Flight #13 - Addressing Substance Abuse in Aviation
Welcome to The Flight Shrink newsletter! This is Dr. Kevin Heacock.
In this edition, we will take flight into a topic that holds paramount importance in aviation: addressing substance abuse. This topic may be uncomfortable, but it's essential to discuss it openly and candidly because the safety of passengers, crew, and the success of flights depend on the sobriety of aviation professionals.
Substance abuse in aviation was definitely a topic I planned to talk about on The Flight Shrink at some point, but after my attendance at the HIMS Basic Education Seminar last weekend I wanted to get this out there now.
HIMS is an acronym and stands for Human Intervention Motivational Study. Before last weekend I thought this was an FAA program, but really it is an industry-wide effort where the airlines, pilots, healthcare professionals, and the FAA work together to preserve pilot careers and enhance air safety.
While some pilots who enter the HIMS program do so because they had an alcohol related event, such as a DUI, most self-identify that they have a problem with alcohol and choose to get help. And this program has been extremely helpful. At the seminar we heard from several pilots who said the program saved their career and likely saved lives other than their own had their drinking continued to escalate into a flight safety concern. The HIMS Program website (himsprogram.com) notes that it has helped over 12,000 pilots.
Understanding the Challenge:
But why did the HIMS program have to be created? What is it about flying that makes substance abuse so challenging? The aviation industry maintains an unyielding commitment to safety. This dedication extends to the sobriety of aviation personnel. While the vast majority of aviation professionals adhere to stringent regulations, substance abuse remains a concern, as any one incident could have an impact on hundreds of lives.
Substance Abuse in Aviation:
Substance abuse encompasses various forms, including alcohol, prescription drugs, or illegal substances. While the HIMS program is for pilots with abuse of any substance, the drug of choice that pilots are most likely to abuse is alcohol. Of those pilots who enter the HIMS program to begin recovery, about 90% have abused alcohol. The aviation profession's unique stressors can occasionally lead to substance misuse as a coping mechanism. And it is vital to remember that this path not only puts careers in jeopardy but lives at risk.
Airline pilot schedules are such that they lend themselves very well to a pattern of alcohol use known as binge drinking. They travel with a new group of people on almost every trip and gathering for drinks at the hotel bar is often a way for them to get to know each other on layovers. They end up staying alone in a hotel room where it is easy to drink more than they would otherwise without anyone knowing.
Pilots in recovery who attended the seminar told us when they were drinking they would have a few drinks in their room before going to the bar to meet up with the rest of the crew, have one or two drinks with them, and then go out on their own or back to their room for more drinks. So that if anything happened and the crew was asked how much the pilot had to drink, they would just say one or two, but really is was 10 or more.
The Consequences:
The repercussions of substance abuse in aviation are severe and far-reaching. They encompass professional ruin, legal entanglements, and, most alarmingly, compromised safety during flights. Identifying the signs of substance abuse early is not just a professional duty; it's a moral obligation to passengers and colleagues.
And this goes, not just for pilot self-identification, but also for peers and other airline staff. As part of the HIMS program, most of the airlines have what they call Peer Pilots. Most Peer Pilots have gone through the HIMS program themselves and are in recovery. While they are primarily utilized to monitor other pilots going through the HIMS program, they are also good resources for pilots to self-identify to or for other airline staff to talk to when they are worried about another pilot’s substance use.
Seeking Help:
If you or a fellow pilot is grappling with substance abuse, remember that seeking help is an act of courage and strength, not weakness. It may feel like you’re giving up or that you’re not good enough if things have gotten so bad that you have to ask for help. But it’s the one’s who don’t speak up for themselves who continue to suffer. So never feel weak for making yourself stronger.
There's an array of resources available for support and recovery, tailored to aviation professionals. Employee Assistance Programs (EAPs) like the HIMS program are available in most airlines. For non-airline pilots, confidential counseling services and dedicated support groups can be invaluable assets on the path to recovery.
Alcoholics Anonymous (AA) is the most commonly used Self-Help Recovery Program, and it is probably the one with the most documented success as well. Some people shy away from AA given its religious foundation. However, there are several AA groups and subgroups that eschew the religious aspects. So if you are looking for a non-religious AA group know there are Atheist and Agnostic subgroups of AA out there. Other self-help recovery programs include SMART Recovery, Rational Recovery, and Celebrate Recovery.
For pilots specifically there is an organization called Birds of a Feather. This is a worldwide network of meetings based on Alcoholics Anonymous. It was established for pilots and cockpit crew members active or inactive in private, commercial, or military aviation. Birds of a Feather provides AA meetings worldwide (including ZOOM meetings), a yearly convention, a newsletter, a Whats App group, a Private Facebook Group and a website (boaf.org) for pilots and cockpit crew members in recovery.
Staying Sober: Practical Steps for Pilots:
Maintaining sobriety is an ongoing journey that requires resilience and support. Here are some practical steps for pilots on this path:
Professional Guidance is paramount. Consult an aviation medical examiner (AME) or a mental health professional with expertise in substance abuse. Aviation Medical Examiners with specialized in substance abuse are known as HIMS AMEs and there is a list of HIMS AMEs on the FAA website (faa.gov). They can guide you through the recovery process, ensuring you meet the necessary requirements to return to the cockpit.
Join Support Groups. Engage with support groups like those mentioned above that are designed specifically for aviation professionals dealing with substance abuse. Sharing experiences with peers who understand the unique challenges can be immensely helpful.
Establish a Sober Network. Surround yourself with a network of individuals who support your recovery journey. Avoid situations or people that may trigger relapse.
Include Therapy and Counseling in your recovery. Consider regular therapy or counseling sessions, even if you're feeling stable in your sobriety. These sessions provide valuable tools for managing stress and preventing relapse.
Utilize Mindfulness Practices. Incorporate mindfulness techniques like meditation or deep breathing into your daily routine. These practices can help manage stress and cravings.
Adopt a Healthy Lifestyle. Prioritize physical health with regular exercise and a balanced diet. A healthy body can better withstand the challenges of recovery.
Have a Relapse Prevention Plan. Work with a mental health professional, AA sponsor, or peer pilot to develop a relapse prevention plan. Knowing how to respond to triggers or cravings is crucial for maintaining sobriety.
Engage in Regular Monitoring. Be prepared for ongoing monitoring of your sobriety, which is a requirement of the HIMS program for returning to work in aviation. Compliance with the monitoring program is vital. This can include carrying a breathalyzer with you everywhere you go. Your HIMS AME can ask for an unannounced test at any time and the breathalyzer they use takes a picture of you while you breathe into it for facial recognition purposes.
This is just a short summary of substance abuse in aviation. Check out the website HIMSprogram.com for more information. Or, if you are subscribed to The Flight Shrink, there is a new chat feature on the Substack App where you can chat with me and other subscribers about mental health in aviation.
Let's navigate the skies together, safe and mentally healthy.
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I'm Dr. Kevin Heacock, The Flight Shrink... Keep on flyin'!