Fly Well: Playing the numbers

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 off-color 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. Long-term 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 work-related 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 fixed-wing 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.