Medical Marijuana

A

annie moluous

Guest
Fighting chronic back pain, I have reduced my oxycodone from 30 to 5 mg/4 per day.
My neurologist suggests marijuana would be better for my health than the oxy.

IF I am one day able to quit the pain meds, I hope to regain my 3d class medical. I might try the injections, yoga is helping, etc.

My questions:
1. what is the strongest "pain relief" agent allowable to the FAA
2. are there any certification issues with the spinal injections?
3. how long must I be "off" the oxy before I can qualify, do I need special evaluations or ?
4. would there be any downside to taking my neurologist advice and using mj while I continue to wean off oxy-she suggests a mix of thc and cbd, she tells me that professional pilots are using the non-thc

I would appreciate any constructive feed back, please take this seriously. I certainly will hire a specialist before making any applications.
 
One of the AMEs will be along to answer the certification questions but I can tell you right now the medical marijuana will be a no go. I would not touch it with a ten foot pole if I were ever going to want to go for certification.

I recommend contacting Dr. Chien if you have been on the oxycodone for a long time as the certification might be tricky. You don't want to apply unless you are completely sure you will be certified. If you get denied that will lock you out of Sport Pilot. Assuming your medical expired and was never denied.

I suffer from chronic back pain and assure you I sympathize completely. I also had a case of RSD so severe I needed oxycodone for a while but got certified afterwards so it can be done but the AME will guide you through that. I can only suggest that MJ is not the way to go to wean down. You were taking 30 mg four times a day and now you only take 5 mg four times a day? That's just 20 mg every 24 hours? I was going to recommend tapering down to 20 or 30 mg per day then just stopping "cold turkey" but sounds like you're already there. Ideally take a few days off work because if you have been on it for a while you will have symptoms similar to a cold or flu. Pamper yourself just like if you had a cold, chicken soup, ginger ale and the like, Imodium for bathroom issues, and in a week or two you will be fine. That's the fastest way to start preparing for qualifying again for the medical.

The biggest challenge will be treating the back pain: It will be worse temporarily but that should improve as your body begins to readjust its own neurotransmitters and you might find with time it is no worse than it was while you were on the drug.

I make good use of therapeutic massage and chiropractic (if that is appropriate for your type of pain). I found the steroid injections to be of no use at all and the AME will have to speak to whether that affects certification. I also rotate between different types of OTC drugs and herbal remedies (not MJ but there are several legal herbs).

The lidocaine patches are very helpful. Salonpas is the OTC version. You can get them in prescription strength which work much better but would need to check that for certification.

Lifestyle changes are very critical for me. I cannot sit in a chair too long, I must do stretches and take walks, limit stress, stay hydrated, get enough sleep that sort of thing.

Good luck to you. You are not alone. Chronic pain is a hard cross to bear but hopefully the AMEs here will be able to help you get back in the air. If not at least it is worth asking.
 
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I reread your post and caught that your neuro says professional pilots use non-thc medical marijuana, that's news to me and I am interested in hearing the doctors' input. Is this acceptable to the FAA? Just because pilots are using it doesn't necessarily mean they told the FAA.:rolleyes:
 
annie moluous said:
Fighting chronic back pain, I have reduced my oxycodone from 30 to 5 mg/4 per day.
My neurologist suggests marijuana would be better for my health than the oxy.

IF I am one day able to quit the pain meds, I hope to regain my 3d class medical. I might try the injections, yoga is helping, etc.

My questions:
1. what is the strongest "pain relief" agent allowable to the FAA
2. are there any certification issues with the spinal injections?
3. how long must I be "off" the oxy before I can qualify, do I need special evaluations or ?
4. would there be any downside to taking my neurologist advice and using mj while I continue to wean off oxy-she suggests a mix of thc and cbd, she tells me that professional pilots are using the non-thc

I would appreciate any constructive feed back, please take this seriously. I certainly will hire a specialist before making any applications.
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Fortunately for Annie, Dr. Bruce is a pain specialist in addition to his aviation credentials....

So as always, he will be able to provide solid advice on how to achieve medical certification while using an FAA permitted treatment.

BTW, the medical marijuana will not be permitted. While it can help many dealing with chronic pain, there are adverse affects that make the FAA say, "Nope. Not Permitted".
 
AggieMike88 said:
BTW, the medical marijuana will not be permitted. While it can help many dealing with chronic pain, there are adverse affects that make the FAA say, "Nope. Not Permitted".
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Also, the FAA is a federal-level department, and remember that mj is still illegal across the board at the federal level. CBD might or might not be a different story, but I wouldn't bet my cert on it.
 
THC is the substance in marijuana that they test for and the acceptable level for this or marijuana is zero. The THC test is known to also detect some level of CBD, so that will get thrown out too. Cannabis base treatments will not work for pilots.

However, this sounds like maybe you are in a situation where you need to put your health first and worry about flying later. If you are in that much pain, sitting left seat in an airplane is probably not where you need to be. Back pain + even mild turbulence can be debilitating.
 
Yep, even if it were legal (and as far as the FEDS are concerned, it ain't), you couldn't fly with it.
 
bflynn said:
THC is the substance in marijuana that they test for and the acceptable level for this or marijuana is zero. The THC test is known to also detect some level of CBD, so that will get thrown out too. Cannabis base treatments will not work for pilots.

However, this sounds like maybe you are in a situation where you need to put your health first and worry about flying later. If you are in that much pain, sitting left seat in an airplane is probably not where you need to be. Back pain + even mild turbulence can be debilitating.
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You are right OP needs to put her (? annie ?) health first but I've been in that situation, where you've had a chronic pain problem that has received treatment, and it is gotten under control and you start to think about getting back to normal again. It all depends on the exact etiology of the problem, the diagnosis. It matters whether you're trending worse, stable, or trending better.

But you are right, one thing OP needs to face is whether it is unrealistic to fly again. But no harm in finding out what it will take to get the medical. If there's any chance, it's important she not accept the medical marijuana which will only complicate her case.
 
I think my post was misunderstood. I am a long way from flying. I do not play to fly with cbd or thc or using opoids. My question is whether using mj to help me is a problem for the FAA, in a future application.

What if my answer to the AME is something like this:

"It took me years but my back is finally better and I got the spinal injection and haven't used opoids for 6 months. I only use aspirin now."

Is it any worse to say:

"It took me years but my back is finally better and I got the spinal injection and haven't used opoids for 6 months. I only use aspirin now. But I did use medmj under Dr. supervision, but have not used mj for 6 months?"

I am looking for input concerning the effect of using mj sometime in the past. What is the FAA position on past use of mj? Is it a forever disqualification? Is there a time limit? What if someone smoked pot, legally or illegally, 2 years ago, but not since then?

I used to work with the IRS. There were policy manuals, available to the public, which stated IRS policy for many many issues. Is there such a policy manual for the FAA position on past use of mj?
 
My question is whether using mj to help me is a problem for the FAA, in a future application.
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Most definitely. As of this point, there is no FEDERAL legal use for THC or CBD. Any use, by definition, is illegal use under question 18n (even if you fail to report it there, you must report it in the medication field and that is going to trigger the same sequence), and going to trigger the substance abuse process.
 
First off, to medical marijuana. If you live in a state where marijuana is legal there’s a dose limit, like in Colorado it’s 10mg THC per dose. In Alaska it’s 5mg. Sure, there are ways around that but it’s established. In those states a medical marijuana card provides access to products with a MUCH higher THC dosage. If you find a pain doctor who’s sympathetic to marijuana you’ll probably get CBD as the useful compound. That’s widely regarded as the healing ingredient in pot and it doesn’t make you high. I give it to my dog every day and her activity is vastly improved with CBD. I have back pain and chemotherapy friends who use it with excellent results, too. If it was me? I’d try it for the back pain and I wouldn’t tell anyone because it’s none of their damn business.
 
original poster said:
I
I used to work with the IRS. There were policy manuals, available to the public, which stated IRS policy for many many issues. Is there such a policy manual for the FAA position on past use of mj?
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You’re looking for the Guide for AMEs.

I’ll save you some trouble. Here’s the specific guidance for history of marijuana use. Doesn’t matter if medical or recreational.

https://www.faa.gov/about/office_or...m/ame/guide/media/DrugUseDispositionTable.pdf

Here’s the deal: don’t try to hide it from the FAA; the application is a federal document. Falsifying a federal form is a stiffer penalty than smoking pot.
 
Understood, you don't want to use it while flying, just during tapering off the oxycodone. But what we are trying to say is that even then, it will complicate your certification. Again, I am not an AME and I hope @lbfjrmd or @bbchien will respond and clarify.

My understanding is the legality isn't the issue. You can in theory be an ex heroin addict and still get certified, IF you have undergone all the required tests and steps to get and stay clean. (someone correct me if that's wrong) The issue is that the more drugs you have used whether legal or not, the more complicated it gets and the more scrutiny you will receive. Even just to use it medically may raise more flags than necessary and cause it to be more difficult than necessary for you to get certified. Impossible? Probably not. But the FAA can make it pretty miserable and $$expensive to jump through all the hoops.

Docs what say Ye?
 
Rushie said:
Understood, you don't want to use it while flying, just during tapering off the oxycodone. But what we are trying to say is that even then, it will complicate your certification. Again, I am not an AME and I hope @lbfjrmd or @bbchien will respond and clarify.

My understanding is the legality isn't the issue. You can in theory be an ex heroin addict and still get certified, IF you have undergone all the required tests and steps to get and stay clean. (someone correct me if that's wrong) The issue is that the more drugs you have used whether legal or not, the more complicated it gets and the more scrutiny you will receive. Even just to use it medically may raise more flags than necessary and cause it to be more difficult than necessary for you to get certified. Impossible? Probably not. But the FAA can make it pretty miserable and $$expensive to jump through all the hoops.

Docs what say Ye?
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Well, if Marijuana was needed to come off of oxycontin, the agency will say that there was an oxycontin withdrawal syndrome--->therefore at least narcotic addiction. So this is several months of negative urines for both substances, then a HMS psychiatry evaluation, and if favorable can be certified. It will be a special issuance contingent on several more years of peeing in the cup.
 
I am also interested in the current state of politics of medical marijuana.

In trying to research this issue here and on other boards, it seems that whenever the word "marijuana" is mentioned that many other pilots seem to think some stoned out irresponsible hippie wants to endanger the skies, even when the non-THC containing CBD use is discussed. My take away is that "marijuana", regardless of form and lack of psychoactive effects is taboo.

Is this the FAA position?

My pain manager also claims that their clients are using non-THC, pure CBD for pain management, which include DOT drivers and FAA professional pilots.

Is it simply checking NO on the application and staying below the legal limit of THC? ( understand that some CBD products contain trace amounts of THC)

I understand that CBD does not interfere with judgment/motor skills but helps with chronic pain.

I also am not looking to fly while under influence, but if CBD is truly benign, why not?

Where can I find the FAA's policy on CBD use?
 
anonymous said:
I am also interested in the current state of politics of medical marijuana.

In trying to research this issue here and on other boards, it seems that whenever the word "marijuana" is mentioned that many other pilots seem to think some stoned out irresponsible hippie wants to endanger the skies, even when the non-THC containing CBD use is discussed. My take away is that "marijuana", regardless of form and lack of psychoactive effects is taboo.

Is this the FAA position?

My pain manager also claims that their clients are using non-THC, pure CBD for pain management, which include DOT drivers and FAA professional pilots.

Is it simply checking NO on the application and staying below the legal limit of THC? ( understand that some CBD products contain trace amounts of THC)

I understand that CBD does not interfere with judgment/motor skills but helps with chronic pain.

I also am not looking to fly while under influence, but if CBD is truly benign, why not?

Where can I find the FAA's policy on CBD use?
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Is CBD even approved for anything other than seizures in the USA? "Off label" use of prescription drugs could be a flag. (Even though CBD is likely to be relatively benign.)
 
CBD is not "on label" for anything. It's still officially a federal schedule I, officially having no medical use and high abuse potential.
 
flyingron said:
CBD is not "on label" for anything. It's still officially a federal schedule I, officially having no medical use and high abuse potential.
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But legal in several states, by prescription, for treatment of epilepsy. It's good that the Feds lack power over the states (beyond withholding funds).
 
Kenny Phillips said:
But legal in several states, by prescription, for treatment of epilepsy. It's good that the Feds lack power over the states (beyond withholding funds).
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Except that's not actually how it works. When there is a conflict between a state law and federal law, it is the federal law that prevails. In many cases the feds obviously decide not to pursue the issue... but they could. See Article VI.
 
deyoung said:
Except that's not actually how it works. When there is a conflict between a state law and federal law, it is the federal law that prevails. In many cases the feds obviously decide not to pursue the issue... but they could. See Article VI.
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Ah, the very poorly written Article VI. As mentioned, the Feds essentially have no power to control the states, except for withholding funds (which has been explicitly threatened several times). Not that that isn't a powerful incentive. Thus the drugs ARE legal in those states. There are many things that the States ignore, as well as the Feds. Driver's licenses are good anywhere. CCW or medical licenses are not.
And as mentioned, the FAA cares not. And I mean that in all possible ways.
 
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Kenny Phillips said:
[...] the Feds essentially have no power to control the states, except for withholding funds (which has been explicitly threatened several times). [...] Thus the drugs ARE legal in those states.
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Well, I'm not a lawyer, so if a lawyer wants to chime in here that would be cool, but I'm quite certain that you're simply wrong here. The feds choose not to enforce the law with respect to marijuana, but that's not because they can't legally do so. Don't confuse a lack of political will or resources for a lack of authority.
 
Folks.... In Post #16 of this thread, when Dr. Bruce answered:
bbchien said:
Well, if Marijuana was needed to come off of oxycontin, the agency will say that there was an oxycontin withdrawal syndrome--->therefore at least narcotic addiction. So this is several months of negative urines for both substances, then a HMS psychiatry evaluation, and if favorable can be certified. It will be a special issuance contingent on several more years of peeing in the cup.
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I believe the information the OP was asking for was provided. And if "Annie" wants more information about this for FAA Medical Certification purposes, then consulting directly with Dr. Bruce or Dr. Lou or another senior HIMS AME is the best course.

However, continuing to discuss and argue about how different States and the Federal view the legalities of cannabis, it's derivatives, and it's "products" isn't really what this sub forum is all about. That's more of a political and Spin Zone topic.

I am pointing this out to say, while the discussion/arguments are useful, it might need to be taken to a different venue. Otherwise we'll find this topic locked by the MC because it become "Spin Zone" fodder.
 
Let me ask this another, non-political, way.

Is current use of CBD disqualifying for a 3rd class medical?

Is use of CBD more than 6 months ago, but not in the last 6 months, disqualifying for a 3rd class medical?

Are there FAA guidelines that I can review regarding the use of CBD?
 
I did not know til I just googled it that there are two completely different kinds of CBD. The one derived from hemp is basically just a food supplement and I doubt would have any implications with the FAA unless possible trace THC gives you positive pee tests. I'm betting this is what the doctors are referring to when they say "professional pilots use it all the time".

The one derived from marijuana is a completely different story and I'm assuming that's the one OP is asking about. Here's a great run down of the legal status of both:

https://medium.com/cbd-origin/is-cbd-legal-legal-status-of-cbd-2018-d1b4a0ed42df

In other words, hemp derived CBD is not medical marijuana, even though it is derived from a "cannabis" plant, it's not the same species that we think of as marijuana.
 
This makes me wonder how one could guarantee there is no THC in CBD?

It seems to me that there would have to be trace amounts present.
 
It matters not if there is THC in it or not. All marijuana and marijuana extracts, THC or otherwise are sched I. They are "illegal substances" as far as the FAA is concerned. Use of CBD is DISQUALIFYING for pilots. The FAA will treat it as with any other marijuana use.
 
original poster said:
Let me ask this another, non-political, way.

Is current use of CBD disqualifying for a 3rd class medical?

Is use of CBD more than 6 months ago, but not in the last 6 months, disqualifying for a 3rd class medical?

Are there FAA guidelines that I can review regarding the use of CBD?
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JonH said:
This makes me wonder how one could guarantee there is no THC in CBD?

It seems to me that there would have to be trace amounts present.
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Here's a good article answering these questions:

https://www.aerocrewnews.com/health_fitness/fitness-corner/cannabidiol-cbd-oil/
 
flyingron said:
It matters not if there is THC in it or not. All marijuana and marijuana extracts, THC or otherwise are sched I. They are "illegal substances" as far as the FAA is concerned. Use of CBD is DISQUALIFYING for pilots. The FAA will treat it as with any other marijuana use.
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Not true according to the article I just posted. If the CBD oil is made from hemp, not marijuana, it is not schedule 1 and the FAA has no policy on it.
 
I disagree with the article. It matters not whether you make it from "hemp" or "marijuana." The article quotes scientific gobbledygook. Canabis Sativa is canabis sativa regardless of whether it's cultivated for high THC or not.

Furhter, for practical matters, CBD is not without psychoactive effects as well. Different biochemistry than THC, but that doesn't make it safe to fly with.
And as far as the LAW goes, you've not swayed me.

As late as 2016 there was a petition with the DEA to reschedule CBD and it was roundly denied.

https://www.deadiversion.usdoj.gov/fed_regs/rules/2016/fr0812.pdf
 
flyingron said:
I disagree with the article. It matters not whether you make it from "hemp" or "marijuana." The article quotes scientific gobbledygook. Canabis Sativa is canabis sativa regardless of whether it's cultivated for high THC or not.

Furhter, for practical matters, CBD is not without psychoactive effects as well. Different biochemistry than THC, but that doesn't make it safe to fly with.
And as far as the LAW goes, you've not swayed me.
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The fact that is appears to act as an anti-anxiety potion is a bit of a red flag.
 
You aren't the subject of this thread!

I' wager that lots of pilots in legal marijuana states have used recreational marijuana without reporting it to the FAA. It's only a matter of time before we see a policy like 8 hours bottle to throttle with alcohol.
 
Stewartb said:
You aren't the subject of this thread!

I' wager that lots of pilots in legal marijuana states have used recreational marijuana without reporting it to the FAA. It's only a matter of time before we see a policy like 8 hours bottle to throttle with alcohol.
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No, we have a policy that any use is contraindicated. The only way this is going to change is if the feds ever change the scheduling on this.
 
Ya, their regs have prevented pot use in the US for as long as I can remember!

If my wife, my kid, my friends were faced with managing pain using Oxy? I'd steer them to try CBD every time.
 
flyingron said:
I disagree with the article. It matters not whether you make it from "hemp" or "marijuana." The article quotes scientific gobbledygook. Canabis Sativa is canabis sativa regardless of whether it's cultivated for high THC or not.

Furhter, for practical matters, CBD is not without psychoactive effects as well. Different biochemistry than THC, but that doesn't make it safe to fly with.
And as far as the LAW goes, you've not swayed me.

As late as 2016 there was a petition with the DEA to reschedule CBD and it was roundly denied.

https://www.deadiversion.usdoj.gov/fed_regs/rules/2016/fr0812.pdf
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The fine print in that document you provided states that the mature stalks and sterilized seeds, and oil therefrom is excluded from the definition. How else do you explain that it's perfectly legal to sell or possess clothing or bags made from hemp?

Make no mistake, I am not saying hemp CBD is safe to fly with. I was just posting information on the difference between hemp CBD and marijuana CBD because it appeared none of us here including myself yet knew it.

OP says his neuro suggests THC-CBD while also saying pilots fly with non-THC CBD, which squares with the information in those articles. I was simply trying to understand what the OP was talking about.

My position on the subject is OP should stay away from ALL forms of CBD or medical mj. Even if the oil he gets is legal, it could still trigger a positive pee test, because it looks like it's hard to verify the quality of what you're buying.

But the biggest issue here is that the OP is looking for some substance to use to get off the oxy, which points to addiction. It's the behavior that's going to be a problem with the FAA, not whether or not medical marijuana is legal, or he uses a non-THC form of it.
 
Rushie said:
But the biggest issue here is that the OP is looking for some substance to use to get off the oxy, which points to addiction. It's the behavior that's going to be a problem with the FAA, not whether or not medical marijuana is legal, or he uses a non-THC form of it.
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And Dr. Bruce has already weighed in....

bbchien said:
Well, if Marijuana was needed to come off of oxycontin, the agency will say that there was an oxycontin withdrawal syndrome--->therefore at least narcotic addiction. So this is several months of negative urines for both substances, then a HMS psychiatry evaluation, and if favorable can be certified. It will be a special issuance contingent on several more years of peeing in the cup.
Click to expand...
 
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