(1st April 2020) Many line pilots, training personnel, and aviation medical examiners worry nowadays about an increase of cannabis consumption by pilots. This is often described as a trivialization of the use of cannabis. Current disinformation seems to imply that younger pilots, early in their careers, are less conscious of the administrative and legal consequences of the use of marijuana, but the problem is not limited to young pilots. The discussion that follows constitutes a factual review of the consequences linked to consumption of cannabis by Canadian pilots in general.

To enjoy the privileges of their Canadian Aviation Document (Recreation, Private, or Commercial License), pilots must comply with Transport Canada requirements regarding intoxicating substances such as alcohol, medications, and other legal drugs (CAR 602.03 for pilots, CAR 900.17 for UAS pilots). Pilots are also required to comply with Transport Canada requirements for illegal drugs as defined by federal legislation.

Intoxicated pilots are treated differently depending on whether they are prosecuted under the Canadian Air Regulation (CAR) or under Article 253 of the Canadian Criminal Code. CAR prohibits alcohol within 12 hours before operating a flight. Since June 2019, Civil Aviation Medical Examiners (CAME) are prohibited to issue to extend a Medical Certificate to pilots how used cannabis in the 28 days prior to the medical exam. The CAR applies when cannabis is found in the pilot’s blood when in charge on an aircraft. Under the Criminal Code, the pilot must be proven impaired at the time he or she was operating the aircraft or had custody of the aircraft.

Cannabis' THC affects the brain’s neurotransmitters and impairs psychomotor skills and short-term memory (Baselt, 2001; Leirer, Yesavage, & Morrow, 1991). As a direct consequence of growing political and media awareness, budgets for research on cannabis, which were almost nonexistent in the past, are being increased, thus allowing scientists to study the potential beneficial effects of its active components for some illnesses as well as any long-term toxic effects.

It has been well demonstrated that today’s cannabis is several times more powerful than previous generations of plants. In 40 years, THC levels have increased from 4% to 20-30%, and the beneficial, counteracting CBD levels have decreased from 4% to 0. Not only today's cannabis is more toxic, but the substance that curbed the effects has disappeared. It has also been shown that it plays a key role in the emergence of serious mental conditions, such as schizophrenia, paranoia, hallucinatory psychosis, and mania, that may have otherwise remained latent in an individual (Bersani, Orlandi, Kotzalidis & Pancheri, 2002; Hambrecht, & Hafner, 2000). The associated abnormal behavior is incompatible with flying and can result in the suspension of a pilot’s Medical Validation Certificate (MVC) for an indefinite duration. A meta-analysis published in the American Journal of Psychiatry in 2020 shows that cannabis users are three times more likely to be involved in violent events. Could this cast a doubt on strict adherence to SOP in the cockpit?

Structured air carriers require drug screening when hiring new pilots. Some pilots, who count on hiring being a foreseeable event, use cannabis but cease a few months before recruitment, then resume consumption once hired. Random workplace drug testing is generally not used in Canada however pilots should know that drug screening is performed following serious aviation incidents, either by the carrier, the civil authority, or sometimes by the military in certain countries. Obviously, it is impossible to predict when or in which country an incident will occur, for example, a runway excursion, flat tire, or an inadvertent incursion on an active IFR runway.

The most frequent excuse invoked by pilots at fault is that they are the victims of secondary cannabis smoke from a few days preceding the screening. However, the screening tests are calibrated to eliminate levels attributable to secondary smoke exposure (false positive). When a screening test is positive, the candidate is considered to be a user, and the chain of administrative consequences begins immediately.

In Canada, a pilot testing positive for cannabis when in charge of an aircraft will lose his MVC with an automatic and immediate removal from flying duties. The length of the MVC suspension period depends on the active participation by the pilot in an approved rehabilitation program and on his close surveillance by a recognized multidisciplinary team. This type of program must be approved by Transport Canada and is presently in use within major unionized air carriers only. Experience shows that after 3 months of treatment a pilot can be reinstated to flying duties approximately 8 out of 10 times but will remain on probation for a minimum period of 2 years, subject to a MOU which may include random testing.

The onus to prove rehabilitation is always on the pilot at the outcome of the therapy. Proving a successful rehabilitation to Transport Canada is a delicate process even when the pilot is treated by a competent team. He or she must be supported by fellow pilots specially trained in pilot assistance and by a group disability plan that provides compensatory income to allow the pilot to dedicate full time and energy to achieve the goal. Conversely, a pilot left to himself will see his suspension period automatically set by Transport Canada at 2 years. Without organized support and flight pay, proving his rehabilitation is extremely difficult. The suspension often extends beyond the initial 2 years and sometimes will end the pilot’s career.

When detected following an aviation incident, the presence of cannabis in the pilot’s body will void the pilot’s professional liability insurance, whether the intoxicating substance contributed to the incident or not. This consequence rapidly becomes a nightmare for the pilot’s family as well as the individual in the event a civil law suits for damages is pressed. In this case, the pilot not only can lose income but also savings and personal assets.

 

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Accident investigation with cannabis as contributor in Canada. TSB A11W0151

Baselt RC. (2001). Drug effects on psychomotor performance. Biomedical Publications, Foster City, CA; pp 403-415. Bersani G, Orlandi V., Kotzalidis GD., Pancheri P. (2002). Cannabis and schizophrenia : impact on onset, course, psychopathology and outcomes. Eur Arch Psychiatry Clin Neurosci. Apr; 252(2):86-92
Hambrecht M., Hafner H. (2000). Cannabis, vulnerability, and the onset of schizophrenia : an epidemiological perspective. Department of Psychiatry and Psychotherapy, University of Cologne, Germany. Aust N Z J Psychiatry. Jun; 34(3):468-75
Leirer VO, Yesavage JA, Morrow DG. (1991). Marijuana carry-over effects on aircraft pilot performance. Aviat Space Environ Med. 62(3):221-7.
Dellazizzo, L., Potvin, S. & al. (2020). Association Between the Use of Cannabis and Physical Violence in Youth: A Meta-Analytical Investigation. The American Journal of Psychiatry. May 2020