President’s Corner 1Q17 “America’s Opioid Epidemic – New Drug Testing Rules Coming – HIMS is here!”
America is in the midst of an epidemic of opioid abuse and dependence. Commonly prescribed medications containing Hydrocodone (Vicodin, Norco, Hycodan), Oxycodone (OxyContin), Hydromorphone (Exalgo ER) and Oxymorphone (Opana ER) are causing widespread deaths and ER visits from overdoses. All elements of the population are affected, including pilots and many other professionals. Because of the cost of obtaining these medications, many innocent users have switched to heroin to support their dependence. Stronger synthetic opioids such as fentanyl are also responsible for many deaths.
The Centers for Disease Control reports that 91 Americans die every day from opioid overdoses and over 1,000 are treated in emergency departments for opioid misuse. Over 15,000 Americans died from opioid overdoses in 2015. Since 2012, more Americans died from drug overdoses (including opioids) than from motor vehicle accidents. The 2015 National Survey on Drug Use and Health found that 10.1% of the US population aged 12 and older used illicit drugs in the previous month and that 8.2% of those aged 26 or older were current users of illicit drugs. Sadly, much of the opioid problem is related to physician over-prescribing following medical/surgical procedures and for chronic pain.
Previously, the Department of Transportation (DOT) did not include semi-synthetic opioids, as listed above, in its routine testing of transportation workers, including aviation personnel. It was possible to be dependent on these medications and for them not be detected on DOT testing done by the airlines. On January 23, 2017, the DOT published a Notice of Proposed Rulemaking (NPRM) in the Federal Register (Vol. 82, No. 13, pp 7771-82) announcing its intent to start testing for the four opioid medications listed above beginning October 1, 2017. I am working closely with the expert legal staff and consultants of the Air Line Pilots Association, International to address pilot concerns and ensure appropriate protections.
Since 1974, the pilots with substance abuse problems (drugs and alcohol) have been able to seek help for these conditions and return to flying. The program known as HIMS (see www.HIMSprogram.com) has helped over 5,800 professional pilots recover from their disease and regain medical certification. The FAA funds an educational program, reaching domestically and internationally, through ALPA, which is administered by our wonderful staff at AMAS.
With the prevalence of the problem in the US population and establishment of testing for opioids in pilots, I anticipate a significant increase in the number of pilots identified with substance use disorders. The HIMS program provides a safety net to save lives, careers, families, and importantly, protect the safety of our industry. Any pilots with concerns may contact the peer pilot resources on the HIMS web site or contact our office for information. Families may also bring concerns to these wonderful volunteers, many of whom are in recovery and strive to help fellow pilots. Seeking help before experiencing serious health, legal, financial, relationship or safety consequences is in everyone’s best interest. The hardest part is making the first call to ask for help. Know that help is waiting for those who need it.
Fly Safely, Stay Healthy!
Quay Snyder, MD, MSPH | President | CEO
AMAS | Aviation Medicine Advisory Service
FAA / ALPA HIMS Program Manager