Recently I received an e-mail from the spouse of a commercial airline pilot. Though her husband has been diagnosed with ADHD (and, from her report, displays strong symptoms), she claimed that FAA guidelines prohibit him from taking medication for it. Could this be true? Yes, it appears so, according to this page on the Aviation Medication Advisory Service website:
Medication Class — Attention Deficit Disorder Medications
Medication Class Description:
Current FAA policy does not allow persons who use any medications for ADD or ADHD to hold an airman medical certificates.
The FAA now has a protocol for evaluating pilots with Attention Deficit Disorder prior to issuing a waiver. Some individuals using medication have been waivered after neurocognitive testing shows adequate performance at least 72 hours off the medication. If the results of this testing is favorable, the pilot may be cleared to fly if no longer taking medications. Individuals with a reliable childhood diagnosis of ADHD may have to wait 90 days after stopping medication to take the required testing. Some of the medications used for ADHD will cause a positive drug test in DOT drug testing programs. Strattera has a warning regarding possible liver damage.
VFS can assist with in coordinating required psychological testing and waiver petitions.
Over at Leftseat blog, I found this about ADHD medications:
Attention Deficit (ADD) – Ritalin (Methylphenidate Hydrochloride), Adderall (Dextroamphetamine Sulfate) and Strattera (Atomoxetine Hydrochloride) are usually not approved by the FAA. Under rare circumstances, individuals using Ritalin have been approved with restrictions. Approval is more likely for adults due to the difficulty in accurately evaluating ADD in young people and typically requires time off medication prior to flight.
If you have any experience or accurate on this topic, please share. Are there any workarounds to this prohibition?
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I was diagnosed with ADHD as a teenager. I outgrew/manage the condition well as an adult. Recently I attempted to get a pilot’s license. I can tell you for certain that any use of stimulant meds is a categorical disqualifier for your medical (required for a pilot’s license). Any pilot that takes them and reports it will lose their license. The Catch-22 is that if you are diagnosed with ADHD, you are disqualified because of the condition, and if you take medication to manage the condition, you are disqualified for taking a prohibited drug. The only way I have found to get/keep your license with an ADHD diagnosis is to (1) be off meds for more than a year, and (2) pass a huge battery of outdated psychological tests (such as WAIS-R, and MMPI-2, costing north of $2k) to prove you are not impaired by your condition when off meds, including a drug test for any stimulants — no easy task. You are then never allowed to go back on any stimulant medication.
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Thanks for sharing that info. The policy sounds similar to that of the military, where it causes many problems.
I hope that some day we find ways to make it possible for people with ADHD to both be pilots and serve in the military while still benefiting from medical treatment.
best,
g
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The Air Force regularly dispenses “Go Pills” (dexedrine) to its pilots in combat. Military pilots in 2003 were regularly exceeding their dosages in Iraq yet my Vyvanse which is not as easily abused would disqualify me???
http://www.msnbc.msn.com/id/3071789/ns/us_news-only_on_msnbc_com/t/go-pills-war-drugs/#.T9izpL9jjQo
I was undiagnosed for 14 years as a police officer, detective and FBI certified computer forensics examiner. It wasn’t until I gave up the adrenaline that certain difficulties emerged. So I can carry a gun, take on great responsibility that affect peoples liberties but can’t pursue a hobby that just may allow me to be just as effective off medication and that much more effective on medication given the Air Force’s reasoning. That’s just not right.
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Hi Gary,
Yes, on the face of it, there is little sense here.
What hobby do you mean?
g
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The restrictions also apply when pursuing a private pilot’s license for recreation purposes.
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Oh, okay. Thanks, Gary.
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I mis-read this as “Meditation and ADD”. Took me a while to figure out it was NOT about that. I was so hopeful that there was some info about how meditation can ever be done by someone with ADD. (significant other) Oh well
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Hi Marni,
Actually, I just hosted a lecture here in Palo Alto with Dr. Lidia Zylowska, author of “The Mindfulness Prescription for Adult ADHD.” Look for the book on Amazon. There is a CD in the back with guided meditations.
It’s true, though, that some people with ADHD will have a hard time with any meditation practice until they take medication. The two together can be quite powerful. Some people with ADHD, depending on severity of symptoms and life situations, will be able to practice the techniques in the book without medication. It just depends on the person.
On the blog I write for CHADD, you can read a guest post by another physician who teachers Mindfulness Meditation for the ADHD community, Dr. Mark Bertin: http://adultadhdrelationships.blogspot.com/2012/06/communicating-mindfully.html
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Thanks for your response!
I requested this book from the library, thanks for the recommendation.
This is something I am interested because of my significant other. Reading the comments on your Meetup page made me curious about common experiences with ADD in relationships. The comments seemed to be more focused on functionality in the world and coping with things like depression.
One question, for example, is how can ADD affect relationships and how can it be worked with. Mood seems to be a huge factor but my inquiry is more about issues like not being able to contain troughs and set internal boundaries with a significant other. The closer someone is emotionally, the more issues there are of course. I’m sure there are many other factors, so the inquiry is endless.
But you gave me a resource to look into and I appreciated it!
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Sorry, I see now that the blog you put a link to is all about relationships!
Thanks!
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Yes, Marni. I also wrote a book that covers many of the questions you ask: Is It You, Me, or Adult A.D.D.?
It’s available as a paperback, a Kindle and Nook book, and as an audiobook.
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I would like to comment and say that I have been going through the problem of being denied my 3rd class medical because I was on Adderall.
I was diagnosed as an adult and had been on the medication for 2 years when I started work on my private pilot license in January. The first step was being denied my medical. The second step was a letter from the FAA stating that I could not fly with ADHD and while taking Adderall, but if I was off the medication for 90 days and could pass a battery of tests (including a UA) I could obtain my medical. September 6th marked my 90th day off Adderall and next Monday I am taking the day off work to complete the testing. I hope that I can pass. This has been a very difficult path to take as I find that my symptoms are worse now than when I started taking the medication. I would encourage shopping around for testing resources as my initial contacts quoted around $2,000 but I was able to find a doctor to do the tests for $750.
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Hi Justin,
That’s a lot of dedication on your part!
There are many things you can do to improve your brain function in the meantime — get exercise in the morning, get enough sleep (not always easy for some people with ADHD, I know!), eat a protein breakfast in the morning.
I wonder if it’s just Adderall (and any other amphetamine stimulant) or if the methylphenidate class is prohibited as well. Same for Strattera, which is not a stimulant (but in my experience is not entirely effective as a standalone treatment for ADHD).
I can see the reasoning. Many people with ADHD don’t take their medication consistently. Or it’s not the most effective medication at the best dosage. So, the testing makes sure that you can function well without your medication (in case you don’t take it!).
Still, it does seem to penalize people who are responsible about being diagnosed and taking medication responsibly.
Good luck!
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Justin,
I was wondering if you could give me the name of the Dr. that you were able to see for the ADHD testing for the $750? What state are you in? I am in Colorado and I got quoted $4000 for all the required tests so definitely want to find someone that can do it for cheaper. How did all your testing go?
Thanks,
Ron
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Pingback from Intuniv For ADHD: Dosing Details « CorePsych on January 25, 2013 at 11:08 am
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This all sounds pretty discouraging. I’m a Marine veteran and just got out in 2010. I was aiming for veterinary school and have slowly been decreasing that goal since then. I’ve always love flight and have just decided to start pursuing it. It’s the only thing left that I can see myself doing for the rest of my life. Once I got into school again, I also got the Dx for ADD, not ADHD and my prescription to the dextroamphetamine is pretty small compared to many other people. Most of it comes from having trouble tuning people out that are around me and having a need-to-know of people coming in and out of the lecture halls. That I can surely thank my military service for, but it adds to the minor case of ADD I have. I wonder how many pilots out there have been able to pull this off. I function just fine without the medication but it helps a ton when I am in situations like that and can’t shut off my trained instincts. It’s heightened situation awareness, basically. Does it sound like I have a good chance of gaining waivers? I was going to try to get into an aviation major starting this fall and was considering becoming a UAV pilot for the National Guard. It’s frustrating to see that this could keep me grounded! I thought I finally settled on that career that will make me happy.
“Love what you do and you won’t work a single day in your life.” Or something like that. I would love to hear some more advice and/or thoughts on this topic. I’m nervous about the battery of tests, though. Thanks!
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I wish I had some answers for you, Justin. The most useful advice I can think of is to maximize all the non-Rx strategies you can.
First, I’d recommend reading Dr. Parker’s book:
Then, I would suggest looking into
–amino-acid supplements (such as tyrosine in the am, on an empty stomach)
–optimizing your diet (protein in the morning, eliminating simple sugars and carbs, etc.)
–incorporating brain-boosting exercise (aerobic in am with “coordinated” exercise, meaning not just running or some other “rote” activity but one that requires coordination and varied movements)
–making sure you’re getting good sleepI hope this helps.
Gina
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