THC positive from ER visit but never smoked.

J

Jyyoo32

Filing Flight Plan
Joined
Jul 27, 2026
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Flightjeff32
Hello, new user here that decided early this year to pursue aviation as a career.

I am deciding to get my first class medical before even starting lessons because I have two episodes of fainting that I went to the ER for and another ER visit getting diagnosed with acute vestibular neuritis and wanted to see if I could even obtain a medical certificate.

I will most likely have to send my entire medical history and the ER visit for vestibular neuritis, they drug tested me and it came back positive for THC. I was surprised because I don't smoke and never have but months later realized it could've been the Full Spectrum CBD oil I was taking orally for muscle tightness and soreness that contained 0.3% THC.

Will this be a disqualifying factor or a deferral that will require a full psych eval and 12 months of testing? I'd hate to have to go through that process because of CBD. I have never smoked marijuana in my life.
 
Have you looked at the FAA guidance?


Use of CBD or CBD-containing products is not specifically disqualifying.
Click to expand...

A marijuana-positive DOT drug test resulting from CBD use (intentional
or inadvertent) is treated as a POSITIVE test.
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A consultation with an AME prior to application is probably a good idea.

That being said, IMO nobody who uses CBD or any other form of marijuana has any business flying an airplane. Saying that "you haven't smoked it" is analogous to someone who drinks a daily 6-pack of beer claiming they don't drink because they've never had vodka.
 
StraightnLevel said:
That being said, IMO nobody who uses CBD or any other form of marijuana has any business flying an airplane. Saying that "you haven't smoked it" is analogous to someone who drinks a daily 6-pack of beer claiming they don't drink because they've never had vodka.
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Yeah, it's unfortunate that the zeitgeist holds that using something with THC isn't the same thing as using something else with THC and, even if it were, there's nothing wrong with THC. At best, the OP was fooled into thinking he wasn't using marijuana when he was. At worst, he knew he was and thought it was something he could get away with because it didn't smell bad.

This doctor is losing patience (and unfortunately gaining patients) with all the pro-weed, pro-CBD, pro-THC talk everywhere. THC is THC. It's bad stuff, no matter where you get it.
 
So, did you self-medicate or were the
Jyyoo32 said:
Hello, new user here that decided early this year to pursue aviation as a career.

I am deciding to get my first class medical before even starting lessons because I have two episodes of fainting that I went to the ER for and another ER visit getting diagnosed with acute vestibular neuritis and wanted to see if I could even obtain a medical certificate.

I will most likely have to send my entire medical history and the ER visit for vestibular neuritis, they drug tested me and it came back positive for THC. I was surprised because I don't smoke and never have but months later realized it could've been the Full Spectrum CBD oil I was taking orally for muscle tightness and soreness that contained 0.3% THC.

Will this be a disqualifying factor or a deferral that will require a full psych eval and 12 months of testing? I'd hate to have to go through that process because of CBD. I have never smoked marijuana in my life.
Click to expand...
So, did you self-medicate or was the oil prescribed by a state-licensed MD not in the employ of the business that sold you the oil?

Giving you a warning right now....you won't find many sympathizers to your plight on this board.
 
murphey said:
So, did you self-medicate or were the

So, did you self-medicate or was the oil prescribed by a state-licensed MD not in the employ of the business that sold you the oil?

Giving you a warning right now....you won't find many sympathizers to your plight on this board.
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It was self medication for about a month. At that time I had no intentions of becoming a pilot so I used it fully aware there were traces of THC.

Gaining sympathy isn't really my goal here. I'm just trying to see where I am at currently and if it's even possible for me to obtain a medical.
 
OneCharlieTango said:
Yeah, it's unfortunate that the zeitgeist holds that using something with THC isn't the same thing as using something else with THC and, even if it were, there's nothing wrong with THC. At best, the OP was fooled into thinking he wasn't using marijuana when he was. At worst, he knew he was and thought it was something he could get away with because it didn't smell bad.

This doctor is losing patience (and unfortunately gaining patients) with all the pro-weed, pro-CBD, pro-THC talk everywhere. THC is THC. It's bad stuff, no matter where you get it.
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Completely honest, I was fully aware there was trace amounts of THC in that CBD oil but didn't think much of it since it is federally legal for the amount contained. At the time, I had no intention of becoming a pilot and my employer recommended the CBD so I tried it for about a month until I felt better.

That said, I'm prepared to go through the hoops and assumed the FAA will still see it as substance abuse, use, and dependence regardless.
 
Yeah, this is an unfortunate reality that I think a lot of folks don't realize. Virtually all the CBD products out there contain some small percentage of THC. So you were using enough to have a positive test for THC. The FAA is not going to take your word for it. I mean, because everyone would say, "oh yea, it's the CBD oil. Must be..." wink wink...

Add me to the list of those docs that take a dim view of medicinal pot, cbd, gas station cannabinoid derivatives (and HOLY $%^& are there a boat load of those, flying under the RADAR. You guys have no idea...!)
 
straightnlevel said:
A consultation with an AME HIMS AME prior to application is probably a good idea.
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Get Yee to a HIMS AME. If as you describe, and if your FBI ringerprint check and DMV record are clean, this can be adjudicated as abuse. With 4 months of negative random peee, you can become issuable, but that testing will go on for 2 years on a special issuance. They WANT TO BE SURE.
 
bbchien said:
Get Yee to a HIMS AME. If as you describe, and if your FBI ringerprint check and DMV record are clean, this can be adjudicated as abuse. With 4 months of negative random peee, you can become issuable, but that testing will go on for 2 years on a special issuance. They WANT TO BE SURE.
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Thank you for the response, Dr, Chen. I will be scheduling a consultation with a HIMS AME soon and will be prepared to go through the hoops regarding the THC/CBD issue.

As for the two episodes of syncope,
The first time was due to not eating or drinking all day and getting up too fast and the second time was when I had a random gushing nosebleed for 3 min and I started freaking out after googling thinking I had a posterior nosebleed and I passed out from the amount of blood and freaking myself out because my arms started feeling weak as well right before passing out.

I believe one of the problem is that I never discussed the reason why I fainted with my doctor as I was too embarrassed after realizing it wasn't a big deal so there's no official record that the reason for the syncope was most likely due to sight of a heavy bloody nose.

Do you suggest I get evaluated with all the stress test, holter monitor, echocardiogram done beforehand or wait to see what the FAA wants me to do specifically?
 
Jyyoo32 said:
Hello, new user here that decided early this year to pursue aviation as a career.

I am deciding to get my first class medical before even starting lessons because I have two episodes of fainting that I went to the ER for and another ER visit getting diagnosed with acute vestibular neuritis and wanted to see if I could even obtain a medical certificate.

I will most likely have to send my entire medical history and the ER visit for vestibular neuritis, they drug tested me and it came back positive for THC. I was surprised because I don't smoke and never have but months later realized it could've been the Full Spectrum CBD oil I was taking orally for muscle tightness and soreness that contained 0.3% THC.

Will this be a disqualifying factor or a deferral that will require a full psych eval and 12 months of testing? I'd hate to have to go through that process because of CBD. I have never smoked marijuana in my life.
Click to expand...

You state there were 3 ER visits. 2 for fainting and a 3rd where you were diagnosed for vestibular neuritis. The problem is fainting is not a typical symptom of vestibular neuritis.

You also state you have muscle soreness and stiffness. It takes 3 to 15 days of consecutive, daily full-spectrum CBD oil use to build up enough trace THC to trigger a positive urine drug test result. Normal muscle soreness and stiffness resolves untreated in 2-3 days.

I suggest you start with a primary care MD, discussing the above symptoms and letting them direct your care before considering getting tests for an FAA medical. Right now you should not be driving a car.
 
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I believe in being supportive of people who come here looking for advice, especially young people who made lifestyle mistakes without fully understanding the consequences.

But, and I will say this as gently as possible, you should consider whether aviation is an appropriate career for you before committing fully to that path.

There is a non-zero chance that at some point in your flying lifetime you will be faced with an emergency. You will have to make decisions and perform complex tasks under extreme time pressure, with your life and others in the balance.

Different people have different levels of capability to handle stress. If you pass out at the sight of a nosebleed, how will you react when you have 30 seconds to do something correctly or you die? If you think I am being melodramatic, I have been in that situation. Twice.

Perhaps read some of the threads in the mishap report forum to get an idea of the situations that pilots find themselves in.

Only you know yourself. I hope I have not offended you. My intent is only to give you something to think deeply about.
 
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Ed Haywood said:
I believe in being supportive of people who come here looking for advice, especially young people who made lifestyle mistakes without fully understanding the consequences.

But, and I will say this as gently as possible, you should consider whether aviation is an appropriate career for you before committing fully to that path.

There is a non-zero chance that at some point in your flying lifetime you will be faced with an emergency. You will have to make decisions and perform complex tasks under extreme time pressure, with your life and possibly others in the balance.

Different people have different levels of capability to handle stress. If you pass out at the sight of a nosebleed, I am concerned about your emotional resilience.

Perhaps read some of the threads in the mishap report forum to get an idea of the situations that pilots find themselves in.

Only you know yourself. Hope I have not offended you.
Click to expand...

No offense taken! I'm still committed to doing this as a career. I was an mma fighter for a good 10 years of my life so I don't really question my mental and emotional resilience.

Sometimes things happen and I happened to just pass out from the gushing nosebleed at that time. I've read many posts about people getting their first class medical even though they've stated they pass out just from the sight of needles or blood draws so I'll have to just consult with a HIMS AME.
 
Jyyoo32 said:
Thank you for the response, Dr, Chen. I will be scheduling a consultation with a HIMS AME soon and will be prepared to go through the hoops regarding the THC/CBD issue.

As for the two episodes of syncope,
The first time was due to not eating or drinking all day and getting up too fast and the second time was when I had a random gushing nosebleed for 3 min and I started freaking out after googling thinking I had a posterior nosebleed and I passed out from the amount of blood and freaking myself out because my arms started feeling weak as well right before passing out.

I believe one of the problem is that I never discussed the reason why I fainted with my doctor as I was too embarrassed after realizing it wasn't a big deal so there's no official record that the reason for the syncope was most likely due to sight of a heavy bloody nose.

Do you suggest I get evaluated with all the stress test, holter monitor, echocardiogram done beforehand or wait to see what the FAA wants me to do specificallJyyoo:
Click to expand...
So I've told you what you need, and you maybe think it won't be demanded?
(????)
They syncope decision tool linked to on page 169 of the current AME guide is for when the AME is in a position to issue. Yours will not be in that position, so the Agency will demand the workup.

Please don't confuse a google search for an AME's understanding of "how this works".


B
 
bbchien said:
So I've told you what you need, and you maybe think it won't be demanded?
(????)
They syncope decision tool linked to on page 169 of the current AME guide is for when the AME is in a position to issue. Yours will not be in that position, so the Agency will demand the workup.

Please don't confuse a google search for an AME's understanding of "how this works".


B
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Doc, I never questioned or doubted you if those tests will be demanded or not by the FAA.

I just asked if I should get all the evaluations and testing done before I receive a deferral letter to "front load" and get it done faster. My "google search" was actually you telling another person on here a few years ago about getting a stress test, 14 day holter, echo, etc so my question was if it was smart to get those done before receiving the deferral letter.
 
Lindberg said:
Why is that? The product the OP used is likely fully legal. Do you feel the same way about all legal intoxicants?
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The polarization around MJ/THC is interesting. As a non-user (other than secondary inhalation driving the streets here in Atlanta), what I think I know tells me that casual use is different, but probably no more harmful than casual drinking. I guess the difference with alcohol is we have tests which can objectively determine if you're impaired, but we don't have those tests for THC.

Is that (and illegality in much of the country) why the FAA is adamant on this issue?
 
bbchien said:
So I've told you what you need, and you maybe think it won't be demanded?
(????)
They syncope decision tool linked to on page 169 of the current AME guide is for when the AME is in a position to issue. Yours will not be in that position, so the Agency will demand the workup.

Please don't confuse a google search for an AME's understanding of "how this works".


B
Click to expand...
So just for my own clarification. He's had syncope x 2, vestibular neuronitis, and a positive test for THC. So he'll need cardiac testing eval and notes from his docs regarding the syncope and vestibular neuronitis that is current-90 days-so does he get the cardiac/neuronitis eval now, see the HIMS AME now? Then my question is, when does the AME submit the app? Before the 90 days so the medical workup is current but then he won't be cleared yet because he needs a negative urine screen after at least 4 months?
 
murphey said:
Yes.
Not only that but the product is not legal at the Federal level, and we operate under federal rules.
Click to expand...
The Full Spectrum CBD I took is federally legal. Though, I think the FAA will still see it as abuse.
 
Lindberg said:
Why is that? The product the OP used is likely fully legal. Do you feel the same way about all legal intoxicants?
Click to expand...
Narcotics? Yes.

IMO Marijuana, THC, and all such derivatives need to be on the DNF list. They are illegal from a federal law standpoint in any case, so your question here is irrelevant.

Alcohol is somewhat different in that there is a well-understood timeline for impairment, paired with clear limits that are tied to an understanding of impairment levels. That said, there is a clear line drawn by the FAA that any hint of alcoholism or poor judgement with alcohol (DWI or similar) immediately invalidates a medical cert, and there is a clear, rigorous process required to return to flight status.

THC, however, remains in the system for much longer, and the data is really unclear as to the relationship between concentration and impairment. Therefore, I support a zero tolerance approach until such time as clear determination can be made as to how much is too much, and how long after ingestion is safe. The fact that it is legal in some states does not imply that it is safe.
 
StraightnLevel said:
Narcotics? Yes.
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So, since I took fentanyl after surgery, I shouldn't be allowed to fly?
StraightnLevel said:
IMO Marijuana, THC, and all such derivatives need to be on the DNF list. They are illegal from a federal law standpoint in any case, so your question here is irrelevant.
Click to expand...
No, they aren't. Hemp-derived THC, likely what was in the product the OP was taking, is legal in concentrations below 0.3% under federal law, and has been since 2018. It's also legal in most states.

The DNF list only applies while you're actually taking the listed drugs.
 
Lindberg said:
So, since I took fentanyl after surgery, I shouldn't be allowed to fly?
Click to expand...
Not until it's completely out of your system.

Lindberg said:
No, they aren't. Hemp-derived THC, likely what was in the product the OP was taking, is legal in concentrations below 0.3% under federal law, and has been since 2018. It's also legal in most states.

The DNF list only applies while you're actually taking the listed drugs.
Click to expand...
No, the DNF list applies until 5 times the dosage interval.

What's the dosage interval for THC, and what is the timeline for elimination of impairment?
 
StraightnLevel said:
Not until it's completely out of your system.


No, the DNF list applies until 5 times the dosage interval.

What's the dosage interval for THC, and what is the timeline for elimination of impairment?
Click to expand...
Okay. So are we down to pilots shouldn't fly while they have THC in their system? Because I don't think anyone disagrees with that.
 
Lindberg said:
Okay. So are we down to pilots shouldn't fly while they have THC in their system? Because I don't think anyone disagrees with that.
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The problem with marijuana is that regular users can have subtle cognitive impairments for up to a month after cessation. In fact, regular or heavy users can have permant cognitive impairments.

So the FAA is in a difficult situation. If a pilot or applicant test positive, is this a positive from some very low level in CBD just barely exceeding the threshold (and, well, we don't know if this doesn't cause subtle impairments as well), or, is this someone who is a chronic user and may have enduring cognitive deficits.

I feel for the OP if he's on the up and up, but I also think that the FAA has no choice. I think if you're a pilot or an aspiring pilot, you should stay away from any pot containing products. From a medical standpoint we don't really know how safe CBD is, we don't know if it actually treats that much in a meaningful non placebo kind of way. Regardless of what the guy at the dispensary or gas station says, or what the CBD bottle says, virtually all CBD products have some residual THC and there is a chance you will test positive.

This guy has a path, but it''s challenge. It just has to be this way.
 
Mark K said:
The problem with marijuana is that regular users can have subtle cognitive impairments for up to a month after cessation. In fact, regular or heavy users can have permant cognitive impairments.
Click to expand...

Regular or heavy use can also cause psychosis and other psychiatric symptoms.
 
....and causes repetitive failure on the neurospcyhological testing.....and failure of the chronically cannabinoid impaired to get a grip on "why I can't qualify"....
Mark K said:
So just for my own clarification. He's had syncope x 2, vestibular neuronitis, and a positive test for THC. So he'll need cardiac testing eval and notes from his docs regarding the syncope and vestibular neuronitis that is current-90 days-so does he get the cardiac/neuronitis eval now, see the HIMS AME now? Then my question is, when does the AME submit the app? Before the 90 days so the medical workup is current but then he won't be cleared yet because he needs a negative urine screen after at least 4 months?
Click to expand...
The timescale is so complicated that we do the stuff we can control and when the other stuff is ready, send him BACK for an update office visit for the "on insurance" stuff, so that file becomes regarded as again current. I've had a few in which the vestibular and the syncope become show stoppers, which saves the potential applicant about $4,000.

You never know what you're getting - a guy with a baked brain (well, extreme cases, you can tell those) on a cognitively recovered guy....

I got chewed out once for advising my then politically correct RFS, that one ATO applicant's every other sentence was "hey....what' happnening mon......". She thought I was being disparaging to an African American CHI potential applicant.

B
 
Mark K said:
The problem with marijuana is that regular users can have subtle cognitive impairments for up to a month after cessation. In fact, regular or heavy users can have permant cognitive impairments.

So the FAA is in a difficult situation. If a pilot or applicant test positive, is this a positive from some very low level in CBD just barely exceeding the threshold (and, well, we don't know if this doesn't cause subtle impairments as well), or, is this someone who is a chronic user and may have enduring cognitive deficits.

I feel for the OP if he's on the up and up, but I also think that the FAA has no choice. I think if you're a pilot or an aspiring pilot, you should stay away from any pot containing products. From a medical standpoint we don't really know how safe CBD is, we don't know if it actually treats that much in a meaningful non placebo kind of way. Regardless of what the guy at the dispensary or gas station says, or what the CBD bottle says, virtually all CBD products have some residual THC and there is a chance you will test positive.

This guy has a path, but it''s challenge. It just has to be this way.
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Cool. We've gone from anyone's who's used legal hemp-derived THC products to substance abusers.

So just like alcohol, it's legal, can be used safely, and can be abused. Those who are under the influence and those who chronically abuse it should not fly.
 
Lindberg said:
You could at least admit you were wrong about the illegality before you move the goalposts again.
Click to expand...
Not sure why you are defending the use of this drug by pilots, but read this before making a statement like that:

www.nolo.com

Marijuana Moved to Schedule III. Does That Mean It's Legal?

Medical marijuana was rescheduled to Schedule III, but that doesn't mean the federal government legalized it. Here's what the April 2026 DOJ order actually did.
www.nolo.com www.nolo.com
 
Lindberg said:
Cool. We've gone from anyone's who's used legal hemp-derived THC products to substance abusers.
Click to expand...
Not exactly. Just saying there isn't an easy way to tell the difference from the urine/blood/hair tests, so what do you do if you're the FAA?

In this case you do have to throw the baby out with the bathwater...
 
It is very apparent that here are supporters of MJ use, and its relatives, who have never put there life at risk of a regular user.

I have, twice. My occupation was very high risk, and I was well trained in avoiding those risks.

You cannot know whether he is just in a good mood, or floating from the weekend use. He started using in Junior High School. A large portion of his brains did not work in he conventional manner. After work one day, he failed to stay on the road on a left turn, and fatally slammed a 3 foot oak tree. His blood confirmed impaired.

The second was let go for a traffic event in a company vehicle. Due to the combined events that day, no tests were done.
 
Lindberg said:
Why is that? The product the OP used is likely fully legal. Do you feel the same way about all legal intoxicants?
Click to expand...
I don’t believe anyone who used ivermectin for COVID should be flying a plane. Not that I think ivermectin has any long term side effects contrary to the safety of flying, but making that choice calls into question core reasoning ability. OTC CBD fails in the same category.
 
Half Fast said:
Remember that as far as the Federal Aviation Administration is concerned, marijuana is illegal everywhere in the country, since it is still prohibited under federal law.
Click to expand...
Time to Google Cannabis Overhaul Act
It may have some implications, and it's in effect now, if I read correctly.
 
Kenny Phillips said:
Time to Google Cannabis Overhaul Act
It may have some implications, and it's in effect now, if I read correctly.
Click to expand...

Are you thinking of the CAOA? It’s been around for several years, and was re-introduced in the Senate a few weeks ago. AFAIK, it hasn’t been passed by either chamber, but if you have more recent info, please share it.
 
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