Medical

Rising use of drugs in aviation, goes mostly undetected

Alcohol has been showcased as a social evil and a threat to aviation safety but alcohol also increases the user to be more open to trying other drugs. How is the regulator or the operator keeping the cockpit safe and drug free?

The regulators have initiated a campaign on crackdown to detect and prevent personnel from entering the workplace after consumption of alcohol. The new emerging trend is that the users are now shifting to other drugs which are not detected by the mandatory pre-flight breath analyser test for alcohol. Drugs and use of drugs has now entered the cockpit of the aircraft that you, me and millions of passengers fly.

Very limit data is available on the use of drugs in aviation. Most of the data is from USA. There is very little research, study carried out in Aisa where there is an aviation boom and the regulators are still grappling with issues pertaining to fatigue.

NTSB study Drug Use Trends in Aviation:Assessing the Risk of Pilot Impairment

Dayton daily news

The number of pilots testing positive for one or more drugs increased in 2015 over the prior five years, though federal officials said the overall number of airline employees testing positive is low.

The newsroom’s reporting comes following the March 16 death of Spirit Airlines pilot who is suspected of overdosing on fentanyl, according to the Montgomery County Coroner’s Office. He and wife were found dead in their bedroom by their children.

CNN report on use of drugs

Forty percent of all pilots killed in noncommercial airplane crashes in recent years have medication in their systems — a marked increase over previous decades, according to a draft government study obtained by CNN.The most common drugs: antihistamines, which can cause drowsiness, and heart medications.The most worrisome: illicit drugs found in nearly 4% of the deceased pilots.All told, pilots tested positive for some sort of drug — be it over-the-counter, prescription or illicit — in 40% of fatal accidents in 2011, up from 10% in 1990, according to the study.The National Transportation Safety Board, which conducted the study, called the jump “significant,” saying it mirrors medicine use in society as a whole.It cautioned that the mere presence of drugs does not necessarily mean drugs contributed to the accident. Indeed, investigators say drugs contribute to about 3% of all fatal plane crashes — a level that has remained constant for two decades.

Barriers to Drugs

Physical barriers can be built to detect and prevent the users of alcohol at work place. Barriers like the one shown in the picture below. ALCLAIR Gate Lane Management Safety System (Industrial Grade) customized for BALCO at Korba and Varroc at Pune, India. It opens and closes the gates on randomized/specific alcohol screening tests, as decided by the administrator. If someone is positive a red light will show and the lane gate won’t open. It allows 15,000 employees per day in three shifts to pass through walking, motorcycle, car, truck lanes (45 such lanes) without getting off the vehicle.

Developed by TRIOPHS of Mindcom Group.

Some 3.8% of deceased pilots tested positive for illicit drugs from 2008-2012, up from 2.3% in 1990-1997, the report said. Marijuana was the most commonly identified illicit drug.“Illicit drug use is particularly concerning to transportation safety because … illicit drug users are often actively seeking the impairing effect of the drug,” the study said.The study did not look at alcohol use, partially because alcohol is produced by dead body tissue, making it difficult to determine if a pilot ingested alcohol prior to a fatal accident.

A 1983 cargo plane accident at Newark International Airport highlighted the problem of drug use. Post-accident tests showed one pilot had smoked marijuana and the other had taken phenylpropanolamine (a drug found in decongestants and diet aids at the time) within 24 hours before the accident. The safety board concluded that the drug use was a factor in impairing the crew’s decision-making and flying abilities.That accident prompted the Federal Aviation Administration to test deceased pilots for drugs. An FAA lab can now identify more than 1,300 different chemicals.

Pilots in Asia are concerned too

Senior pilots in Asia where there is a boom in aviation growth, have admitted that they have witnessed an increase in user of drugs other than alcohol. Primary reason being the the ability to evade the mandatory pre-flight alcohol test, ease of use and availability.

A few airlines have been carrying out random drug check which detects 10 drugs in a quick check. The regulator has no policy for prevention and detection of these drugs. The regulator on paper bans the use of psychoactive drugs but does not go beyond that.

There is no policy on educating the crew and other employees nor is there a rehabilitation programme. Without a long term plan and lack of social/psychological experts dealing with such issues, this is an issue waiting to explode.

Drug testing around the globe.

BIOCHEMICAL TESTING

Biochemical testing is a process whereby a sample of breath, blood, urine or other body fluid or tissue is procured from an individual and submitted for biochemical or biophysical laboratory examination and analysis, and where the result of this testing is cited as proof of a particular conduct.

Whether or not to institute biochemical testing of employees can be one of the most difficult decisions to make in establishing problematic substance use prevention programmes. Such testing involves living individuals, as opposed to the post-mortem toxicology testing generally required as part of an accident investigation.

Evidence of current impairment

One of the most critical things to remember is that a test for psychoactive substances other than alcohol does not provide evidence of current impairment. Unlike alcohol testing, where a certain blood alcohol level is a significant indicator of impairment, a particular concentration of other psychoactive substances or their metabolites in a person’s body cannot be easily correlated to a particular degree of impairment. Although one can presume recency of use if the substance is present in an employee’s blood, whether and how much it is affecting the individual cannot be determined even from a blood test. Further, substances can be detected in hair and urine for days or weeks after the use occurred (the detection time varies with the type of drug and frequency of use, among other factors). If testing for drugs other than alcohol is being considered, therefore, it must be recognized that such testing could reveal evidence of conduct that may or may not have affected the workplace.

CANNABINOIDS (MARIJUANA) INFORMATION SHEET (ICAO Doc9654)

Marijuana is one of the most underestimated drugs of abuse. It is used for the mildly tranquilizing and mood- and perception-altering effects it produces.

Description

• Usually sold in plastic sandwich bags, leaf marijuana will range in colour from green to light tan. The leaves are usually dry and broken into small pieces. The seeds are oval with one slightly pointed end.

Less prevalent, hashish is a compressed, sometimes tar-like substance ranging in colour from pale yellow to black. It is usually sold in small chunks wrapped in aluminium foil. It may also be sold in an oily liquid.

• Marijuana has a distinctly pungent aroma resembling a combination of sweet alfalfa and incense.

• Cigarette papers, roach clip holders and small pipes made of bone, brass, or glass are commonly found. Smoking “bongs” (large bore pipes for inhaling large volumes of smoke) can easily be made from soft drink cans and toilet paper rolls.

• Trade/street names include Marinol, THC, Pot, Grass, Joint, Reefer, Acapulco Gold, Sinsemilla, Thai Sticks, Hash, Ganja and Hash Oil.

Signs and symptoms of use

Acute

• Aggressive urges

• Anxiety

• Confusion

• Fearfulness

• Hallucinations

• Heavy sedation

• Immobility

• Psychical dependence

• Panic

• Paranoid reaction

• Unpleasant distortions in body image

Chronic

• Reddened eyes (often masked by eyedrops)

• Slowed speech

• Distinctive odour on clothing

• Lackadaisical “I don’t care” attitude

• Fatigue and lack of motivation

• Irritating cough, sore throat

Health effects

• Marijuana smoke is irritating to the lungs. Chronic smoking causes emphysema-like conditions.

• One joint causes the heart to race and be overworked. People with heart conditions are at risk.

• Marijuana is commonly contaminated with the fungus Aspergillus, which can cause serious respiratory tract and sinus infections.

• Marijuana smoking lowers the body’s immune system response, making users more susceptible to infection.

Mental function

Regular use can cause the following effects:

• Delayed decision-making

• Diminished concentration

• Impaired short-term memory, interfering with learning

• Impaired signal detection (ability to detect a brief flash of light), a risk for users who are operating machinery

• Impaired tracking (the ability to follow a moving object with the eyes) and visual distance measurements

• Erratic cognitive function

• Distortions in time estimation

• Long-term negative effects on mental function known as “acute brain syndrome”, which is characterized by disorders in memory, cognitive function, sleep patterns and physical condition.

• Increased incidence of psychiatric disorders.

Workplace issues

• The active chemical, tetrahydrocannabinol (THC), is stored in body fat and slowly released over time. Marijuana smoking has a long-term effect on performance.

• A five to eight times increase in THC concentration in available marijuana products during the past several years makes smoking three to five “joints” a week today (1995) equivalent to 15 to 40 joints a week in 1978.

• Combining alcohol or other depressant drugs and marijuana can produce a multiplied effect, increasing the impairing effect of both the depressant and marijuana.

 

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