Adderall

I'm a doctor still in residency training. The bulk of kids we see are Medicaid patients with low socioeconomic class parents. We see tons of kids in our clinic that get diagnosed with ADHD and placed on some form of stimulant/non-stimulant for treatment. Most of us are well aware that the kids probably don't have ADHD, but instead have terrible/worthless/clueless parents. As much as we would love to counsel the parent on behavior and study skills and everything else, 99% of the time it doesn't help. A lot of us feel that placing the kids on these medications give them *some* hope of at least not getting kicked out of school or making all C's instead of D's. Never realized could be potentially making it difficult for them to be a pilot in the future, though!
Then you are, in my opinion, being taught bad medicine for the 2010s and are doing a great disservice.

For a lot of these kids, their way out is in the military; then they acquire a skill and the computerized record (everything is now accessable) leaves them without a career and up the crick without a paddle.

Shame on your mentors.

Professor of Medicine, Univ. of Illinois.
 
I'm a doctor still in residency training. The bulk of kids we see are Medicaid patients with low socioeconomic class parents. We see tons of kids in our clinic that get diagnosed with ADHD and placed on some form of stimulant/non-stimulant for treatment. Most of us are well aware that the kids probably don't have ADHD, but instead have terrible/worthless/clueless parents. As much as we would love to counsel the parent on behavior and study skills and everything else, 99% of the time it doesn't help. A lot of us feel that placing the kids on these medications give them *some* hope of at least not getting kicked out of school or making all C's instead of D's. Never realized could be potentially making it difficult for them to be a pilot in the future, though!

And right there in a nutshell is why I left pediatric neurology.
 
Thanks for all the replies.

Basically he has the classic scenario of being diagnosed as a teenager with ADD. A few years later he seems to have outgrown it.

From what I have been able to research, it looks like a minimum of 90 days with no prescription and then a psych eval costing $750-$2500. I'm glad I was able to bring this up with him before getting denied a medical as SP might be a good option.

If you "outgrew" it, then you never had it in the first place and were misdiagnosed.

The diagnosis stands until you pass a pretty comprehensive battery proving that you DONT have it.

Here's the kicker... even those WITH ADD, and who ARE medicated... they have developed compensatory mechanisms to overcome and carry on with normal daily activities without the outward appearance of impairment.

When under stress or duress, those mechanisms break down and the ability to react and adapt are severely impaired. Doc Bruce has discussed this in the past as "executive function" or ability to execute required actions..

True ADD doesn't belong in a cockpit.

The question should be is the prospective airman willing to spend thousands of dollars to evaluate if he/she is indeed diagnosed with ADD or not, and then proceed with flight training if clear.... with the understanding that if they do in fact have ADD they are not eligible for an airman's medical certification in the US at this time.
 
The question should be is the prospective airman willing to spend thousands of dollars to evaluate if he/she is indeed diagnosed with ADD or not,...
Pardon the picking of a nit, but it doesn't take thousands of dollars to determine whether or not someone is diagnosed with ADD -- just a brief review of his/her medical records will tell you that. The thousands of dollars pays for the medical evaluation to determine whether that person was misdiagnosed and doesn't really have it. I think, but am not sure, that there is also an option B, in which it is determined that although the person has it, it is sufficiently controlled that s/he can still safely fly as a pilot. But either way, it doesn't take much to determine whether someone is diagnosed or not -- just look at the records.
 
Pardon the picking of a nit, but it doesn't take thousands of dollars to determine whether or not someone is diagnosed with ADD -- just a brief review of his/her medical records will tell you that. The thousands of dollars pays for the medical evaluation to determine whether that person was misdiagnosed and doesn't really have it. I think, but am not sure, that there is also an option B, in which it is determined that although the person has it, it is sufficiently controlled that s/he can still safely fly as a pilot. But either way, it doesn't take much to determine whether someone is diagnosed or not -- just look at the records.

Pardon my nit picking response and let me reflect my assertion to reflect the following:

"PROPERLY diagnosed with ADD/ADHD", as opposed to "diagnosed with ADD/ADHD"

The spending of multiple thousands of dollars don't guarantee a reversal of a previous diagnosis, particularly if that previous diagnosis was in fact the correct one.
 
Pardon my nit picking response and let me reflect my assertion to reflect the following:

"PROPERLY diagnosed with ADD/ADHD", as opposed to "diagnosed with ADD/ADHD"

The spending of multiple thousands of dollars don't guarantee a reversal of a previous diagnosis, particularly if that previous diagnosis was in fact the correct one.
I think that's a fair statement.
 
And the only thing they test for chemically when you go in for the FAA medical exam is sugar in your urine. But you really don't want to lie to the FAA -- eventually, they do seem to find out, and then they administer the aviation equivalent of capital punishment.

That's all they are SUPPOSED to check for. Unfortunately, the seven way test strips are easier to come by than simple glucose ones. This led to a rather odd discussion with my AME:

DOC: There's something wrong here.
ME: I'm spilling ketones, I know.
DOC: Why is that.
ME: Atkins diet.
DOC: Um... why don't you go eat some carbs and get a UA and bring it in.
 
I was prescribed adderol for chronic fatigue due to shift work. It was prescribed as take when needed. I've never been diagnosed with any attention deficit disorders. Will that be disqualifying as well.
 
I was prescribed adderol for chronic fatigue due to shift work. It was prescribed as take when needed. I've never been diagnosed with any attention deficit disorders. Will that be disqualifying as well.

Maybe not disqualifying, but not simple either. This will take knowledgeable handling because one wrong phrase could be make or break.
 
I was prescribed adderol for chronic fatigue due to shift work. It was prescribed as take when needed. I've never been diagnosed with any attention deficit disorders. Will that be disqualifying as well.

Maybe not disqualifying, but not simple either. This will take knowledgeable handling because one wrong phrase could be make or break.

I'm no AME and not a doctor either:

http://www.drugs.com/pro/adderall.html

>>>
Adderall® is indicated for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) and Narcolepsy.
<<<

If you are being given Adderall, then you need to see what the doc actually diagnosed you with. I don't think FAA likes narcolepsy.
 
If you have not filled the RX - don't... if you have I would stop taking it asap and call bruce... just my 2 cents..
 
I was prescribed adderol for chronic fatigue due to shift work. It was prescribed as take when needed. I've never been diagnosed with any attention deficit disorders. Will that be disqualifying as well.
It's a pretty safe bet that you would be denied an FAA medical certificate.

If you were to discontinue, then it likely would be possible to get a medical. But, I would expect that the FAA will want a lot of expensive testing to prove (to their satisfaction) that you don't have either ADHD or some type of sleep problem.

You really need to sit down with a well qualified AME before you shoot yourself in the foot.
 
If you were to discontinue, then it likely would be possible to get a medical. But, I would expect that the FAA will want a lot of expensive testing to prove (to their satisfaction) that you don't have either ADHD or some type of sleep problem.
The medication is verboten, but assuming the OP stops taking it I'm not sure the FAA would demand a lot of testing if the diagnosis was clearly fatigue due to a work situation.
You really need to sit down with a well qualified AME before you shoot yourself in the foot.
Definitely. And before you do, get the actual diagnosis from the doctor (the codes).
 
I just wanted to say my sons on adderall....and it is more than the honour. system. when he goes to see any doctor...the doctor can see that he was prescribed adderall because adderall is schedule 2 it is kept in some kind of computer database that any doctor he sees can look up. I imagine this would be true with an FAA doctor as well.
 
Greetings,
I was diagnosed with ADHD as a child. I outgrew the hyperactive aspect and was able to stop taking meds for it when I was about 15. I graduated high school without the meds and was able to join the Army after graduation. I served from 2003-2007 and was honorably discharged. After getting out, I used my GI Bill to go through flight school, first obtaining a FIRST CLASS MEDICAL CERTIFICATE! I earned my private pilot's license for single and multi-engine, complex aircraft, both in 2009 WITHOUT MEDICATION! In 2011 I became a full time single father of 3 which was a chore for the old thinker, to say the least, so I requested my primary care doc put me back on meds so i could better keep track of everything. Shortly after I began taking meds for ADD again, I went in for a flight physical to renew my medical certificate and was denied. I passed all my flight classes, tests, and became a licensed pilot without the meds and now that I'm on them and better able to multi-task than ever before, I'm unfit to fly! I miss flying dearly and I want to get my medical certificate back but haven't the slightest clue how to go about it or if it's even possible. Please help!
 
You have a rather high mountain to climb, especially if you did not show your previous diagnoses and Rx use on all your previous FAA medical apps.

I hadn't been on any type of medication for it since I was a child and I don't recall any of the applications asking about the conditions. The only reason it came up is because I was asked if I had any new medications. I had no idea it would be an issue. I just want to get back in the air.
 
As Mason stated. You have a large mountain now. Count on 12-18 months. Contact Dr Bruce and be 100 percent candid. He can smell BS a mile a way! You lie to him and your best shot is gone.
 
The way I see it, all the multitasking going on in the cockpit is great for ADD. Free the beast!

But the multitasking they are doing is jumping from one distraction to another without actually DOING anything that should be done. This is especially pronounced during a crisis, where "coping mechanisms" that people with ADD have used to mask their condition break down.

Your way of seeing it is fundamentally flawed.
 
As Mason stated. You have a large mountain now. Count on 12-18 months. Contact Dr Bruce and be 100 percent candid. He can smell BS a mile a way! You lie to him and your best shot is gone.

I'm an extremely patient man. If there's chance enough to make it worth my while, I'll do what it takes. I see Dr. Chien mentioned a lot in different forums. Does it matter if I live hundreds of miles away in a different state?
 
My impression from reading the bazillion posts about ADD / ADHD is that the FAA tends to be pretty reasonable about it. All they really want is for the airman to pass, while not on medications, the proper tests that should have been performed when they were diagnosed, but usually weren't. It's become a common situation for them to sort out, so they have an established protocol with refreshingly clear requirements.

Call Dr. Bruce or Dr. Lou, be honest, and go through the protocols. There's really not much else you can, or should, be doing at this point.

Rich
 
Lots of testing ahead. You have no choice but to go through it all if you ever want to fly again. And nobody here can help you with it. Welcome to the broken FAA medical system.

Talk to Dr Chien. I did this from NC to Peoria, it's not a problem.
 
Got an email about this about a week back....was that you?

I have no idea where this came from. From time to time in aviation you hear things that started with "It can't be so it cant be so it can't be so" which becomes "the exception must be so, the exception must be so the exception must be so".

Adderal and all the stimulants are grounding. They have such a profound effect on cognitive performance and the FAA can't control whether you are on it or off it, for a part-time Rx....as in the moment yo have the accident.

I would be very surpised if there is any truth to this. I can't think of a single condition where part-time use would be appropriate. I can see how a PMS or VFS interested company might want to troll for business.....and I've been to many FAA psychiatry meetings....

Which is interesting because the military Flight Surgeon used to give us this stuff all the time for a long cross country or an oddball backside of the clock NVG mission. He would also meet us or issue us with a "down" pill at the conclusion of the flight.
 
My impression from reading the bazillion posts about ADD / ADHD is that the FAA tends to be pretty reasonable about it. All they really want is for the airman to pass, while not on medications,
No.

They want proof that you don't actually have ADD / ADHD.

For those that do, you aren't going to pass the tests medication or not. And that's the end of your medical.

Of course, one can claim that there is no such thing as ADD and everyone will pass the test since the condition doesn't exist, but then would be sadly mislead.
 
Question on this dated, but recently alive, thread.

Are there actual designated HIIMS Psychiatrists? Or just ones that meet the criteria of the FAA? As in, are there ones that opt in to this program and have FAA training?

If someone wanted to try to reverse a diagnosis, do they need to be sponsored from an AME, or could they get the tests done directly with the approved psych, and if positive (yes - you have ADD) drop it. If negative on the ADD, engage Dr Bruce to help fight the fight?

Are the psychs in this program required to report to the FAA (if you went, that could blow up sport pilot too?).
 
If someone wanted to try to reverse a diagnosis, do they need to be sponsored from an AME, or could they get the tests done directly with the approved psych, and if positive (yes - you have ADD) drop it. If negative on the ADD, engage Dr Bruce to help fight the fight?

Terry, unfortunately the world is not black and white. The letters that the Approved Psychs must write need to address specific points in the diagnosis and in a specific way. This is the knowledge that a good HIMS AME brings to the table. You might be able to get by without one, but if your information package submitted to the FAA is incomplete or incorrect, you then have to refute that diagnosis too, and all this can get very expen$ive

The advice is to assemble the best medical team you can, with the best documentation you can before submitting to the FAA. Failing on the first try will cost you time and money. -Skip
 
Terry, unfortunately the world is not black and white. The letters that the Approved Psychs must write need to address specific points in the diagnosis and in a specific way. This is the knowledge that a good HIMS AME brings to the table. You might be able to get by without one, but if your information package submitted to the FAA is incomplete or incorrect, you then have to refute that diagnosis too, and all this can get very expen$ive

The advice is to assemble the best medical team you can, with the best documentation you can before submitting to the FAA. Failing on the first try will cost you time and money. -Skip


Thank you Skip - we wouldn't go to the FAA without Dr Bruce C. He has been so supportive in my 3 rd class quest historically, and so educational, I wouldn't tackle something like that without his input.

I was just curious if it were possible to see the test results etc. without starting a whole FAA thing (can you go to a HIMS Dr and learn the outcome prior to deciding how to proceed).

Also, most of the HIMS related info online was DUI related. Surprising to me (I'm too square).
 
You sure can. You engage them privately. The person doing the referral controls the work product. It's HIPAA.
 
That's the deal - if it really is ADD I don't think you outgrow it. Maybe you can learn to cope, but it might be that he didn't have it to begin with. The good Dr is best for this.

Most kids diagnosed with ADD or ADHD do outgrow it. Only a minority continue to have the condition in adulthood.
 
Most kids diagnosed with ADD or ADHD do outgrow it. Only a minority continue to have the condition in adulthood.
Most kids are probably misdiagnosed. ADD/ADHD is not something that you outgrow or otherwise spontaneously get better.
 
I am 25 and just recently had to do this. I was diagnosed with ADHD when I was 16 and was prescribed adderall. It took me nearly 2 full years of ridiculous testing and interviews to get my diagnosis reversed. Some of the most expensive and worthless examinations I could of ever imagined.
 
two full years how many tests did you have to do , i thought it was one 6- 8 hour test please give some details on the tests how many there are etc
 
Hello,
I was recently perscribed Adderall for ADD symptoms. I talked to my Primary Care Physician and she said that I was never "officially" diagnosed. There is no record of me being diagnosed with ADD on my records. My transcript basically says I am taking Adderall to cope with ADD symptoms for academic benefit. I have no psychological defects and I am backed up by a psychologist, seconding my normal cognitive function. My questions: Are there any loopholes I could get through? ( Such as: since I am not diagnosed, do I have to tell the AME or could I stop taking the Adderall 4 days before my exam, and have a clean drug test?) Technically, I am not diagnosed, just have a prescription for Adderall. Could I get around telling the AME since I am not diagnosed? It would not be lying, considering I don't have ADD, I just take Adderall.
 
Hello,
I was recently perscribed Adderall for ADD symptoms. I talked to my Primary Care Physician and she said that I was never "officially" diagnosed. There is no record of me being diagnosed with ADD on my records. My transcript basically says I am taking Adderall to cope with ADD symptoms for academic benefit. I have no psychological defects and I am backed up by a psychologist, seconding my normal cognitive function. My questions: Are there any loopholes I could get through? ( Such as: since I am not diagnosed, do I have to tell the AME or could I stop taking the Adderall 4 days before my exam, and have a clean drug test?) Technically, I am not diagnosed, just have a prescription for Adderall. Could I get around telling the AME since I am not diagnosed? It would not be lying, considering I don't have ADD, I just take Adderall.

Oh boy----this sounds like either your pulling our leg or your serious;y confused. How are you paying for the medication? If insurance is covering it then I'm sure it's got a recorded diagnosis somewhere.
 
I'm curious how this all works. I'm going for my medical soon. I don't even have a primary care doc. Are they going to want old medical recs? Do they drug test at the medical? Or is this all the honor system?
Only answer the questions asked, volunteer nothing. People screw themselves by volunteering information. You fill out the form before you show up, the doc looks you over and it's done (3rd class). My last medical took ten minutes.
If you lie on the form and they later find it out, you are screwed forever.
 
Hello,
I was recently perscribed Adderall for ADD symptoms. I talked to my Primary Care Physician and she said that I was never "officially" diagnosed. There is no record of me being diagnosed with ADD on my records. My transcript basically says I am taking Adderall to cope with ADD symptoms for academic benefit. I have no psychological defects and I am backed up by a psychologist, seconding my normal cognitive function. My questions: Are there any loopholes I could get through? ( Such as: since I am not diagnosed, do I have to tell the AME or could I stop taking the Adderall 4 days before my exam, and have a clean drug test?) Technically, I am not diagnosed, just have a prescription for Adderall. Could I get around telling the AME since I am not diagnosed? It would not be lying, considering I don't have ADD, I just take Adderall.

Contact a qualified, specialist AME. Call Bruce Chien ( www.aeromedicaldoc.com ), whose skill and expertise in this field without peer. Be absolutely straight, he can't help you without all the information (and won't, and shouldn't, if information is withheld). He's a great guy, and the best shot.
 
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