life long Dr retired and i needed to find a new Dr to advise me how to go about stopping these things. He stated i was addicted and had to start a taper program. he. put me on Clonidine and pramipexole for RLS. Both work wonderful.”


You do not qualify for BM after a clinical diagnosis of substance dependence within the previous 2 years, as defined in §67.307(a)(4) of 14 Code of Federal Regulations

67.308(a)(4) Substance dependence, except where there is established clinical evidence, satisfactory to the Federal Air Surgeon, of recovery, including sustained total abstinence from the substance(s) for not less than the preceding 2 years. As used in this section—
(i) “Substance” includes: alcohol; other sedatives and hypnotics; anxiolytics; opioids; central nervous system stimulants such as cocaine, amphetamines, and similarly acting sympathomimetics; hallucinogens; phencyclidine or similarly acting arylcyclohexylamines; cannabis; inhalants; and other psychoactive drugs and chemicals; and
(ii) “Substance dependence” means 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—
(A) Increased tolerance;
(B) Manifestation of withdrawal symptoms;
(C) Impaired control of use; or
(D) Continued use despite damage to physical health or impairment of social, personal, or occupational functioning.
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FWIW, 14CFR §67.307(a)(4) is for a 3rd class medical, which BasicMed is not.
 
Palmpilot is correct. This situation is incorporated into the BasicMed big 3 by reference.

But the 15 are very much not limitations. Just the 3.
 
Palmpilot said:
If there are any light sport aircraft available for rent nearby, that would be an option while waiting for the two-years to run out.
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You need to read the 67.306 again. established clinical evidence, satisfactory to the Federal Air Surgeon, of recovery, including sustained total abstinence from the substance(s) for not less than the preceding 2 years.

A person not know or have reason to know of any medical condition that would make that person unable to operate a light-sport aircraft in a safe manner. I think the FAA would consider lack of clinical evidence of recovery as reason to know they can’t operate an LSA in a safe manner.
 
Clip4 said:
You need to read the 67.306 again. established clinical evidence, satisfactory to the Federal Air Surgeon, of recovery, including sustained total abstinence from the substance(s) for not less than the preceding 2 years.

A person not know or have reason to know of any medical condition that would make that person unable to operate a light-sport aircraft in a safe manner. I think the FAA would consider lack of clinical evidence of recovery as reason to know they can’t operate an LSA in a safe manner.
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BasicMed references 67.306. The sport pilot rules do not.
 
Palmpilot said:
BasicMed references 67.306. The sport pilot rules do not.
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A person may not know or have reason to know of any medical condition that would make that person unable to operate a light-sport aircraft in a safe manner is a SP regulation.

Unless you think the FAA considers untreated substance dependence as able to operate an LSA in a safe manor.
 
It's a tricky reference, but it's in the special issuance section of BasicMed. 68.9(a)(1)(iv) calls out the 3rd class standard of 67.307(a)(4) which references psychoactive drugs. Gabapentin is classified as pyschoactive because the brain adapts to it's use which, which as the OP found establishes dependence.

Choices are a special issuance under 3rd class rules.
Be off the drug for 2 years and become eligible again.

And I'll admit that without having read through all the references and medical information, I would never have caught that.
 
Clip4 said:
A person may not know or have reason to know of any medical condition that would make that person unable to operate a light-sport aircraft in a safe manner is a SP regulation.

Unless you think the FAA considers untreated substance dependence as able to operate an LSA in a safe manor.
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How about treated dependence?
 
Clip4 said:
A person may not know or have reason to know of any medical condition that would make that person unable to operate a light-sport aircraft in a safe manner is a SP regulation.

Unless you think the FAA considers untreated substance dependence as able to operate an LSA in a safe manor.
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Being drug-free and proving it to the FAA are two different things. If he's no longer under the influence of the substances involved, then he doesn't have reason to believe know that he's unsafe.

[Edited to reflect Clip4's correction.}
 
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Gabapentin, in particular, requires quite a long taper, often many weeks, even if you've only used it for a month or so.
 
Palmpilot said:
Being drug-free and proving it to the FAA are two different things. If he's no longer under the influence of the substances involved, then he doesn't have reason to believe that he's unsafe.
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Reason - a statement or fact that explains why something is the way it is.
Know - be aware of through observation, inquiry, or information.
Believe - accept (something) as true

George hasn’t done meth for a week. He doesn’t believe he has a medical condition that would make him unsafe to operate an aircraft, but he has a reason to know. The regulation does not contain the word believe and his beliefs are irrelevant.
 
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I don’t want to fly with the OP
 
Clip4 said:
Reason - a statement or fact that explains why something is the way it is.
Know - be aware of through observation, inquiry, or information.
Believe - accept (something) as true

George hasn’t done meth for a week. He doesn’t believe he has a medical condition that would make him unsafe to operate an aircraft, but he has a reason to know. The regulation does not contain the word believe and his beliefs are irrelevant.
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You're right, I misquoted the regulation and have edited my post accordingly. I don't consider his beliefs to be definitive. I'm just saying that the objective reality of whether he's under the influence of a drug that could make him unsafe to fly is not the same thing as convincing the FAA of whether he is safe to fly or not. For a person who is exercising sport-pilot privileges, the responsible thing to do would be to seek expert advice on what that objective reality is.
 
4RNB said:
I don’t want to fly with the OP
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Why not? I not seeing where the op did anything wrong. That remark makes him out to be a criminal.The OP knew he may have a condition and seeked doctors advice and grounded himself because of the drugs when he needed to. Would one rather they hid this info? Should he now be grounded for life?
Gabaepentin seems to be a ween off medicine so is it truly a addiction? I was put on it back in the 2000s for couple months with a cervical fusion and instructed to ramp up my dosage after I went on it and ramp it back down as I was getting taken off of it. I never had a addiction to it that i knew of nor ever diagnosed with a addiction.I took them how the doctor prescribed. Since the OP seen another doctor other than the prescribing one , is he truly diagnosed being addicted or does the new doc mean you need to ween yourself off since it sounds like he quit them cold turkey?
 
the dude said:
Why not? I not seeing where the op did anything wrong. That remark makes him out to be a criminal.The OP knew he may have a condition and seeked doctors advice and grounded himself because of the drugs when he needed to. Would one rather they hid this info? Should he now be grounded for life?
Gabaepentin seems to be a ween off medicine so is it truly a addiction? I was put on it back in the 2000s for couple months with a cervical fusion and instructed to ramp up my dosage after I went on it and ramp it back down as I was getting taken off of it. I never had a addiction to it that i knew of nor ever diagnosed with a addiction.I took them how the doctor prescribed. Since the OP seen another doctor other than the prescribing one , is he truly diagnosed being addicted or does the new doc mean you need to ween yourself off since it sounds like he quit them cold turkey?
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Why not?
Rheumatoid arthritiis
Cognitive issues
Self medicating
Assumed to be older.
 
4RNB said:
Why not?
Rheumatoid arthritiis
Cognitive issues
Self medicating
Assumed to be older.
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Sounds like the gabepentin was causing the cognitive issues and he has since quit taking. Self medicating? the OP is or was taking the meds on a doctors prescription."My main concern is the question on the Basic medical form about ever been diagnosed with addiction. Im not a drinker nor have I ever used illegal drugs or have used any opioids in the last 5 years. "prescription only" '. If he can perform the fight duties with the arthitus, is it grounding?
 
You are ineligible for BasicMed upon development of a new mental, neurological, or cardiovascular issue since the issuance of your most recent medical certificate. The addiction falls into the "mental" category as far as the feds are concerned.

You're going to have to get with a HIMS AME on this one and go through the process to obtain a special issuance medical certificate in order to restore your BasicMed eligibility. Sustained and provable total abstinence from the substance for not less than the preceding two years. 10-panel w/EtG, 14 tests random in nature over a 12 month period minimum (the HIMS AME may set you up with a frequency greater than this). HIMS psychiatrist, and possibly neuropsych evaluation, AA attendence minimum twice weekly, and either individual or group aftercare counseling. And quarterly follow up visits to your HIMS AME. It is a long and arduous (and expensive) route.
 
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