Ira Rampil, M.D.
Candler Field Museum, 2nd Floor
349 Jonathan's Roost Road
Williamson, GA 30292

doc (at) bluesky-medicine.com

Alcohol

• Obtain a detailed history of the applicant's alcohol use, the circumstances surrounding all alcohol-related incidents (include those reported in 18v and any others that may have occurred)
• Obtain copies of all court records and arrest reports, including B.A.C. (blood alcohol Concentration), related to the event(s) if the incident(s) occurred within the 5 years prior to the exam. This includes copies of relevant military records if the incidents occurred while the applicant was a member of the U.S. armed forces (includes military court records, records of non-judicial punishment, and military substance abuse records)
• Forward the court records, arrest reports, and any military records to AMCD Aerospace Medical Certification Division of the FAA in Oklahoma City
• Advise the applicant that the reporting of alcohol or drug offenses (i.e., motor vehicle violation) on the history part of the medical application does not relieve the airman of responsibility to report each motor vehicle action to the FAA within 60 days of the occurrence to the: Security and Investigations Division.

Deferral Criteria:

The Examiner must defer certification for any of the following:

• Inability to obtain and review the court and arrest records within 14 days of the date of the exam
• -For the alcohol- or drug-related driving incidents:
• 3 arrest(s), conviction(s), and/or administrative action(s) within a lifetime
• 2 arrest(s), conviction(s), and/or administrative action(s) within the previous 10 years
• Any arrest, conviction, and/or administrative action for which the applicant registers a blood alcohol level 0.15 or higher
• Any arrest, conviction, and/or administrative action for which the applicant refused blood alcohol testing

Issue Criteria:

• None of the Deferral Criteria are met (see Deferral Criteria list below)
• For reported incident(s) that occurred more than 5 years prior to the exam, based on the exam, the Examiner determines the applicant’s history does not indicate a substance abuse or dependence problem
• For reported incident(s) that occurred within 5 years of the exam, based on the exam AND review of the court record(s) and arrest report(s), the Examiner determines the applicant’s history does not indicate a substance abuse or dependence problem

In case of a Deferral:

The airman may still request certification by providing to AMCD the following:

• A detailed personal statement regarding his/her past and present patterns of alcohol or drug use
• A complete copy of his/her current driving record in any state that he/she has held a driver’s license in the last 10 years
• Copies of any court records and arrest reports related to the event(s), including B.A.C. (Blood Alcohol Concentration), that have not already been provided to the AME. This includes copies of relevant military records if any event(s) occurred while the applicant was a member of the U.S. armed forces. Relevant military records means military court records, records of non-judicial punishment and military substance abuse records
• Obtain a substance abuse evaluation from an addictionologist or addiction psychologist/psychiatrist familiar with aviation standards

Substance Abuse

Substance dependence refers to the use of substances of dependence, which include alcohol and other drugs (i.e., PCP, sedatives and hypnotics, anxiolytics, marijuana, cocaine, opioids, amphetamines, hallucinogens, and other psychoactive drugs or chemicals).

Substance dependence is defined and specified as a disqualifying medical condition unless there is clinical evidence, satisfactory to the Federal Air Surgeon, of recovery, including sustained total abstinence from the substance for not less than the preceding 2 years.

Substance dependence is evidenced by one or more of the following: increased tolerance, manifestation of withdrawal symptoms, impaired control of use, or continued use despite damage to physical health or impairment of social, personal, or occupational functioning. Substance dependence is accompanied by various deleterious effects on physical health as well as personal or social functioning.

There are many other indicators of substance dependence in the history and physical examination. Treatment for substance dependence-related problems, arrests, including charges of driving under the influence of drugs or alcohol, and vocational or marital disruption related to drugs or alcohol consumption are important indicators. Alcohol on the breath at the time of a routine physical examination should arouse a high index of suspicion.

Diagnosis

• Use of a substance in the last 2 years in which the use was physically hazardous (e.g., DUI or DWI) if there has been at any other time an instance of the use of a substance also in a situation in which the use was physically hazardous
• If a person has received a verified positive drug test result under an anti-drug program of the Department of Transportation or one of its administrations; or<
• The Federal Air Surgeon finds that an applicant's misuse of a substance makes him or her unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held, or that may reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the applicant unable to perform those duties or exercise those privileges.

The Medical Certification path requires the local AME to defer the application to AMCD. A detailed description of the process starts here.