Recovering Opiate Addict - Go Straight to HIMS AME?

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LeftSkidLow

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LeftSkidLow
Hello - I have seen Dr. Fowler or Dr. Bruce’s responses but I am unclear in some interpretations. Thank you both for your efforts here.

I have my Commercial, Instrument rated rotary-wing license from the Military and just started taking lessons again in the R44. I have been clean for 2 years and was on Subutex for approximately 6 months and worked with a therapist for a year.

I also saw someone 10+ years ago during my divorce who prescribed me Wellbutrin and I am sure there is a record for general depression somewhere due to that. I have never been arrested and I voluntarily entered an outpatient MAT program for the opiate addiction.

Living in Florida, there are HIMS AME’s nearby that I could try and make an appointment with.

Being a helicopter pilot, getting a sports license is not an option for me and after reading about the ongoing experience of other addicts who are 5+ years in the HIMS program and are still waiting for the FAA to clear them for a 3rd class medical I’m about to just give up before even trying.

Is this something you can even come back from? I know I will be an immediate deferral, so my question is if there is any benefit to seeing a HIMS AME first and what supporting documentation I should have on my person before making an appointment for a consult. Will any documentation even matter since it will be deferred anyway at that point?

I know this is almost impossible to answer, but what is the approximate cost I am looking at
as well? All I’ve read so far is “$$$” or the words “a lot” which are subjective.

Thank you to anyone who has taken the time to read this and I appreciate anyone’s input if someone has some.

I completely own the position I put myself in and feel gut punched knowing I might have thrown one of the most precious opportunities of my life away.

Hopeful,
Sean
 
Sean,

….I would start with the HIMS AME and NOT with an application.


Dr F and I have different approaches to the same endpoint. I think, because the bureaucracy is soooo far behind, that the fastest way is to gather all that is needed B4 any application and the get it through at once….and not do the back and forth. By the time you get through the back and forth you could have made substantial progress in time getting what the will require….while you were waiting fit the back and forth.

You’re going to need some proven neg. Urine sobriety (as you 6 months or off silo one recovery is as of now just “an assertion”(unless you can prove differently). You for sure need HIMS Psychiatry (~3.5 K) and a HIMS Neuro psychology evaluations (~3K), but how to deploy them so you don’t have to go back yet again requires knowledge precision.

But if you Had subutex you were dependent and that means for upper class you need formal rehab……that’s a “what’s in your insurance wallet” question.

lastly there is a path back to second class w/o rehab…but is going to take you nearly 4 years of diligent work, patience, documented recovery activities…if you go the “no rehab” route. 1.5 years if you do formal rehab….

in either case you will be random pee testing and that is about $1,400/ year (as cheap as I can get it with humans at the other end (VERY important)…..
 
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Dr. Bruce - Thank you for your reply.

Just to clarify a few points.

I got my commercial license 23 years ago, but never used it. Went into a different profession after the military.

I am only looking for a Class 3 medical.

I was not counting my time clean until I was off the Subutex. Last dose was 2 years ago. Can you confirm the FAA would still require me to go to rehab?

Thank you very much for the information.
 
I read the rehab info wrong. Since I am only looking for a Class 3 that does not apply I believe.
 
I find that the faa is sometimes less strict than I am.
 
Sean,

I also am a recovering opiate/polysubstance addict with 3 years of sobriety. The whole HIMS process cost me around $8k. $2,000: Psychiatric Eval, $2,600: Phycological Eval/Cogscreen, $2,000: General HIMS AME stuff, $1,600: Random drug testings (14 of them per year). I went straight to a HIMS AME at 1yr of sobriety under my belt. He then signed me up for 14 random drug tests and told me I needed to start documenting my AA meetings and recovery activities. After 10 or so months of proven monitored sobriety, I scheduled appointments with the HIMS Psychiatrist and Phycologist. Once I had 2 years of sobriety, we submitted an application for a 1st class medical and all the associated reports and paperwork need to go with it. It took 10 months after that date for the FAA to approve my 1st class medical. Let me know if you have any other questions.
 
LeftSkidLow said:
Thanks AAQ. That’s really helpful. Appreciate it.
Click to expand...
I forgot to say… the ongoing cost of drug and alcohol HIMS can be quite alarming as well. The FAA determined that i need a follow up psychiatric evaluation every year as well as the continued 14 random drug tests. I have heard some people have had to have follow up Psychological testing as well. So the ongoing cost of my HIMS SI medical is

$1,800/yr for follow up Psychiatric testing. (Until deemed unnecessary by the FAA and my AME )
$500/yr for HIMS AME
$200ish/yr for medical exams
$1,600ish/yr for randomized drug testing

$4,100/yr total to just maintain my medical.
 
That is surprising. $1,600 just for random screenings seems excessive. Since you hold a 1sr class medical I assume you are flying for a living. I’m hoping the annual requirements won’t be the same for a 3rd class, but I doubt it. I am getting some paperwork in order and will go see the HIMS AME for a consult and see what he has to say.

If its going to be 4K a year in upkeep, I’ll just keep flying with a CFI I guess. I doubt I would spend that much in a year just flying for a hobby.

Thanks again for taking the time to respond.
 
LeftSkidLow said:
That is surprising. $1,600 just for random screenings seems excessive. Since you hold a 1sr class medical I assume you are flying for a living. I’m hoping the annual requirements won’t be the same for a 3rd class, but I doubt it. I am getting some paperwork in order and will go see the HIMS AME for a consult and see what he has to say.

If its going to be 4K a year in upkeep, I’ll just keep flying with a CFI I guess. I doubt I would spend that much in a year just flying for a hobby.

Thanks again for taking the time to respond.
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I have to take 14 drug tests a year. 12 being urine and 2 being blood PEth tests. They average to about $120/ea. You may be able to find cheaper testing services but I’m just using what my AME singed me up for. While I do hold a 1st class medical, I don’t fly for a living. If I did, I wouldn’t be so bitter about the cost as the air carrier would be paying for it. I’m a student pilot and my college requires me to have a 1st class to complete its flight program! But i wish you the best of luck, i know some people get SI medicals and transition straight to basic med. I don’t know if that is a realistic option, but may be one to look into for your situation.
 
I’m not sure what you mean about transitioning to a basic medical?

As a student the upkeep costs have to be tough. I hope it all works out for you in the end. I wish you the best in achieving your goal.
 
LeftSkidLow said:
I’m not sure what you mean about transitioning to a basic medical?

As a student the upkeep costs have to be tough. I hope it all works out for you in the end. I wish you the best in achieving your goal.
Click to expand...
I am by no means the expert on Basic Med. However, there are some great posts about basic med on this site. I would butcher the idea of it if i tried to explain it to you. But there are some great posts that explain it well.
 
You can read up about Basic Med on the AOPA web site, and many other places. You would not be eligible for it until after you get a special issuance for an FAA medical at least once.
Jon
 
LeftSkidLow said:
That is surprising. $1,600 just for random screenings seems excessive. Since you hold a 1sr class medical I assume you are flying for a living. I’m hoping the annual requirements won’t be the same for a 3rd class, but I doubt it. I am getting some paperwork in order and will go see the HIMS AME for a consult and see what he has to say.

If its going to be 4K a year in upkeep, I’ll just keep flying with a CFI I guess. I doubt I would spend that much in a year just flying for a hobby.

Thanks again for taking the time to respond.
Click to expand...

I have a 3rd class medical with a Special Issuance; you can read my story from start to finish here. I've been active in recovery for 21.5 years now and am still required to pee in a cup randomly, 14 times every 12 months, and have an AA attendance sheet signed.

Prior to having an SI, I was required to see a HIMS Neuropsychologist for the full battery of cognitive testing. I also have to see my HIMS AME four times/year, but half of those can be virtual. I was NOT required to see a HIMS psychiatrist.

I'm paying $2750/year to maintain my 3rd class medical and may be jumping to basic med later this year, perhaps early next, depending on what my AME hears back from the FAA on dropping some of the requirements. My AME recently increased their pricing and he charges the same for a 5 minute virtual visit as he does for a 20 minute in-office visit and will start billing monthly for "monitoring of Drug/Alcohol testing" (which, to me, is likely looking over the report that gets emailed to him, then dragging and dropping it into the directory he's set up for me on his computer).

Four visits/year: $1100
Drug/Alcohol monitoring: 50*12 = $600
Pee in a cup: 75*14 = $1050

As of next month, in addition to the 21.5 years of active-in-recovery sobriety I have, I will also have a concurrent two-year recent history of random drug/alcohol monitoring and evidence of weekly attendance at recovery meetings. My AME will be asking the FAA whether or not they would be willing to remove any of the hoops I currently have to jump through in order to maintain my 3rd class. If yes, I'll probably keep the 3rd class. If not, I'll likely jump to basic med.
 
To the OP: There is a 3rd class only pathway. But it will take two years B4 you can even start: due to 67.307 "no airman shall have abused...within the pst 24 months...", the only way you can satisfy that is 2 years of a private FAA-STD urine test program. Of course during that time one has to show evidence of adequate recovery activities (AA log, 2x/wk, AA sponsor letter, working knowledge of the 12 steps), and after the 24 to the HIMS psychiatrist for their concurrance.
 
Great job on two fronts.
First and foremost your sobriety. Keep up the good work! Always great to hear someone doing good.
Secondly for having to determination to work through the system. It is long and arduous and can be very discouraging along the way.
 
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