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Thread: Drug Testing Coming To Your Next Medical?

  1. #1
    mvivion's Avatar
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    Drug Testing Coming To Your Next Medical?

    Check out this little news article:

    http://www.usatoday.com/story/travel...rash/15325543/

    MTV

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    I thought that's why I was peeing in the cup all these years. Or at least trying to pee in a cup. It took an extra 45 minutes last week.

  3. #3
    PerryB's Avatar
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    Sounds like the definition of "drugs" is the biggest issue here. If I end up dead in the cub with Claritin in my system, was I under the influence of drugs? God bless the bureaucracy. Another case of government piss-ants trying to make themselves seem important.
    After Monday and Tuesday, even the calendar says WTF !

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    "We still can't make that link between toxicology results and impairment," said Joseph Kolly, NTSB's director office of research and engineering. "But that does not mean we cannot have good recommendations that are likely going to improve and reduce the risk of impairment."

    Asshat!

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    skywagon8a's Avatar
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    Well here we go again, picking on a small percentage of a small group of people who's voice goes generally unheeded. Show me the tests that were done on fatal automobile drivers You know the ones who are drinking alcohol while on illicit drugs, texting on their cell phones at a head on closure speed of at least 100 mph at a spacing of less than 20 feet. You know the ones who are required to take a simple eye test every other five years. The ones who cause over 10,000 fatal accidents per year. If we pilots had as many accidents per year as the automobile drivers, there would be no airplanes in a short period of time. Does anyone wonder why the bureaucrats who perform these studies pick on airplanes? It is because they know there will be no backlash and that they can rest assured that their cushy lifetime jobs will be secure.

    Sorry if this sounds as though we are being picked on. It is because we are. This has been going on for more than the last half a century that I have been involved in aviation. When one hammer gets laid down, another gets picked up. It's a never ending battle. The vast majority of pilots take utmost care to do the correct thing. We as a group are continuously being hammered from all directions. Other transportation modes are given a free ride in comparison to aviators. All the more reason to eliminate the third class medical.

    Sorry Mike, I read the article that you linked. It hit a nerve this morning.
    N1PA

  6. #6
    mvivion's Avatar
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    Quote Originally Posted by PIPER J5.5 View Post
    I thought that's why I was peeing in the cup all these years. Or at least trying to pee in a cup. It took an extra 45 minutes last week.
    Your urine sample is for blood sugars, I believe. As far as I know, at present, there is no test for drugs in the flight physical..........at the moment.

    Greg, yes, that quote from a supposed scientist: We can't correlate these drugs with the accident.....REALLY got my goat. They're obviously convinced that there is a direct correlation, and in some cases there may be, but it sure looks to me that once again the NTSB is on a witch hunt.

    Pete, the reason I posted this was because it struck a nerve with me as well.

    This article appeared in USA Today. Adding fuel to the hysteria that "Those people" who fly around in little airplanes are a hazard to society.

    Grrrr.

    sorry I got your blood pressure up this AM, Pete.

    MTV

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    The Governor here in Maine wants to drug test welfare recipients who have had drug violations and he is getting backlash because it's unconstitutional They have the right to get our money with no questions asked.

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    skywagon8a's Avatar
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    Three Cheers for LePage ! Hip Hip Hooray! Hip Hip Hooray! Hip Hip Hooray! He is one governor who actually isn't afraid to say what needs saying.
    N1PA

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    Anne's Avatar
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    I never understood why pilots who fly for fun, like most of us, had to complete a medical and a flight review every two years, and why our airplanes had to have an annual inspection, plus the ELT battery replacement and transponder check every two years, just to maintain currency. Other forms of recreation have no such requirements. Keeping "current" takes up my time and my money, and adds nothing to flight safety.

    Anne.
    Baloney is still baloney, no matter how thin you slice it.

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    Perhaps that explains why I see an abundance of broken down snow machines and boats (depending on the season) when traveling around. Rarely do I see a broken down airplane.

    I don't think I want to share my airspace with some guy who hasn't flown for 15 years in a plane that hasn't seen a mechanic's inspection for 15 years and that guy decides today's a good day to go flying.

    By the way, there's no rule against me taking over the counter cold meds on the day of my flight physical.

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    They started random drug tests of airline pilots in the 1990s. Air tour pilots now get tested. I have not heard how many they catch, but most of the pilots I know simply do not do drugs. One would think that it is more of a problem in an automobile.

    They are tightening the screws, and lately it is accelerating. Pretty soon it will be all them and no us. They will be regulating a nonexistent general aviation.

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    The NTSB is tasked with making pretty much all transportation safer, regardless of whether they can actually do anything about it. Like it or not, it's their job to investigate these things.

    In the article, the most important statements are: "The study did not assess whether the drugs had impaired the pilots or led to crashes," and "But the study didn't find a statistical significance between accident pilots who lost control of their planes in flight while using potentially impairing drugs and those who didn't."

    That means they can't show anything beyond this:"
    The NTSB found that increasing drug use by aging pilots followed the same pattern as in the general population." It's a report of a fishing expedition.

    In my previous life as a Clinical Laboratory Scientist and Lab Supervisor at the second busiest trauma center in California, I have done and supervised tens of thousands of blood alcohols and urine drug screens for drugs of abuse (not Claritan
    ). I've even been unlucky enough to have testified as an expert witness (in testing, not impairment) several times. Drug and alcohol use is rampant.

    A really big problem in testing is that, with the exception of alcohol, urine drug tests indicate drug use, not a level of impairment. Even alcohol is dicey. Think about a functioning alcoholic vs. a 18 year old. The kid might be face down in the mud at a level the alcoholic would barely notice. Since we're usually testing for drug breakdown products (metabolites), we can't even pin down time of use very closely. Hence the near impossibility of directly connecting a positive drug screen to impairment at a given time.

    Before the late 1990's, alcohol and drug testing was slow, cumbersome and expensive. So much so that it was only done in extreme cases in hospitals. It is cheap, fast and accurate enough now that for at least the last ten years there are more tests done than you would ever imagine.

    To give you an idea, every trauma patient, every labor and delivery patient, every baby born to a mother with a positive drug screen, and every psych patient gets a blood alcohol and urine drug screen either in the ER or on regular admission. Any patient with an altered level of
    consciousness will get one too, as well as anyone the treating physician has a question about for whatever reason. This is common in small hospitals now, too.

    These tests are for clinical use as aids in diagnosis and treatment, not to supply the courts with random information to peruse. In fact, at least in California, law enforcement cannot have access to any lab results without either consent or a warrant.

    As you may imagine, if a case comes to the attention of law enforcement, warrants are not that hard to get. If you're dead, the coroner will get them simply by asking. They get the body, too, and can test for whatever they like.

    I have seen many, many pregnant mothers with positive screens for barbiturates, opiates, and methamphetamine. Often more than one. Alcohol, too. I've seen trauma patients positive for as many as six different classes of drugs of abuse. And I've seen blood alcohols as high as 0.65, over eight times the 0.08 level considered legally impaired in California. Levels below 0.35 are so common they don't even surprise us.

    I know of one person, currently serving two, consecutive, 20 year terms for vehicular manslaughter, whose ER blood alcohol was only 0.12 an hour after killing a mother and child in a traffic collision..

    Why are they worried about us? Pilots are regulated by the Federal Government, so the NTSB has more sway. Driving and all the rest are governed by states where the NTSB has much less influence. And the study a few years ago showing far too many pilots not reporting drug prescriptions or medical disability retirements didn't help any.

    The bottom line is that while they may have a difficult time actually passing regulations requiring drug testing for private pilots, I suspect it will come eventually, and then all bets are off. The commercial folks already have to deal with it. The concern will never go away no matter how much we wish otherwise.

    Tom

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    WindOnHisNose's Avatar
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    Excellent post, Tom. Thank you.

    The subject of drug testing came up at my recent recertification course, and there are currently no plans to do so, according to the Federal Air Surgeon. There was a considerable amount of time spent, however, in making us AME's aware of the overuse and abuse of benadryl and Claritin by pilots.

    Please refer to the "50 Shades of Gray..." thread on self-grounding:
    http://www.supercub.org/forum/showth...edical-Reasons

    There you will see a listing of the elapsed time from drug use to safe return to flight status:
    Benadryl: 60 hours.
    Zyrtec: 40 hours
    Claritin, 24 hour: The FAA does not have a recommendation for this

    I suspect there will be a recommendation for Claritin shortly. I have been pretty amazed at how many people I know that take benadryl occasionally to help them go to sleep, pilots and non-pilots.

    Randy

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    Quote Originally Posted by stewartb View Post
    I don't think I want to share my airspace with some guy who hasn't flown for 15 years in a plane that hasn't seen a mechanic's inspection for 15 years and that guy decides today's a good day to go flying.
    I take my car in every 10,000 miles for an oil change and check-up, even though it's not required. There's nothing to stop you from having your airplane inspected as often as you wish. There's nothing to stop you from flying with a CFI when you want to in order to increase your skills. But this is not mandated for any other personal recreational activity, and I don't understand why it is mandated for private pilots.

    Anne.
    Baloney is still baloney, no matter how thin you slice it.

  15. #15
    WindOnHisNose's Avatar
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    Quote Originally Posted by mvivion View Post
    Check out this little news article:

    http://www.usatoday.com/story/travel...rash/15325543/

    MTV
    Geez, Mike Vivion, you are a pretty big cause of high blood pressure around here today! Better watch out, they might ask us to bring in a printout from our computers to document that we have not been exposed to the dreaded MTV virus!

    Randy

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    mvivion's Avatar
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    Quote Originally Posted by Anne View Post
    I never understood why pilots who fly for fun, like most of us, had to complete a medical and a flight review every two years, and why our airplanes had to have an annual inspection, plus the ELT battery replacement and transponder check every two years, just to maintain currency. Other forms of recreation have no such requirements. Keeping "current" takes up my time and my money, and adds nothing to flight safety.

    Anne.
    Anne,

    I certainly don't disagree with your point. That said, if you aren't feeling like you're getting some BENEFIT out of your flight reviews, you REALLY need to find a flight instructor who will give you some value added in that process. A flight review should not be just a quick one hour ground (sorta) and a quick (almost) one hour flight. There should be some challenges offered, and specific to your flying. When was the last time you did a bunch of one wheel landings, for example. That's just ONE exercise that'll make you a sharper pilot.

    MTV

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    I second that.

    Most of my flight reviews involve crosswinds and one or two wheel landings. I find a whole bunch of tricycle gear folks who do not know what slow flight is, and even more who lean away from a turn. Flight Reviews are a good idea.

    I tailor mine. If a pilot is going to be flying a Stearman one day and a Cirrus the next, we spend the hour looking for crosswinds in the Stearman. With few exceptions, if a pilot comes to me for a flight review with three hours since last review, I say No. If a pilot flies as much as me, we just go out and learn something from each other.

    A lot of my current work is proselytizing. I have converted quite a few to the Cub religion in the last year or so.

  18. #18
    nanook's Avatar
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    we've been subjected to drug testing since the late 80's (part 121, 135)...this has resulted in less than something like 1/10 of !% positives in all those years...get used to it...big brother is here....

  19. #19
    Anne's Avatar
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    Quote Originally Posted by mvivion View Post
    Check out this little news article:

    http://www.usatoday.com/story/travel...rash/15325543/

    MTV

    It's odd how this study came out right as we're petitioning for flying with just a driver's licence. The numbers seem to be quite high, considering I don't know anyone who flies while on any drugs.

    Anne.

    Baloney is still baloney, no matter how thin you slice it.

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    There are a couple more things that should be mentioned about drug screens and the like.

    First, you should know that virtually all public sector jobs require drug testing, at least when applying. Hospitals are the same. Dept. of Justice background checks are very common, if not universal, too. Most large employers are requiring drug testing of all applicants. I've had two drug screens and two DoJ background checks in the last four years. Did I like it? No. Could I do anything about it? No, other than not apply for the job.

    Public safety, and employer liability are the drivers.

    Another issue, more relevant to pilots is the type of drug testing done. Most testing panels routinely used in hospitals test for drugs of abuse. THC (marijuana), cocaine, PCP, opiates (heroin, codeine, etc.), amphetamines (and methamphetamines) and barbiturates (Phenobarb, Nembutal, Seconal etc.). Some also test for benzodiazapines (Diazepam, Librium, Valium, Xanax and the like). Most employer drug screens are the same. Some use an expanded panel, but not most.

    Drug tests normally do not test for the long list of drugs pilots are forbidden to use, or restricted from using without AME intervention. No Claritan for example. Some drugs don't even have FDA approved tests since the manufacturer determined monitoring the levels served no useful medical purpose. When these tests are available they tend to done only in reference labs and are expensive.

    Then there is the issue of just what a test result means. Timing of the test aside, the predictive value of a result (the odds of getting a positive result when the person is actually using the drug, or of getting a negative result when they are not) is not 100%, and often not even close. Every test has an error rate, with false positives and false negatives. Some are much worse than others. E
    ven the confirmatory tests aren't perfect.

    Screening tests are designed to be pretty sensitive (positive at low levels) but not all that specific (more false positives) as a result. Confirmatory tests are just the opposite. Not as sensitive, but much less likely to be positive in the absence of the drug.

    Without going through the math, a positive drug screen in a population that is actually almost completely negative is very likely to be wrong. For example, testing all of the nuns at the Vatican for methamphetamine is unlikely to be productive. Any positive is probably incorrect and will require follow up. A negative result in an overwhelmingly positive population is likewise probably wrong. Timing can add even more ambiguity.

    Personally, I'm more unhappy about my tail number routinely being attached to all my radar returns than the prospect of drug testing. But that's just me
    .

    The devil here, is in the details. It sounds like the FAA probably understands this, and at least for the moment would rather focus on something more easily measured, like our neck sizes.

    Tom

  21. #21
    mvivion's Avatar
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    AOPA comments on this "study" by NTSB: http://www.aopa.org/News-and-Video/A...udy-incomplete

    if you are not an AOPA member, please consider joining......GA pilots don't have all that many friends in today's world.

    MTV

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    We had a little lecture when it all started. I remember them saying that any positive would result in some horrible result, and that a false positive was a positive.

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    Biotex's Avatar
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    Quote Originally Posted by mvivion View Post
    Your urine sample is for blood sugars, I believe. As far as I know, at present, there is no test for drugs in the flight physical..........at the moment.

    You are correct. I just got home from getting my medical today. The assistant said it was for sugars.

  24. #24
    mvivion's Avatar
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    Quote Originally Posted by WindOnHisNose View Post
    Geez, Mike Vivion, you are a pretty big cause of high blood pressure around here today! Better watch out, they might ask us to bring in a printout from our computers to document that we have not been exposed to the dreaded MTV virus!

    Randy
    Well, ya know, Randy, it seemed like the collective blood pressure was getting a little on the relaxed side....so SOMEbody had to take action.......Just trying to help.

    MTV

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    txpacer's Avatar
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    I've had to study for the pee test twice in the last six months, and I only run a simulator. Must be the haircut.

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    Quote Originally Posted by txpacer View Post
    I've had to study for the pee test twice in the last six months, and I only run a simulator. Must be the haircut.
    Was it supposed to be random testing? It may be a compliment to you. In my OTR trucking days I seemed to regularly be picked for random testing when coworkers that I knew were smoking dope and eating pills were never picked. After I voiced my opinion that I was being picked regularly because they knew I would test clean and they wouldn't have to park the truck I was assigned somehow my name never came out of the bag again. jrh

  27. #27
    Chuck Avon's Avatar
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    N86250 I had the same thing happen called 4 times in 6 weeks for random tests same reason keep druggies in truck seats.These are 80000 lb trucks 5 ft from some ones wife and kids in the mini van.With a DOT 2 year medical in there pocket and dope in the bunk.

  28. #28
    skywagon8a's Avatar
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    These are the ones to worry about "wife and kids in the mini van"! I had one of these run into me this past winter while I was stopped waiting for her to go by. $5,000 later.$%#& Her excuse was that she was taking her kids tubing and that she wasn't looking.
    N1PA

  29. #29
    soyAnarchisto's Avatar
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    You have to be kidding me about claritin. I have no drowsiniess symptoms with any antihistimine - I've tried them all. I have to take a huge dose of benadryl to make me sleepy. And a double dose of zirtec is the only OTC antihistamine that makes an appreciable affect on my seasonal allergies in the summer. I had a close call because I wasn't paying attention and reported Zyrtec and didn't pay attention to FAA requirements and almost lost my medical. Now I only take and report claritin. But in the summer I need it every day because the effect of staying off of it is FAR worse.

    Why they hell can't we get some leeway with antihistamines, at least for 3rd class medical is WAY beyond me. Because millions of people are on the road driving on this stuff. If I have to stop taking claritin or risk waiting a week after the last dose - that's just plain idiotic.

    Does anyone in the flight surgeons office use real science or is it filled with JDs instead of MDs?

  30. #30
    soyAnarchisto's Avatar
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    Quote Originally Posted by bob turner View Post
    A lot of my current work is proselytizing. I have converted quite a few to the Cub religion in the last year or so.
    Preach on, brotha man!

  31. #31
    mvivion's Avatar
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    Greg,

    One of the problems with things like antihistamines is that not everyone tolerates them as well as you do. And, like any other "drug" that has the potential to sedate, one of the results is that we often are not the best judge of our own functionality. Talk to any drunk about that, for example .

    Nonetheless, there are indeed quite a few "can'ts" in medical certification that make little sense.

    Comparisons to driving are probably valid to most pilots, but try convincing the general public of that.....let alone the FAA.

    MTV

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    If self assessment works then I'm taking morphine before every flight. Seriously, Allegra makes me feel less bad than if I didn't take it but it doesn't mean I'm tip top for going flying. I found that out one day when I flew into bad weather and lost the normal visual references. Whether impaired by the drug or by the condition the drug was treating didn't seem very important at the time. I wasn't at my best and it wasn't important until it was.

  33. #33
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    The whole thing with drug testing seems lopsided. A guy who took a couple hits of pot three nights ago ago will come up dirty, yet the guy who drinks to near-comatose state every night (or every day) will not.
    In fact, I suspect a person could be legally drunk when taking the drug test and not have it show up.
    Which do you think causes more impairment?

  34. #34
    WindOnHisNose's Avatar
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    Quote Originally Posted by mvivion View Post
    Greg,

    One of the problems with things like antihistamines is that not everyone tolerates them as well as you do. And, like any other "drug" that has the potential to sedate, one of the results is that we often are not the best judge of our own functionality. Talk to any drunk about that, for example .

    Nonetheless, there are indeed quite a few "can'ts" in medical certification that make little sense.

    Comparisons to driving are probably valid to most pilots, but try convincing the general public of that.....let alone the FAA.

    MTV
    ...what Mike said...

    Randy

  35. #35
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    Fair enough. I only have to wait 8 hours after my last drink but 5 days for Zyrtec? Who's drunk if they believe that's reasonable?

    What chaps my hide is the 1-size fits all approach. Because a portion of the community is affected worse than the rest - we have to stop using medications and live with symptoms which are worse than side affects. And why do they apply the same rigor to 3rd class medicals as 2nd and 1st?

    Why can't my AME be given authority to clear me to take certain OTC medications. Clearly there is tests somewhere to determine these things have sedative affect on populations. Can't my AME administer the test to me and make an observation about my sedation? I could maybe live with that.

    And where is the science that justifies these regulations? I'd like to know how special I am that I am in a minority and feel no sedative affects - but most everyone else does? Why isn't the flight surgeon required to cite the peer reviewed studies publically that justify these positions - and why they need to change so frequently.

    Quote Originally Posted by WindOnHisNose View Post
    ...what Mike said...

    Randy

  36. #36
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    Quote Originally Posted by soyAnarchisto View Post
    Fair enough. I only have to wait 8 hours after my last drink but 5 days for Zyrtec? Who's drunk if they believe that's reasonable?

    What chaps my hide is the 1-size fits all approach. Because a portion of the community is affected worse than the rest - we have to stop using medications and live with symptoms which are worse than side affects. And why do they apply the same rigor to 3rd class medicals as 2nd and 1st?

    Why can't my AME be given authority to clear me to take certain OTC medications. Clearly there is tests somewhere to determine these things have sedative affect on populations. Can't my AME administer the test to me and make an observation about my sedation? I could maybe live with that.

    And where is the science that justifies these regulations? I'd like to know how special I am that I am in a minority and feel no sedative affects - but most everyone else does? Why isn't the flight surgeon required to cite the peer reviewed studies publically that justify these positions - and why they need to change so frequently.
    What's Doctor Phil's most famous line

    Glenn

  37. #37
    soyAnarchisto's Avatar
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    I honestly don't know - I don't follow that quack cause I never watched Oprah. I'm more of a General Hospital kind of guy.

    What's Eddie Spaghetti's (lead singer of the Supersuckers) most famous quote?

    "**** only gets so shiny when you're polishing turds!"

    The thing is I don't think the FAA does much polishing - they just drop them and thy are what they are.

    Quote Originally Posted by cubdriver2 View Post
    What's Doctor Phil's most famous line

    Glenn

  38. #38
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    Quote Originally Posted by soyAnarchisto View Post
    Fair enough. I only have to wait 8 hours after my last drink but 5 days for Zyrtec? Who's drunk if they believe that's reasonable?

    What chaps my hide is the 1-size fits all approach. Because a portion of the community is affected worse than the rest - we have to stop using medications and live with symptoms which are worse than side affects. And why do they apply the same rigor to 3rd class medicals as 2nd and 1st?

    Why can't my AME be given authority to clear me to take certain OTC medications. Clearly there is tests somewhere to determine these things have sedative affect on populations. Can't my AME administer the test to me and make an observation about my sedation? I could maybe live with that.

    And where is the science that justifies these regulations? I'd like to know how special I am that I am in a minority and feel no sedative affects - but most everyone else does? Why isn't the flight surgeon required to cite the peer reviewed studies publically that justify these positions - and why they need to change so frequently.
    OK, I'm only posting this because you asked for it http://youtu.be/FpBxGJzmbfE

    Glenn

  39. #39
    fancypants's Avatar
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    Quote Originally Posted by soyAnarchisto View Post
    Why isn't the flight surgeon required to cite the peer reviewed studies publically that justify these positions - and why they need to change so frequently.
    I wonder about this, too. I'd like to take a peek under the kimono. Might be worth crafting an FOIA request, if only to see what justification they use to avoid compliance.

  40. #40
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    Meh, the FOIA probably won't work:

    FAA 1270.1 Freedom of Information Act Program Ch. 3 Para. 35 (a)

    Exemption 2: Internal Matters. Exemption 2 protects from disclosure records which relate to internal personnel rules and practices of the agency. The Exemption protects internal documents, the disclosure of which would risk circumvention of a statute or agency regulation, or impede the effectiveness of an agency’s activities.
    ...
    Exemption 5: Privileged Information. Exemption 5 protects inter-agency or intra-agency memoranda or letters which would not be available by law to a party in litigation with the agency. The three most frequently invoked privileges are the deliberative process, the attorney work-product and the attorney-client product.
    Last edited by fancypants; 09-11-2014 at 06:59 PM.

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