Passing class III exam with history of prescribed painkillers?

[timshel]

Hey everyone, I have been infatuated with aviation my whole life, as I am sure much of you are. I was always interested in getting a PPL. Unfortunately as a teenager I was a passenger in a very bad car crash. I suffered very severe spinal injuries, and as a result was put on painkillers for years. my back slowly recovered but I still had chronic pain and the reality of having to take these painkillers was not making me a pleasant person to be around. Eventually I was prescribed a drug called suboxone, giving me a more stable life rather than the ups and downs of taking various short-lasting painkillers. I stayed on suboxone for years, but my back began to grow strong again, I began working out and making my muscles stronger to compensate for a messed up back. I have stopped taking this medication now and am drug-free.

Does anyone know whether having this on my insurance records will automatically disqualify me? will taking a clean drug test make a difference? I am new to the certification process, I was taken on a "discovery flight" and it made me want to try as hard as I can to make a private pilots license a reality, but I don't want to lie or do anything to risk my chances (if i even have any). Any feedback would be appreciated.

 

[Mason]

You took the meds as prescribed, for a legitimate reason, and are now off them. You will have to report the injury and treatment, but I don't think you will have any problem passing a medical, at least not for this.

 

[timshel]

Thank you for the reply. That makes me feel better, but I don't want to get my hopes up just to have an expensive doctor's visit ruin my skyward ambitions.

 

[timshel]

FWIW I don't have a criminal record, no DUI's, etc. I'm 100% sure I can ace the rest of the medical exams. 20/20 vision, no other health problems than a bad back and the painkillers. I feel healthier than ever now! I imagine they would like to see some confirmation that I have ceased taking the medication and am stable--I can certainly have my GP vouch for me, but I don't know too much about the FAA's guidelines regarding having a history of prescription drug use. I am ignorant to a lot of this so i appreciate all the advice I can get. I would think that a healthy, sober flight trainee wouldn't have a problem but I know the FAA doesn't mess around.

 

[Capt. Geoffrey Thorpe]

I would not pin your hat on an unqualified opinion from someone who is not a well qualified AME. I would schedule a consultation with a Senior AME before committing to an FAA medical. Or, at a minimum, run through the AOPA turbo medical - you can get a free 6 month trial membership.

Whatever you do, don't take the actual medical exam until you can be confidant that you can pass and you have any and all potentially required documentation on hand.

 

[timshel]

I would not pin your hat on an unqualified opinion from someone who is not a well qualified AME. I would schedule a consultation with a Senior AME before committing to an FAA medical. Or, at a minimum, run through the AOPA turbo medical - you can get a free 6 month trial membership.

Whatever you do, don't take the actual medical exam until you can be confidant that you can pass and you have any and all potentially required documentation on hand.

Thanks for the reply. I definitely agree with you on that, I want to do it legit. what is the turbo medical?

 

[Skip Miller]

Suboxone is not listed in the AOPA database which means I can't tell whether it is approved or not. Google tells me the generic name is Buprenorphine, a narcotic. Now that you are off it, I believe you can get a medical but the narcotic factor may cause you to need to jump through a hoop or two. Ask your AME.

-Skip

 

[flyingron]

If you are CURRENTLY taking the medication, you will NOT be approved. It is disqualifying. If you are off the medication (and the underlying reason you were taking it is not also still present and disqualifying) this should NOT be a problem. What you don't want to get caught at is a lie by omitting this if you are still taking it or still have the issue that you were taking it for. We had a crash up here in NJ where a prominent pilot (a doctor himself) was dosing himself with such pain killers for an underlying migraine condition. It wasn't brought to light until he crashed killing three.

 

[Capt. Geoffrey Thorpe]

Thanks for the reply. I definitely agree with you on that, I want to do it legit. what is the turbo medical?

"As a supplemental planning tool, AOPA’s TurboMedical® is an interactive online medical application planning system designed to help you identify any potential problems that might result from your MedXpress application. TurboMedical replicates MedXPress, but takes it one step further by providing you additional guidance on what documentation you will need for the FAA based upon your responses to the questions asked on the FAA application. Having the necessary records with you when you see the AME can often be the difference between an office issuance and a deferral that could result in weeks or months of waiting before the FAA issues your medical certificate."
https://www.aopa.org/go-fly/medical-resources/turbomedical

 

[timshel]

If you are CURRENTLY taking the medication, you will NOT be approved. It is disqualifying. If you are off the medication (and the underlying reason you were taking it is not also still present and disqualifying) this should NOT be a problem. What you don't want to get caught at is a lie by omitting this if you are still taking it or still have the issue that you were taking it for. We had a crash up here in NJ where a prominent pilot (a doctor himself) was dosing himself with such pain killers for an underlying migraine condition. It wasn't brought to light until he crashed killing three.

Yep, I am off of the stuff and healthy. I certainly would not want to risk my ability to fly by doing so.

 

[azure]

I'm not an AME, so take what I'm about to say in that light and with a grain of salt. If Dr. Bruce Chien answers your question here, then you can ignore everything I (and everyone else) writes.

But to my understanding, the painkillers are NOT an issue if you are off them (and have been for a reasonable period of time, say, at least 5 times their biological half life). In fact, you do not need to, and in fact SHOULD NOT list them under medications you are currently taking.

The injuries are a different story.

You list doctor visits within the last three years and the reasons for them, diagnoses received, treatment if any. That's it.* The injuries (and the painkillers) will come up in the course of that, or during the AME's quizzing you about those visits. The FAA is concerned with your recovery from the injuries, whether you have any residual disability from them (including ongoing pain), and what the chances are for your developing any degree of disability down the line. If you have any residual disability I'd expect you would need a special issuance. If there is any risk of sudden paralysis or the like, then you could have a problem. In any case I would expect to be deferred. But if you are completely recovered with no remaining disability or a "ticking time bomb" that could incapacitate you at any moment (and that would be in the FAA's judgement, not your doctor's), then you should eventually be issued.

The advice to see an experienced AME who specializes in difficult cases for a consultation is good - don't just fill out an 8500-8 and stumble into an AME's office for a 3rd class exam or you could face a denial, which has a number of consequences including being locked out of flying under light sport rules.

But don't worry too much about the painkillers - again, as long as you are off them now and have no foreseeable need for them, the fact that you used them previously (with a legal prescription) shouldn't be an issue.

*You also answer whether you have been diagnosed with certain conditions ever in your life. I don't recall seeing back injuries among those questions, but it's been a while so I could be wrong.

 

[timshel]

I'm not an AME, so take what I'm about to say in that light and with a grain of salt. If Dr. Bruce Chien answers your question here, then you can ignore everything I (and everyone else) writes.

But to my understanding, the painkillers are NOT an issue if you are off them (and have been for a reasonable period of time, say, at least 5 times their biological half life). In fact, you do not need to, and in fact SHOULD NOT list them under medications you are currently taking.

The injuries are a different story.

You list doctor visits within the last three years and the reasons for them, diagnoses received, treatment if any. That's it.* The injuries (and the painkillers) will come up in the course of that, or during the AME's quizzing you about those visits. The FAA is concerned with your recovery from the injuries, whether you have any residual disability from them (including ongoing pain), and what the chances are for your developing any degree of disability down the line. If you have any residual disability I'd expect you would need a special issuance. If there is any risk of sudden paralysis or the like, then you could have a problem. In any case I would expect to be deferred. But if you are completely recovered with no remaining disability or a "ticking time bomb" that could incapacitate you at any moment (and that would be in the FAA's judgement, not your doctor's), then you should eventually be issued.

The advice to see an experienced AME who specializes in difficult cases for a consultation is good - don't just fill out an 8500-8 and stumble into an AME's office for a 3rd class exam or you could face a denial, which has a number of consequences including being locked out of flying under light sport rules.

But don't worry too much about the painkillers - again, as long as you are off them now and have no foreseeable need for them, the fact that you used them previously (with a legal prescription) shouldn't be an issue.

*You also answer whether you have been diagnosed with certain conditions ever in your life. I don't recall seeing back injuries among those questions, but it's been a while so I could be wrong.

Thanks for the reply. I have glanced over the form online (I don't know if its a current version or whatever), and you do have to check whether you have had substance dependence in the last two years. I imagine I would still have to check that, or since its prescribed maybe not? I don't know.

In terms of how my back is doing now--it's pretty good. I can't do any significant running, but other than that I am not affected other than occasional pain which i can live with. Being on those drugs is no way to live. I would hope that the AME could check it out instead of seeing a specialist, MRIs, X-rays, etc.

 

[azure]

Thanks for the reply. I have glanced over the form online (I don't know if its a current version or whatever), and you do have to check whether you have had substance dependence in the last two years. I imagine I would still have to check that, or since its prescribed maybe not? I don't know.

I'm pretty sure they're talking about "substance dependence" in the context of abuse. Abuse can happen with a prescription or without, but unless you were abusing as opposed to using for pain control, I don't think you're obliged to check that box and personally I wouldn't.

One way you could do this is to fill out the form to the best of your ability and make an appointment with a difficult-case AME, but make sure to specify that it's for a consultation and not a 3rd class exam. Carry the confirmation number from the MedXPress session with you in case the AME says you have nothing to worry about, do you want to go ahead with the exam? Many AMEs will do that. Then, and only then, give him the confirmation number.

During the consultation, just be forthcoming about everything. Don't hide anything. If the AME thinks you should have checked the substance dependence box then he will say so. You can't do anything about it at that point, but if you decide to go ahead with the exam then once he enters the confirmation number and takes your exam "live", he can check it for you (effectively if not literally). As long as you give the AME any information that could possibly be relevant, the details of what boxes you check on the 8500-8 just aren't important. The final report the AME sends in to the FAA is what is going to count, which includes your 8500-8 and any modifications and notes the AME makes.

BTW you can always bring up a current version of the 8500-8 without actually filling it out for submission by registering from a throwaway email account. If you don't fill out and/or don't submit the form, it disappears after some time (I think 60 days). In fact, it disappears anyway unless "activated" by an AME before that time.

 

[timshel]

Ah got it. Yeah, definitely want to do a pure consult first so I can figure out hoops I need to jump through. I would rather have to wait longer, or do some potentially annoying things to reassure the AME than risk denial. Thanks for the advice!