I got the following from a major airline: Dr Fowler, I have a HIMS question for you. As you may remember, I used to be the HIMS Committee Chairman at my airline, but when I transitioned to Chief Pilot I passed those duties to someone else. Recently, the new HIMS rep came to me concerning an individual who, several years ago, self-disclosed an alcohol problem and entered the HIMS Program through our company. This pilot went through a 30 day out-patient treatment, obtained a peer sponsor, completed 90-in-90 and received his Special Issuance FAA Medical through an AME near his home. After 2 or 3 years he was released by his AME from regular monitoring and now, after a new marriage to a Vietnamese national, has relapsed and was observed by the current HIMS rep in public consuming alcohol, though not apparently drunk. He confessed this as a practice and that his new wife does not like his drinking (indicating that he likely gets drunk). This pilot self-disclosed and so was never "officially" diagnosed as alcohol-dependent. Still, he understood that maintaining long-term sobriety was a condition required by the HIMS Program. My airline does not have a contract with HIMS graduates that would force this pilot back into HIMS as a condition of employment, but I'm certain after this that we will see that happen. From an HIMS-AME perspective, what is the process for handling a relapse after release from regular monitoring and the requirement for a Special Issuance Medical? The pilot has been told by our Union HIMS rep to contact his AME, but we have no proof that he has done that. What would you counsel in that respect? The guy has a problem; he knew it before; he knows it now. Anything legal we might need to know? Thanks! my initial response: 1st ... it's the airline's responsibility to immediately ground a pilot that is suspect (ie alcohol) and report same to the FAA. It will then be up to the FAA to take action. A better route would be for the pilot to self report and seek help from the company and the FAA. This disease is one of chronicity ... and relapses. Major life changes are ripe for such. Dr. C's comments would be appreciated too.