Comment by anonymars
4 months ago
Here's a fun fact. In the US, if you would like to fly a plane, and you have undiagnosed and thus untreated ADHD, no problemo.
But if you do end up taking stimulant medication for ADHD, that's not allowed. So unfortunately sometimes (rather often with the FAA) it's better not to ask questions you don't want the answer to.
The amount of undiagnosed ADHD (and secretly treated anxiety and depression, for that matter) in the aviation industry is off the charts. I have a lot of respect for most of the FAA, which is professional, reasonable, and evidence-based. But the FAA aeromedical division is a joke. They're bullies with a stone-age mentality about treatments and medications that have been accepted for decades.
I might agree in principle, but aviation pilots are glorified bus/truck drivers. It's the farthest thing from a job that might cater to a typical "ADHD" skills profile. What you really want in that role is people who can be dependable without relying on intoxicating substances that might have weird side effects.
There is a large adult population with undiagnosed and untreated ADHD. A generation ago that population was even higher. A bunch of them are pilots.
So then the question is, if in a professional pilot and I think I might have ADHD, do I follow up on that hunch? Of course not, because a diagnosis would cost me my career.
There’s good research to show that stimulants reduce the rate of car crashes in people with ADHD. I have no doubt that if we encouraged pilots to seek ADHD treatment, it would improve safety.
IMO the diagnoses that should exclude someone from flying are those that could cause them to become suddenly incapacitated. For everything else, we can just test whether someone can safely fly an airplane, which we already regularly do for pilots.
This is the same fallacy that always comes up. People are already flying this way!
What is the difference between someone with ADHD who passed their pilot lessons but doesn't have a diagnosis and is not taking medication vs someone with ADHD who is getting help?
Why is this an aeromedical issue and not a certification issue? What is the training and testing for if not to confirm that someone has the capability to successfully fly a plane?
I'm speaking from experience as someone who has worked as a professional pilot.
This was a big theme / topic on the latest season of Nathan Fielder’s “The Rehearsal” this year: https://ew.com/nathan-fielder-flies-full-boeing-737-plane-do...
Hell, taking medication or not, if you have had a diagnosis in the past (and didn't lie on your medical history), merely having current symptoms is grounds for your FAA medical certificate being deferred.
The fact that somebody can be completely undiagnosed, untreated, and potentially self-medicated, will get their medical certificate issued while those seeking treatment and function at the same level as their peers get deferred is madness. I completely understand concern being warranted, given a majority of airline accidents can, unfortunately, be attributed to pilot error, but it shows a maddening lack of understanding of the condition by the agency. Especially when their justification for telling AME's to defer individuals actively taking ADHD medication has nothing to do with the condition itself, but some bullshit that it actively increases cognitive deficits? Give me a break, I'd rather they just be honest, "we don't trust people who need stimulants to properly follow routine checklist procedures that are the bread and butter of a commercial pilot's job."
> but some bullshit that it actively increases cognitive deficits?
It doesn't look like obvious "bullshit". A number of ADHD medications are well-known intoxicating substances; it's not unfathomable that they might induce some kind of cognitive or behavioral impairment (not necessarily the same kind one might get diagnosed for, either).
It's similarly not unfathomable that they might possibly remotely provide a benefit to the people that derive a reported benefit from them.
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Not doubting the truth of your claim, just trying to understand you mean... How would the FAA know a pilot has ADHD if the condition is undiagnosed?
You know, enough symptoms will start to match.
Then you just don't get it officially diagnosed - then it doesn't exist! (officially)