Drugs and Alcohol Found in Fatal Civil Aviation Accidents Between 1989 and 1993

Abstract

The Civil Aerospace Medical Institute (CAMI) conducts toxicology tests on aviation accident victims to determine the effects of drugs on performance and identify the extent to which drugs and alcohol are being used by pilots involved in aviation accidents. Specimens (including blood, urine, liver, kidney, and vitreous) are collected near the accident site and shipped to CAMI. The specimens then are inventoried and accessioned for the analysis of drugs, alcohol, carbon monoxide, and cyanide. All data collected by the laboratory is entered into a database for future analysis. For this study, the database was searched and sorted based on the class of drug, controlled dangerous substance (CDS) schedules I and II, CDS schedules III-V, prescription drugs, over-the-counter drugs, and alcohol. Specimens from 1845 pilots were received for postmortem toxicology analysis between 1989 to 1993. CDS schedules I and II were found in 74 of the pilots analyzed and CDS schedules III - V were found in 28 of the pilots. Prescription drugs were found 110 of the pilots analyzed; over-the-counter drugs were found in 207 and alcohol at or above the legal limit of 0.04% was found in 146 pilots. The reported number of positive drug cases has doubled over the past 5 years. Over-the-counter medications are the most frequently found drugs in fatal aviation accidents and many of these drugs, or the medical conditions for which they are being used, could impair a pilot's ability to safely fly an aircraft. The increased number of positive cases found in this research is most likely the result of improved methods of analysis, rather than an increase in the use of drugs. The low incidence of CDS III-V drugs found in fatal aviation accidents may be a result of the difficulty in finding and identifying the new benzodiazepines commonly prescribed in this class.