AOPA Pilot Magazine - August 2013 - 28

FLY WELL

Playing the numbers

BY DR. JONATHAN M. SACKIER

Moderation in all things—especially alcohol

DR. JONATHAN
SACKIER will be a

featured speaker
at the 2013 AOPA
Aviation Summit in
Fort Worth, Texas.

28 | AOPA PILOT August 2013

EIGHT: HOURS, BOTTLE TO THROTTLE. Eighteen: Army
recruitment age; constitutional amendment initiating
prohibition. Twenty-one: Legal drinking age; constitutional amendment overturning prohibition. Summer is
here, and barbecues and beer beckon, so let’s consider
a substance capable of causing headaches—alcohol.
We have brewed and distilled for eons. Whether
quaffed during religious ceremonies, enhancing celebrations, or addressing life’s hardships, hooch’s
capacity to induce ecstasy and evil is documented in
equal measure.
Drinking is part of our social fabric; savoring fine
wine, tossing back cold brews while watching football,
toasting with champagne. In moderation, wonderful—
and, in fact, wine especially seems to have some health
benefits that improve cardiovascular and brain function. However, adult beverages are potentially harmful,
especially in those who may lack self-control.
The pleasing, relaxing effects reflect the highly
addictive and sedative effects of this ubiquitous drug.
Some people are easily inebriated—women more than
men—while others seem immune. Body weight, age,
health, and obviously the amount and rate of consumption affect the outcome. Easily absorbed,
especially on an empty stomach, alcohol is metabolized by the liver and eliminated in breath and urine
at a constant rate, about one standard drink per hour
(a beer, small glass of wine, or single shot of spirits)—
so, when consumed faster than eliminated, symptoms
mount. Except for fat, alcohol penetrates every tissue,
explaining its widespread effects. Mental processing is impaired, impacting mood, thought, speech,
balance, hearing, and vision; movements become disjointed; heart rate and blood distribution are altered;
judgment suffers; and sleepiness ensues. Not desirable attributes for a pilot.
What of the eight-hour rule? After a real bender, it’s
possible that not all the alcohol has been eliminated—
regardless, sleep is disturbed and certain symptoms are
“hanging over,” such as dehydration, headache, gastrointestinal consequences, feeling wobbly, discomfort
with bright lights, or emotional concern about that offcolor joke you told while pickled (if it is a good one,
though, please send it to me). In fact, in addition to
bottle-to-throttle time, FAR 91.17 also prohibits flying
while under the influence—which might last a couple
of days after a night on the town. Some people swear by

folk remedies, but literal or metaphorical hairs of the
dog do not work; neither does black coffee, breathing
oxygen, or standing under a cold shower.
When pickled, people appear flushed, unbalanced,
incoherent, and spend time bent over a toilet. Longterm abuse damages every organ, including heart,
liver, intestines, brain, and nervous system. If you, or
someone you know, shows signs of drinking out of
control, seek help—alcoholism kills, and not just the
sufferer. Signs of dependence include increased use;
tolerance; signs of withdrawal when not drinking; or
continued drinking despite physical, social, or workrelated impacts.
David Kenny, manager of the Air Safety Institute
accident database, told me that general aviation accidents attributed to alcohol impairment are rare.
Between 1992 and 2011, there were 108 such fixedwing accidents, 70 of which were fatal—not surprising,
as most involved a loss of control in flight. During the
same period there were three fatal and one nonfatal
helicopter accidents. Possibly because of public attitudes toward drunk driving, the frequency of these
accidents has declined, with no fatal accidents where
alcohol use was fundamental occurring in 2002 or
2008. Thankfully, accidents where alcohol impairment
was likely a factor but not judged to be the principal
cause were even fewer: 43 fixed-wing accidents, 35 of
which were fatal, plus two fatal and one nonfatal helicopter accidents.
The FAA and your AME are appropriately sensitive
to pilots who may have a history of alcohol dependence and abuse; poor decision making while under
the influence; or chronic drinking, causing brain damage. A DUI can result in denial of your medical and is
problematic for the FAA, especially with blood alcohol above 0.15, which suggests higher tolerance and
abuse potential. The FAA will request police and court
records, the airman’s driving record, and a personal
statement regarding his or her use of alcohol.
The Human Intervention Motivation Study—a
collaboration between pilots, the FAA, the airline
industry, and the medical profession—supports returning impaired airline pilots to work after treatment and
rehabilitation. So raise a glass to the good life, but in
moderation—and not in proximity to flying.
AOPA
EMAIL jonathan.sackier@aopa.org

AOPA Pilot Magazine - August 2013

Table of Contents for the Digital Edition of AOPA Pilot Magazine - August 2013