Now I've connected two and two. See the E-mail. The problem is "SQUIRREL" (from the movie "up"). This person is successful, and competent WHEN HE HAS THE MEDS. Their view, is what happens when he forgets his med, on the day of the accident.
So he either has to have a multi year implant, dosage of which he cannot forget/control, and get a multiyear SI for operating only with that med, or he has to be able to operate without the med(s).
Dr. Bruce - apologies for resurrecting such an old thread, but I’ve been doing a lot of research on this recently, and you hit on what seems to be the crux of the issue for me (an aspiring pilot who takes ADHD meds)—the FAA’s refusal to permit pilots to use the ADHD meds.
As I see it, the current system actually incentivizes unsafe behavior: pilots who recognize that they would benefit from ADHD medication will not get treatment in order to avoid problems with their medical. Sure, they’re competent
enough to fly without the meds, but they’d be
better (and, assuming no adverse reactions to the pills),
safer pilots with it.
If the FAA requires a pilot to demonstrate
X amount of focus/concentration to get a medical, and the pilot without medication functions at
X+10, but with mediation would be
X+40, it seems like the current system incentivizes people to be less safe than they could be.
I 100% understand the concern with people forgetting their medication. I’ve done it (no more than a couple days a year, but it does happen, usually when something throws off my morning routine). People who cannot demonstrate a minimum required amount of focus without medication (the “SQUIRREL” people) have no business flying planes. If they forget to take their pill and then go flying, bad things could happen.
But what about people in the middle? Like you said, the FAA only requires that pilots score better than the bottom 15%. That leaves a huge crop of people who CAN demonstrate sufficient focus without medication, but who would nonetheless derive substantial benefit from medication, both in the cockpit and in other areas of life. The current system forces such people to choose between the very real benefits of medication and being able to fly.
Wouldn’t a more rational setup be something like the following?
1. If you’re currently prescribed ADHD medication, the FAA will need to see medical history demonstrating that you’re stable and don’t exhibit any dangerous side effects.
2. To prove that you’d be safe even if you forgot to take your pill, the FAA can require you to stop medication for a period (however long is necessary to flush the drugs from your system—I believe the current standard is 90 days). Then you’ll have to pass the battery of neuropsych tests, take the drug test, etc.
Once you’ve proven that you’re safe enough even without the meds, and that you’re unlikely to suffer any problematic side effects, you should be good to go even if you’re actively taking the drugs, right? Maybe throw in some follow-up periodic certifications from your prescribing doctor for good measure to ensure no side effects have developed. Federal law requires that prescribers of ADHD meds meet with their patients at least every 90 days before writing a new script, so there will be plenty of ongoing medical contact.
That would seem to uphold current safety standards while also addressing an increasingly prevalent medical diagnosis. And it prevents a growing number of pilots and would-be pilots from having to choose between being able to fly and living up to their full potential outside the cockpit.
Curious for your thoughts.
