IMPORTANT Adhd medication

8 Replies

IMPORTANT Adhd medication

Posted by Logan Lambright on Nov 28, 2017 12:15 pm

Hi, My name is logan, I am 15 years old and currently a sophmore in highschool. I have the great oppurtunity to fly as part of our aviation program, And soon want to get the medical so i can truly begin flight training. BUT i have sever adhd, sitting in the 1 percentile or bottom 1 percent for attention. I currently take a medication that does wonders to help me, but I recently read that if on meds for ADHD i wont pass the medical, What can i do? I really want to continue flying and get certificates, But the medication is extremly helpful in school.
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Re: IMPORTANT Adhd medication

Posted by Drew Blessing on Nov 28, 2017 10:12 pm

Hi Logan,
In the current Guide for Aviation Medical Examiners (https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/guide.pdf) it unfortunately looks like all ADHD medication are on a 'Do Not Issue' list. You may have to discontinue the medication for a minimum of 90 days before applying for your medical and will also probably have to provide lots of documentation and records on your current status post-medication.

I am currently in the process of obtaining a special issuance for a medical condition - Atrial Fibrillation. Everything is submitted to the FAA and now I have to wait for a response. I'm fairly confident I'll receive approval, but we'll see. What I can recommend is that you find a good Aviation Medical Examiner who has experience dealing with special issuance cases. They will have the experience with the FAA and the knowledge needed to help you navigate the confusing process. Maybe they will know of a special issuance path that allows you to stay on the medicine. My CFI referred me to my AME and he has been instrumental in getting all the documents together to send to the FAA - he did research to know exactly what documentation was needed, he called my cardiologists directly and instructed them on what documentation he needed, and he reviewed it all before sending it to the FAA. He's also checking on the status every week or two. 

Best of luck to you - if you're really passionate about flying I hope you will search out a great AME and will stick through the lengthy process to get approval. 

Re: IMPORTANT Adhd medication

Posted by Ronald Levy on Nov 30, 2017 10:06 am

It is possible to get a medical after taking ADHD meds, but only if you stop taking them for at least six months, get and pass a full psychiatric evaluation, and never take those meds again.  I'm not a physician, but it sounds from what you posted that you might not be able to do that.  However, the real expert on this specific issue is Dr. Bruce Chien, an MD, Aviation Medical Examiner, and experienced pilot and flight instructor.  His practice is specialized in difficult aeromedical certifications such as your situation.  You can find his contact information at http://www.aeromedicaldoc.com.  If there's anyone who knows how to help you get what you want, he's the one.  Just tell him all the facts and only the facts, and give straight answers to any questions he asks, and he'll give you all the help he can.

Re: IMPORTANT Adhd medication

Posted by Reid Sayre on Dec 4, 2017 9:24 am

Here is a link to an article from AOPA. I do not believe that you need to be a member to see this article:

  https://pilot-protection-services.aopa.org/news/2014/may/21/heads-up-for-student-pilots

Note that "Unfortunately, both the condition and the medications to treat ADHD are disqualifying for all classes of medical certification." Times do change however, so take the steps mentioned in the article and other replies to your post and let us know the results.
 

Re: IMPORTANT Adhd medication

Posted by Lauren Mcgavran on Dec 4, 2017 11:20 am

Have you looked into the sport certificate? You will need to be able to self-certify that you can safely operate the airplane, but if you and your Drs. think that you are medically safe, then you can fly light sport airplanes. You can always upgrade later if the medical situation changes. If you choose to go this route, DO NOT apply for a medical. You CANNOT fly sport if your medical has been denied, revoked, or suspended.

Re: IMPORTANT Adhd medication

Posted by Joe Stubblefield on Apr 30, 2018 9:11 am

if You can get a medical or get special issuance as I did for diabetes, then you can get basic med. As per the nice FAA lady doctor at Sun n Fun, then you are no longer subject to the FAA drug rules...so in my case, I can consider drugs and combinations of drugs not allowed by FAA with two caveats as per the FAA doctor.....one, I must still judge myself able and safe to fly and two, must have a doctor to sign off on the exam part of basic med every four years. She said, we are not subject to the regular medical rules of part 67. We are still subject to the higher rules of aviation which require everyone to determine if on any given day they are capable of flying safely and especially not hurting anyone else. That part never changes! Anyone looking at conditions requiring special issuance should consider basic med before dealing with FAA as an option if meds might become a problem. I got tired of the FAA losing my stuff once every 2-3 years and issuing a nastygram months after my medical to provide info that they or my AME had lost. Also, if you do need help with your medical and live in the mid Atlantic or NE region, then talk to the FAA medical team in Jamaica, NY. They are wonderful! Also, the medical folks at AOPA are very helpful. Never deal with Kansas City unless you have to. Other regional offices might also be more helpful than the very busy KC office.

Re: IMPORTANT Adhd medication

Posted by Ronald Levy on Apr 30, 2018 7:20 pm

Joe Stubblefield:
if You can get a medical or get special issuance as I did for diabetes, then you can get basic med.

You cannot get a Special Issuance if you are diagnosed ADHD.  You must be psychiatrically cleared as not being ADHD to get any medical issuance, and if you have been prescribed ADHD meds, you are presumed to be ADHD regardless of why you were prescribed those meds.  As I said above, the only path available is to get a HIMS psychiatrist to say you really aren't ADHD, and that's a very tough path.

As per the nice FAA lady doctor at Sun n Fun, then you are no longer subject to the FAA drug rules...

I don't think that's quite true.  If the FAA has determined that a drug is incompatible with flight deck use, the burden is on you to show you can safely fly as PIC with that drug in your system, and that's not easy when it comes to psychoactive drugs like ADHS meds.  Logan's situation with ADHD isn't at all the same as dealing with diabetes, where the principle concern is whether you might black out during flight due to the chemical effects of a hyper/hypoglycemic condition rather than how drugs like ADHD meds affect your judgment and reactions.

​Note further than for a physician to sign the Basic Med checklist, s/he must certiy that:

"The individual is aware of the regulations pertaining to the prohibition on operations during medical deficiency and has no medically disqualifying conditions in accordance with applicable law."

​...and ADHD is medically disqualifying, with no Special Issuance possible short of that diagnosis being cancelled.

 

Re: IMPORTANT Adhd medication

Posted by Joe Stubblefield on May 7, 2018 7:49 am

I can only forward what FAA personnel told me and was confirmed by AOPA medical staff. What I intended here is not specific info on ADHD but just trying to get information broadcast that I have not seen or heard anywhere else so that people with med issues might have some positive hope from a “viewpoint” if not policy from FAA. I am sure there are combinations or even single meds not approved for class 3 medicals that may under this “FAA opinion”  be considered under Doctor advice for a given treatment for various conditions. All I am trying to say is that there seems to be more latitude under basic med than has been generally broadcast. The medical staff at AOPA will even agree with this. The individual should still make sure whatever they take, even if FAA approved, does not cause a bad reaction that would make for unsafe flying.

Re: IMPORTANT Adhd medication

Posted by Ronald Levy on May 8, 2018 5:16 pm

Joe Stubblefield:
I can only forward what FAA personnel told me and was confirmed by AOPA medical staff.

What the FAA may have told you about diabetes meds vis a vis Basic Med isn't relevant here.  You cannot go Basic Med without having previously held a regular FAA medical certificate, and Logan hasn't had one.  Further, any history of ADHD diagnosis or having taken an ADHD med (with or without an ADHD diagnosis) is disqualifying for even an SI medical certificate, and Logan has both in his (her?  about 10% of Logans are female) medical record.  The only route possible is to stop taking the ADHD meds for at least 6 months, then do the full 4-axis HIMS psychiatric evaluation, and have the HIMS psychiatrist conclude you aren't really ADHD.  That is a long, difficult, and rarely completed route.  Even Sport Pilot., where you need not ever have held an FAA medical certificate, is not an option for Logan since you are required to certify that you do "[n]ot know or have reason to know of any medical condition that would make [yuu] unable to operate a light-sport aircraft in a safe manner", and the FAA has repeatedly made clear that they consider ADHD to be among the mental conditions (like bipolar disorder and schizophrenia) incompatible with safe piloting.

​I suppose that if Logan already had an FAA medical certificate at the time of the ADHD diagnosis, and did not apply for a new one (an application which would certainly be denied, ending Basic Med as an option), one could argue that s/he could then go the Basic Med route since ADHD is not specifically mentioned as disqualifying for Basic Med.  However, the FAA AME Guide says, "Attention-Deficit/Hyperactivity Disorder (ADHD), formerly called Attention Deficit Disorder (ADD), and medications used for treatment may result in cognitive deficits that would make an airman unsafe to perform pilot duties."  14 CFR 68.9 says that for Basic Med:
 

(c) Special rule for mental health conditions. (1) In the case of an individual with a clinically diagnosed mental health condition, the ability to operate an aircraft under §61.113(i) of this chapter shall not apply if—

(i) In the judgment of the individual's State-licensed medical specialist, the condition—

(A) Renders the individual unable to safely perform the duties or exercise the airman privileges required to operate an aircraft under §61.113(i) of this chapter; or

(B) May reasonably be expected to make the individual unable to perform the duties or exercise the privileges required to operate an aircraft under §61.113(i) of this chapter;


​In this case, absent a full 4-axis HIMS psychiatric evaluation or complete ignorance of the FAA's basic position on this condition, it is difficult to imagine a physician being able certify that "I am not aware of any medical condition that, as presently treated, could interfere with the individual's ability to safely operate an aircraft," and then we're back where we started.