substance abuse and certification

Discussion in 'Medical Topics' started by lbfjrmd, Nov 22, 2015.

  1. lbfjrmd

    lbfjrmd Pre-takeoff checklist

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    Q: I am soon to be denied on my first attempt at a 2nd class medical due to my past alcohol abuse. I was hoping to gather some information about what to do after the denial. I have 3 years sober right now but I didn't do it using AA or any of those types of programs so I was told my sobriety is not valid. Is there any hope aside from getting into AA for X amount of years and then reapplying?

    A: Your sobriety is good and to be congratulated. You do not have to use AA or any program ... but sobriety has to be documented especially with 1st class. But you are seeking other than ... so we shall discuss that. (As usual any letters you have received from the FAA are helpful to me). I suspect you will have to go the HIMS route and you could anticipate flying in about 6 months after it officially begins with the FAA. But it is possible, if the FAA gives you the option, to document your sobriety with letter(s) from any sobriety community, pastors, doctors, etc for the past 2 years. Again it depends on your denial letter and options made available to you by them. I have many pilots with problematic alcohol abuse in their past ... and for 3rd class if it have been > 2 years some documentation usually suffices. A 2nd class allows for commercial flying and come with more hoops to jump through ... a thought for you to ponder if flying for hire is not in your immediate future.

    anonymous airman - DM
     
    Last edited: Nov 23, 2015
  2. lbfjrmd

    lbfjrmd Pre-takeoff checklist

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    Q: First request by FAA was for an explanation about my last arrest and a copy of my driving record . I provided those things as well as 3 character reference letters for good measure and they then sent me back a request for a substance abuse evaluation. I went to an evaluation but the evaluator told me I was abstaining but not in recovery (due to no affiliation with AA) and she told me that any report she wrote up would not be very favorable. I figured I'd be better off letting the 60 day time period lapse than to send the FAA such a report so I told her not to bother writing me a report.
    December 1st will be the 60 day limit so thats where I stand. I had given up but figured I'd give it one last ditch effort. Your advice appreciated.

    A: For non-pilots recovery is in the eyes of the beholder! I do not think any professional can pronounce one in recovery and attendance at AA is not required. What you got was typical for the standard civilian type eval. For the FAA sobriety has to be documented ... or as i indicated previously - with self stated 2+ year sobriety it is possible for anything less than 1st class. New information you have now revealed to me is the ARREST! To let the FAA request time out ... or not ... that is the ?

    Requesting the HIMS route covers all bases (sub abuse eval, shrink, documents sobriety etc), is quicker for most without your stated sobriety, costs much more, but with the arrest it may become your only option. I think it would be better to send what you have and again state your sobriety date; or request the HIMS route. I would respond. You may elect to bag flying ... but you CAN get a medical. Your decision.
     
  3. lbfjrmd

    lbfjrmd Pre-takeoff checklist

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    Q: Ah yes, multiple arrests actually. All of which the FAA knows about and the only one they asked for info on was my most recent (2011) for fighting in public. They asked if alcohol was involved and I had to honestly say it was since I was at a bar when the altercation took place. Wouldn't have been there if I didn't drink. 2003-Possession of marijuana. 2003- DUI. 2005- Possession of alcohol by minor. There are other arrests too but they aren't related to booze or drugs so I'll spare you the details unless you want those too. That 2011 arrest was my last offense of any kind. I can pass any amount of random drug/alcohol tests for however long I just didn't want to have to go fake reliance on AA to appease the FAA. I don't have an evaluation to send the FAA so all I can do at this point is wait for the denial.

    A: send in the sub abuse evaluation you mentioned. Reply! With this additional info i am pretty sure you will need to request - or FAA will recommend a HIMS approach ... for any class medical. If you decide to pursue, have any primary care doctor start random urine full drug testing with EtG and EtS ... at least 14 tests in a 12 month period. Also find a facilitated group meeting for drug and alcohol counselling and begin weekly attendance. Good luck.

    ps fax or email me FAA letter(s) including the last one you will get in Dec or Jan. I am always learning too! lbfjrmd gmail 8504335881
     
  4. Unregistered

    Unregistered Guest

    Is it a similar procedure required, if you were taking medications not reported to AME and on medical, and the FAA finds out, and they pull your medical? How do you get back in the air?
     
  5. lbfjrmd

    lbfjrmd Pre-takeoff checklist

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    if it was a prohibited med would be the problem. Either apply honestly (best) or write them and ask. Mental Health 99% requires HIMS! Substance abuse 98%. I always submit deferred and wait for their response ... i never rec sending unrequested info.
     
  6. lbfjrmd

    lbfjrmd Pre-takeoff checklist

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    so airman elected to not respond to FAA. Got his letter today for him to surrender an un-expired certificate. Ball is now in his court.
     
  7. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    The original "I don't know it all" of aviation.
    Lou, I like the Q&A thing you're doing here. Reads like some of the other helpful articles in various aviation periodicals.

    So if there are other topics of interest to you where you think write ups like this would help, I encourage you to them in this format.
     
  8. RJM62

    RJM62 Touchdown! Greaser!

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    You can lead a horse to water...

    Doc Lou, I want to thank you for your contributions here. You have some pretty huge shoes to fill, but it's also becoming apparent that you have some pretty big feet. Thanks for your help, advice, and information.

    Rich
     
  9. lbfjrmd

    lbfjrmd Pre-takeoff checklist

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    :wink2:
     
  10. lbfjrmd

    lbfjrmd Pre-takeoff checklist

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    Hi again, sorry to keep pestering you HIMS/AME flight doc

    I'm really considering selling a vehicle of mine to afford the HIMS route but I have a few more questions about it.

    1. You mentioned your fee is 1000/year, is this whole thing a 1 year ordeal or 2?

    2. Are the shrinks in Atlanta looking for me to be "in recovery" or what? Like I've said before I don't use any programs to maintain my sobriety so I would hate to spend the three thousand dollars on them just to find out that I don't "pass" their tests.

    3. How much can I expect to pay per urine screening and approximately how many will I be called to do per month? Just trying to get better handle on what this will end up costing me.

    4. During this process am I allowed to continue my training? I know I can't solo without a medical certificate but I'd like to at least train up til the point of soloing.

    I think those are all the questions I had. Please let me know at your earliest convenience.

    ************

    anonymous really wants his pilot medical! So in response: yes you can continue to train. ~14 random urine testing with both metabolites of ethanol - jeesh i'm guessing but say $30. 1st year shrinks cost you about $2500. The special issuance last 5 years, maybe less for 3rd class. Years 2 - 5 assuming you do not fall off the wagon, you only see one shrink once a year and me quarterly. BUT ... the documented sobriety starts when you begin documentation AND attend weekly facilitated group meetings for substance abuse. Then a few months later you see the shrinks. AA, Birds of a Feather, Most Excellent Way etc ... good for your recovery but not required by FAA. My fee $1k per year ... usually 2 or 3 years for a 3rd class, 5 years for 1st and 2nd. So you may need to sell a car or 2 or 3 if they are clunkers! I think you are fairly young. Big decisions ... nothing like spending a shixt - pile of $$$ to begin a new career!

    ps i myself am in recovery - 16 yrs - and went through all of the above and much much much more to keep my medical license!!!!
     
  11. lbfjrmd

    lbfjrmd Pre-takeoff checklist

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    I read your post. I thought in your email the other day you said that for 3rd class I wouldn't need to do any group meetings? Did you just mean AA isn't required but some other regulated weekly meetings would be required?[/QUOTE]

    maybe not ... after you get the special issuance. Every case is a little different ... to the FAA. 1st big step is to get shrinks say you are fine and in recovery.
     
  12. Boeing76

    Boeing76 Filing Flight Plan

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    I have a stressful problem and need answers. Last year the FAA denied my third class medical because they saw records that I was smoking marijuana for a while due to my phychiatrist putting down that info in my history while I was visiting her. I'm only 20 years old and working on my private pilot certificate. I have done my solo back in 2014 and haven't flown since today September 19. I've been sober since may of last year due to this problem. The FAA just sent out a letter saying I have to take a 5 panel drug screen in the next 48 hours and see a HIMS/AME psychiatrist and be in a drug abuse program for a minimum of a 12 month period and do 14 random drug test for abstinence. The problem that is stressing me out is will I be able to continue my training while seeing the HIMS and doing he program at the same time ?or do I have to Waite 12 months and complete the program and then start flying?
     
  13. Rushie

    Rushie Pattern Altitude

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    As far as I know you can fly you just can't solo or act as PIC. Good luck with all of this.

    Unfortunately the message, loud and clear: Never, ever tell any doctor anything. :(

    No, that's not advice. But you just learned the hard way; there is no confidentiality anymore, none, zip.
     
  14. Ravioli

    Ravioli Final Approach

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    Really?

    The lesson isn't "Don't smoke pot?"
    The lesson is "don't tell your psychiatrist?"

    And of course every right thinking, pot smoking, 20 year old sees a psychiatrist who can rat them out to the FAA.

    At least he had the presence of mind to post anonymously to the internet on a thread started by a doctor.
     
  15. Rushie

    Rushie Pattern Altitude

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    No, you completely misunderstand me. I'm saying that message will be the net effect. I'm not saying that's the right message.

    Much like the way people don't want to report snoring because they'll get caught up in the sleep apnea testing. It's the unintended consequence. This will dampen people's willingness to tell their doctor they smoke pot, which is a terrible thing.
     
  16. Ravioli

    Ravioli Final Approach

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    I know I can be a bit oblique at times... but your declarative statement, with your added emphasis, seemed loud and clear.
     
  17. Palmpilot

    Palmpilot Touchdown! Greaser!

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    Sure, if you edit out the qualifying statement below it. :rolleyes1:
     
  18. Ravioli

    Ravioli Final Approach

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    How does that qualifying statement negate the premise?

    "This isn't advice, but..... here's my premise restated."
     
  19. Palmpilot

    Palmpilot Touchdown! Greaser!

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    "No that's not advice" negates the premise that the statement "Never, ever tell any doctor anything" which immediately preceded it was advice.
     
  20. Ravioli

    Ravioli Final Approach

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    Followed immediately by: "But you just learned the hard way; there is no confidentiality anymore, none, zip."

    c'mon.
     
  21. Mike Smith

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    Regardless of whether or not smoking pot is a good idea, the idea that there is no confidentiality with your doctor is chilling. We tend to look at these scenarios only through the lens of an faa medical, but once the genie is completely out of the bottle imagine the ramifications of the fear of telling your doctor something that could cost you your job? In the case of the commercial pilot, it already is.
     
  22. Rushie

    Rushie Pattern Altitude

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    That was stating a fact, or at least what I believe to be a fact, and in no way negates that it does not drive my advice. My advice would be: "Be truthful with your doctor, despite the fact that it will not remain confidential. Then, if you apply for something that will dig into your medical history, be proactive and address the history with the right consultant before making the application."

    My statement about there being no confidentiality and my tongue in cheek statement about never telling your doctor anything refers to the fact that nothing observed remains unchanged by the observer as shown by quantum mechanics, and it applies just as surely to human behavior. But bureaucrats and politicians are not known for their deep insight. When you shine a spotlight on people's behavior, they will alter it. Simple as that. Hence the FAA looking at all our medical records causes us to behave slightly differently in creating them. Because you want that change to be pilots won't smoke pot doesn't make it so; the change will likely just be, they will stop yapping to their doctor about it.

    I'm not the first to realize this; in fact the FAA itself did when it created the SSRI approval path for unipolar depression. Pilots were not getting treatment for depression due to fear of losing their certification. But there is a trade off point where prying into people's personal business stops yielding a social benefit and starts resulting in an overabundance of stealth and duplicity and in the case of not being honest with your doctor, harm to your health.
     
  23. wsuffa

    wsuffa Touchdown! Greaser!

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    In the present world, with the Internet, electronic health records, insurance companies, the MIB, and state/federal regulations, there really is no such thing as "confidentiality" or "privacy" any more. Much of our society has traded privacy for convenience. And you might as well assume that the government or an employer can get any info on you that you want.

    A recent article about how Vermont's single payer health care had failed noted that it's replacement involves "coordinated care" which means that doctors share data with other doctors, hospitals, and social workers as part of the health care process. Great if it brings down cost, bad to the extent tha what you tell one will end up with everyone else.
     
  24. Rushie

    Rushie Pattern Altitude

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    I am so sorry to hijack the flight doc's thread, and I think the Q and A format is a wonderful idea. I hope the takeaway message from my derailment is to be proactive in addressing these things before you apply - too late for Boeing76 although I assume he likely still would have ended up with the whole HIMS and pee test ordeal, but if he'd started out in 2014 by consulting this AME he wouldn't now be stuck not being able to solo for another year or more.
     
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  25. Goliath737

    Goliath737 Filing Flight Plan

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    I have a similar situation I am dealing with and would truly appreciate any response in overcoming my dealings with the FAA. The Matter at hand is Title 14 CFR, Section(s) 67.107(a)4, 67.207(a)(4), 67.307(a)(4) Medical Standards and Certification due to my Substance (alcohol) dependence, evidenced by tolerance manifested by elevated BAC. I am 26 years old, currently obtaining a Bachelors in Aviation as I work endlessly to graduate and move forward someday becoming an Aviator. In June 2016 when I was 24 years young, I've been arrested two times for driving under the influence of alcohol. I was at a game party watching the NBA finals Golden State Warriors v.s. Cleveland Cavaliers battle. After Game 1 finished, I left the parlor and received my first d.u.i with a BAC of (0.28). Within the same year, in the following month of August 2016, I was arrested less than a mile away from my house with a BAC of (0.14). After reading the following thread, I thought to perhaps get my predicament involved to inform others dealing with similar situations, as well as receiving some helpful advice. I've defeated most of my legal troubles but my main concern then and still has been is the FAA...

    • December 27, 2017, I submitted my very first Medexpress Application to get the ball rolling as I foreseen the denial coming.
    • Jan 04, 2018 - I attended an appointment a set with an AME (non-HIMS) to evaluate my circumstance, I filled out the application accurately providing correct remarking to my background and admitting to my recent arrests due to alcohol, everything was fine up until this point. Automatically I was deferred.
    • January 10, 2018, The FAA responded with a Consideration which I assume to be standard for as they requested a personal statement for each arrest/conviction, court documents, police arrest documents, and information on separate arrest when I was 19 years old Misdemeanor batter p.c. 242. I submitted everything within 15 days of the 30 days given.
    • February 23, 2018 - Under the CFR mentioned in bold above, I've been denied. In response, I drafted a reconsideration letter under Title 14 CFR Section 67.409 and sent back to specifically addressed to the Federal Air Surgeon in Oklahoma. which they received on March 10, 2018
    From this brief timeline, I've managed to continue my education, pay off court-ordered fines, and visit a driver performance course every Thursday for 2 hours for an 18month period that I have almost satisfied. It is understood the FAA doesn't care too much about these courts mandates, however, going through this process has really awakened a person inside of me that is more fulfilling, noble, full of integrity, and wiser young adult. (Not sure if 26 is considered young anymore but in today's society I think it merits.) Since the second letter I received I've been consistently calling AOPA as well as the FAA for further information. I cannot expect for anyone to predict my outcome but Any advice is appreciated as I will not let my Dreams go a waste because of moronic decisions I've made in my young past. I've researched a few HIMS-AME's in my area, and I am skeptical of quickly jumping towards this route for not hearing from the FAA. Could this possibly increase my chances of obtaining a Third class medical to pursue my Private License? Can I still pursue to dream careers of becoming a Charter Pilot? ATP sometime in my far future? Any answers are appreciated even brutally hohonest onces. Peace & Love.

    -Goliath737
     
  26. Clip4

    Clip4 En-Route

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    25 months ago you had 2 DUIs within 80 days of each other. The FAA is going to deny your application from today until enternity - Nothing is going to happen without HIMS and nothing is going to happen quickly or inexpensively.
     
    Last edited: Aug 19, 2018
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  27. murphey

    murphey Final Approach PoA Supporter

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    Your first mistake was dealing with the FAA with no knowledgable/expert support.

    Contact lbfjrmd or Dr Bruce Chien directly. Do not pass go. Do not collect $200.

    aeromedicaldoc.com is Dr Bruce.
     
  28. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    @Goliath737....

    Based on what you have provided, striking out on your own without guidance from the right AME was not the best thing.

    From my current "alcohol and the medical certificate" cut/paste...
    ___________________

    The FAA acts as a warden to prevent individuals that have developed a tolerance for high alcohol limits from obtaining and exercising pilot privileges. So for individuals such as yourself, the ball will be placed squarely in your court to prove beyond shadows of doubt that you are willing to prove you are worthy of flying privileges by doing everything they will ask of you.

    The letter you may have gotten from the FAA medical division will have the specific details of what the FAA wants in order for you to apply for a medical certificate with a Special Issuance for alcohol dependency. Search back through Medical Topics forum, and you will see that the requirements will include
    • A $6000 to $10,000 budget to pay for they various things the FAA will require of you.
    • A neuro cognative psychological screen of extreme depth that only a very few HIMS psychologists can administer, paid for out of your pocket
    • Direct sponsorship with a Senior HIMS AME, to whom you report to frequently and to whom you must demonstrate you are doing what is required to earn the medical certificate. There are very, very few of these AME’s, so plan on frequent travel to see the one who is working your case.
    • 90 days of intensive alcohol dependency treatment. Could mean in-patient.
    • 100% sobriety and abstinence from all alcohol. Wine with girlfriend and beer or drinks with buddies is now verboten,
      für immer
    • Documented attendance with alcohol dependency meetings
    • Many, many random pee in the cup whiz quizzes
    • And much, much more.

    All of this must be done in exacting detail for you to be granted a Special Issuance medical. Only after continued proven 100% sobriety for a very long period of time will you be allowed back into the normal issuance group.

    Reading this and then saying back to us, “but I am not an alcoholic, I do not have a drinking problem” is an incorrect response.

    That you were involved in two DUI incidents is a strong indicator that, per the FAA standards, there is a problem.

    The correct response is saying, “fine, I have a problem. Let’s get with meeting the requirements and make this thing happen.”

    Humble and humility wins the day over arrogance and unwillingness to accept and change.

    And based on what you wrote, you show a desire to change. Good. But quit trying to do this alone and hire either Dr. Bruce Chien (@bbchien) or Dr. Lou Fowler (@lbfjrmd ) to be your Case manager.
     
  29. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    Just re-read you post and wanted to comment on this. The FAA is going to require the entire gamut of you and possibly more.

    BAC of 0.28 and operating a motor vehicle is going to put you in the "functional alcoholic" and "high alcohol tolerance" category. And the FAA is very aware that a human doesn't get there with infrequent drinking. One only gets there with frequent consumption of significant quantities of alcohol.

    The written letters you mentioned are not going to be enough. You must start a lifestyle of proven sobriety immediately. This means zero consumption, attending very frequent AA meetings (with someone documenting your attendance), very frequent UA's proving you are clean, and much, much, MUCH more.

    If you are not willing to commit to the program, then let the dream of commercial pilot go, enjoy your drinking, and move on to something other than flying airplanes.
     
  30. Goliath737

    Goliath737 Filing Flight Plan

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    FARLOW,

    Thank you this was exactly the response I was looking for. Along with Saving and working countless hours of overtime while still attending school I will rise to the challenge. Going through this without the right AME was in fact my own fault as i went to the nearest in my community. As I am doing my research, Dr. Bruce is on the other side of the region from me. How would this be possible. Don't get me wrong i'm sure not the richest, but am willing to invest in the right people rather than waste my time. Your response is appreciated.
     
  31. Goliath737

    Goliath737 Filing Flight Plan

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    With respect to this addition, I can assure you I've placed myself in a hole and made this unwise decision on my own. Could i simply walk into a Kaiser hospital for such programs? Besides the driver performance program I couldn't even point in the direction where i could find an AA or any of these sponsorship's you are suggesting and even now.
     
  32. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    First step would be calling me Mike

    Second would be contacting Dr. Bruce via the "How To Start" page on his website.

    He will respond by email to start the initial conversation, which continues by email.

    Next is hiring him to be the case manager. He will provide you the list of steps to do and list of resources that aid in completing the steps.

    You start working the steps.

    Once you have all of of the required documentation gathered up, you send it to Dr. Bruce for review. Once reviewed, if Dr. Bruce feels you will be successful, then he will schedule your official exam at his office in Bolingbrook, IL. (Note: everything before this was done "remotely". You don't go to his office unless he is confident of a successful outcome)

    You purchase an airplane ticket and fly out to his office.

    After the exam, the final packet of information is assembled and sent to FAA medical. Then you wait for the FAA to decide your fate. And this wait could be a very long time, especially if your situation warrants review by the FAA's top psychologist in Washington DC.

    For more how it works detail, find the recent threads and posts by Cogscreamer.


    A final and very, very important note is that Dr. Bruce does not have time for airmen who will just be a waist of his time. His case load and "outside of the office" workload is HUGE. So you must be both honest with yourself and him that if once the journey starts, it will go all the way with no dodging, lying, or argument. If that last bit starts to happen, you will get shut out from his help.
     
  33. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    The original "I don't know it all" of aviation.
    I see you acknowledging that you typed "placed yourself in a hole". But are you ready for the long hard journey to be 100% sober? Taking an inventory of yourself, your life, your relationships, and the stresses these create, can you honestly say that you won't return to drinking when they become overwhelming? Relapsing and subcumbing to your addiction is a very quick way to show the FAA that your not ready to gain the required SI and medical certification. Saying with your mouth now "I want to do this" won't mean anything if you cannot deal with stress without returning to "liquid encouragement".

    I don't think the driver performance program is part of what the FAA wants. It might have benefited your criminal law status. But likely not the FAA administrative law requirements.

    AA.org provides resources to find meetings.

    Not sure what "walking into a Kaiser hospital" is asking.
     
  34. Goliath737

    Goliath737 Filing Flight Plan

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    Mike, all of this info is appreciated. Bruce has responded to me and provided me additional information on to get this ball actually rolling. I understand you personally do not know me, or the series of events that occurred but I can assure you I will succeed in this program and it is unfortunate that I have led myself to this, yet I have nobody else to blame other than myself. I’m sure when you were 24years old you could relate to college parties and idiotic decisions made during these times if you endulged with the guys (&hot chicks). 25monhs later doesn’t necessarily make me a changed man either, but I am taking responsibility of my actions from that moment on and have eliminated ANYONE & ANYTHING that compromises my future. My only regret in this situation is not having the knowledge or proper guidance up until now in which approach I should take and who to deal with. Sitting in these driver performance classes which in my eyes seems to be relatively similar to what I’d assume an A.A. meeting would be all about has provided me with insights of a plethora of struggles humans like myself encounter and how we all have delt with alcohol in various ways. It is a humbling experience for someone twice as old as me or even some in their adolescent years to sit around each other and illustrate their experiences. Anyways, I sure wish to keep in touch with you on this process as I’ve spoken to many humans in my life some at the professional level (airline, charter), as well as some working on their instrument ratings. None could have provided the details in which you’ve stated that were exactly paraphrased from a Senior AME I’ve spoken with prior to Bruce. Again you feedback is truly appreciated. Maybe I’m in over my head being 26years old, to still apply for third class medical to only obtain my private rating before taking the next steps but deep down I know I’ll regret it years later for not atleast attempting to make amends to this self inflicting wound.
     
  35. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    Best of luck to you!
     
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  36. Rushie

    Rushie Pattern Altitude

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    You are pretty wise and insightful for only 26 years old. You are absolutely doing the right thing to fix this. The process of fixing it so you can get a class 3 will pay off multiple times over throughout your lifetime in ways that have nothing to do with flying but you're saving yourself from the long term affects of too much alcohol.

    You're in over your head only in that you haven't yet been exposed to a lot of these concepts but you'll catch on quickly and soon become an expert about this issue and even be able to help others. Even you posting here will help others.

    Best of luck to you and keep us posted. Stick with Bruce he will steer you right.
     
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  37. Goliath737

    Goliath737 Filing Flight Plan

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    thank your for those kind words. It is the support of only a very people like you that fuel my drive, but hey I was once told, “No Support is sometimes the only support you need”. I will definitely continue to post on this thread and would appreciate any additional information that may come to mind.
    -Until then Peace & Luv ..
     
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  38. AggieMike88

    AggieMike88 Touchdown! Greaser!

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  39. Goliath737

    Goliath737 Filing Flight Plan

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    Mike,

    This is gold!! Thanks for this as I’ve downloaded these PDF’s to keep record and mentally prepare myself for this process ahead.
     
  40. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    Don't forget to also read the added comment from Dr. Bruce.
     
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