CFI-to-CFI Newsletter - Volume 12 Issue 4 - 8

PILOTS BEWARE. There are medications and
common products that could cause a false
positive drug test.
Substance abuse, or even the suspicion of
it, has consequences for the pilot, mechanic
or ATC controller who gets drug tested at the
workplace. A positive DOT drug test under FAA
Order 2150.3b requires revocation of all pilot
certificates. Part 121 and Part 135 (and some
145) operators are required to test pilots and
other certificate holders performing safetysensitive
positions for pre-employment, random
drug testing, post-accident, reasonable cause,
return-to-duty cause, and follow-up testing.
Failure of a random DOT drug test carries a
penalty of revocation of the airman certificate as
well as the medical certificate.
The FAA HIMS (Human Intervention
Motivational Study) program helps commercial
pilots with drug/alcohol problems get back into
the cockpit after testing positive. The HIMSAME
will help the pilot meet the necessary
FAA requirements to receive a special issuance
certificate through a lengthy and costly process.
The program's success rate is about 85 percent.
THE NIGHTMARE OF FALSE POSITIVES
But what if you are not a drug user? The
definition of a false positive laboratory value in
drug screening is a drug level that is reported
positive even if the patient is drug-free. In
most cases, the false positive is caused by an
interaction or cross sensitivity between the drug
test assay used and a prescribed medication.
A common drug level panel ordered for the pilot
will include THC (marijuana), cocaine, opioids
(codeine, morphine, or heroin), amphetamine,
and phencyclidine (PCP). Additional substances
that can be detected are benzodiazepines
(Valium®, Xanax®, Ativan®), LSD, MDMA
(Ecstasy), and opioids (hydrocodone, oxycodone).
In June 2018, the FDA approved cannabidiol
(Epidiolex®) for the treatment of seizures. The
active ingredient in this medication is CBD. In
December of 2018, the Farm Bill was signed
into law. It removed hemp, defined as cannabis
and derivatives of cannabis with extremely low
concentrations of the proactive compound delta9-tetrahydrocannabinol
(THC) with no more
than 0.3% THC, from the definition of marijuana
in the Controlled Substances Act (FDA July
25, 2019). The Departments of Agriculture in
each state are responsible for the establishment,
operation procedures, and industrial hemp
licensing programs. Twelve states have laws that
delineate THC levels in cannabidiols (CBD).
CBD products are not considered psychoactive.
There is some preclinical work at this time
showing CBD may be psychoactive based
on some preliminary data in patients with
anxiety and addiction (Neurotherapeutics.
2015;12(4):825-836). This is the same CBD, only
in lower concentration, that is used in products
found in CBD stores, health food stores, and
airport shops. CBD products are not regulated by
the FDA. The amount of THC in some products
INFORM YOUR PROVIDER OF ALL OTC
MEDICATIONS YOU ARE TAKING. ENSURE
THAT ALL OF YOUR CURRENTLY PRESCRIBED
AND OTC MEDICATIONS ARE INCLUDED WHEN
RENEWING YOUR MEDICAL.
may be falsely reported. There has been some
anecdotal data of pilots who have used CBD
products with a low THC component, and who
had a random drug level show up positive for
THC. A newly hired Colorado pilot was fired
in 2017 due to accidentally eating a marijuana
edible from a friend. He tested positive for THC
before starting his job. THC is fat soluble and
will stay in the body for weeks. The pilot did
receive his certificates back through working
with the FAA.
Medications that could potentially cause a
false positive for THC include proton pump
inhibitors, omeprazole (Prilosec®), pantoprazole
https://www.himsprogram.com/about-hims/ https://www.fda.gov/news-events/congressional-testimony/hemp-production-and-2018-farm-bill-07252019
CFI-to-CFI Newsletter - Volume 12 Issue 4

Table of Contents for the Digital Edition of CFI-to-CFI Newsletter - Volume 12 Issue 4
