NTSB: More Drugs Showing Up In Fatal Crashes


More pilots in fatal accidents have potentially impairing drugs in their systems than ever before, according to the National Transportation Safety Board’s “2013–2017 Update to Drug Use Trends in Aviation” report, published today. Overall drug use, prescription and illicit, is on the rise, according to the NTSB’s data. One-fifth of the pilots had some form of cardiovascular drug in their systems. 

Moreover, the NTSB feels that there is an “ongoing need for the FAA to publicize—for pilots’ use—information about marijuana given its decriminalization in several states and its unchanged classification as an illicit drug per federal law” and a need for additional research to “assess the relationship between drug use and accident risk.” The FAA has taken steps to inform pilots of the connection between drug use and risk factors, and has begun addressing the marijuana issue now that it has become legal in many states. (It is still a banned substance for pilots.)

“Over the 5 years between 2013 and 2017, 1,042 aviation accidents involving US pilots occurred in the United States in which the flying pilot was fatally injured. Of these, 952 pilots (91%) had available toxicology test results,” says the report. “Similar to the last 5 years of the 23-year period examined in the previous study, the average age of the pilots in this update was 56 years. During the 5 years ending in 2017, 266 (28%) fatally injured pilots tested positive for at least one potentially impairing drug, 144 (15%) pilots tested positive for at least one drug indicating a potentially impairing condition, 94 (10%) pilots’ test results indicated evidence of use of at least one controlled substance, and 47 (5%) tested positive for an illicit drug.”

Chart: NTSB

While marijuana use is on the rise overall and is showing up in more pilots’ toxicology screens, “sedating antihistamines continued to be the most common category of potentially impairing drugs found in pilots who died during the report period, with 11.9% testing positive for at least one drug in this category, which increased from 9.9% during the preceding 5 years. Sedating pain relievers, a category that includes opioids, was the second most common category of potentially impairing drugs at 5.3%. Of the 50 pilots who tested positive for sedating pain relievers, 46 were positive for at least one opioid,” according to the report.

The NTSB distinguishes between the presence of the drugs themselves and the potential for their presence to be part of an underlying condition. “The three most common drugs indicating a potentially impairing condition were hydrocodone, a sedating opioid used to treat severe pain; citalopram, an antidepressant; and diazepam, a sedating benzodiazepine used to treat severe anxiety and muscle spasms,” according to the report, which goes on to say that the accident causes themselves involving pilots who tested positive for drugs have not changed since the previous study.

Chart: NTSB

Of the drug types found, the NTSB noted that there was a large increase in those related to cardiovascular conditions (up from 12.4% to 18.2%), sedating antihistamines (up from 9.9% to 11.9%) and antidepressants (up from 5.3% to 7.1%). Drugs related to erectile dysfunction are more common now, too, showing up in 3.5% of the accident cases, up from 1.6% in the previous study and less than 1% in the 2003-2007 study.

Marc Cook
KITPLANES Editor in Chief Marc Cook has been in aviation journalism for more than 30 years. He is a 4000-hour instrument-rated, multi-engine pilot with experience in nearly 150 types. He’s completed two kit aircraft, an Aero Designs Pulsar XP and a Glasair Sportsman 2+2, and currently flies a 2002 GlaStar.

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  1. What I see with the chart is a growing aging pilot population. Not sure why the mention of cholesterol lowering drugs since there is no FAA medical standard for cholesterol. I’ve been on blood pressure meds for 30 years, all approved by the FAA. So are the drugs mentioned in the chart legal for that pilot by the FAA, or did the NTSB just lump all drugs found into the chart data? Not sure what the NTSB wants here. The Canadians have set 30 days as the waiting period to fly after consuming marijuana. I doubt there would be any support for drug testing of pilots not flying for air carriers. Considering that only .15% of pilots involved in air carrier flying test positive for illegal drugs, one has to wonder what benefit drug testing pt 91 or private pilots would be, and who would get stuck paying for that.

  2. I agree with Matt. I’m not sure where the NTSB is headed with this. They seem to make a big deal about the rise of cardiovascular medications, but that basically tracks the introduction and then widespread use of statin drugs for cholesterol control. Blood pressure and cholesterol drugs have been well proven to be safe and effective and pose little risk to the user being impaired for flying. One thing not mentioned was the number of pilots who had alcohol in their systems. I suspect that was more than all the other drugs combined, or was there in combination with the other drugs. Sadly, alcohol remains one of the largest factors in fatal automobile and aircraft crashes.