NTSB: Drug Detection Up among Pilots Killed in Accidents

A new NTSB safety research report reveals that 28.6% of pilots killed in aircraft crashes between 2018 and 2022 tested positive for potentially impairing drugs, and 52.8% tested positive for at least one drug of any type, continuing an upward trend. However, drug presence identified through toxicology testing does not necessarily indicate pilot impairment, the report emphasizes. The report adds to similar earlier NTSB studies between 1990 and 2012, and 2013 and 2017.

Among drug categories identified in toxicology reports, the most commonly detected included cardiovascular medications, sedating antihistamines, non-sedating over-the-counter drugs, cholesterol-lowering medications, prostate or erectile dysfunction drugs, and illicit drugs. Overall, 27.7% of pilots killed in aircraft accidents tested positive for two or more drugs.

Detection of potentially impairing drugs increased slightly to 28.6%, with the sedating antihistamine medication diphenhydramine remaining the most detected in this category. Illicit drug detection increased to 7.4%, driven primarily by increases in THC, the primary psychoactive chemical in marijuana.

Drug prevalence varied by pilot age, certification level, and type of operation. Drug presence was lower among pilots conducting Part 135 operations than among those operating under Part 91; among pilots with an active medical certificate versus those without one; and among pilots holding airline transport and commercial pilot certificates than those with a private, sport, student, or no certificate.