FAA Substance Abuse: Triggers, Disqualification, and HIMS

An FAA substance abuse disqualification happens when a pilot meets the agency’s definition of substance abuse or substance dependence under 14 CFR 67.107, and the effect is the same across first-, second-, and third-class medical certificates: no medical, no flying, for at least two years. The rule reaches alcohol, illicit drugs, and misused prescriptions, and it can be triggered by a DUI, a failed workplace test, or a pattern of use that the Federal Air Surgeon concludes is unsafe. Getting back in the cockpit is possible, but the path runs through a Special Issuance and, in most cases, the Human Intervention Motivation Study (HIMS) program.¹

What the FAA Counts as Substance Abuse

Substance abuse under 14 CFR 67.107 is a use-based finding that looks back two years. Any of three things is enough on its own:¹

Repeated use of a substance in a physically hazardous situation, meaning at least one prior instance of the same behavior. A first DUI may not clear this bar on its own; a second one does.
A verified positive drug test, a breath or blood alcohol concentration of 0.04 or higher, or a refusal to submit to a DOT-required drug or alcohol test.
A finding by the Federal Air Surgeon that the pilot’s misuse of a substance makes them unable to safely exercise the privileges of the certificate.

That third category is broad on purpose. A pilot who has never tested positive and never been arrested can still be disqualified if the case history convinces the Federal Air Surgeon that continued use is a safety risk.

How Dependence Is Different

Substance dependence is a clinical finding rather than an event count. A pilot is dependent under 14 CFR 67.107 if they show any one of four markers: increased tolerance, withdrawal symptoms, impaired control over use, or continued use despite damage to health or work or personal life. One marker is enough. The regulation covers alcohol, opioids, CNS stimulants such as cocaine and amphetamines, cannabis, sedatives, hypnotics, anxiolytics, hallucinogens, inhalants, and other psychoactive substances. Tobacco and caffeine are excluded.¹

A dependence finding is disqualifying unless the Federal Air Surgeon accepts clinical evidence of recovery that includes at least two years of total abstinence. The two-year clock runs from the last use, not from diagnosis or the end of treatment, and the Federal Air Surgeon has final say regardless of what an outside clinician recommends.¹

The practical difference: abuse looks at what you did, dependence looks at what you have. Either one grounds you.

What Actually Gets a Pilot Flagged

The FAA does not wait for a pilot to volunteer bad news. Several reporting channels feed substance information into the certification file, and the agency cross-references them.

DUIs and Other Motor Vehicle Actions

The most common trigger is a “motor vehicle action” under 14 CFR 61.15: a conviction for driving while intoxicated or impaired, a license suspension, cancellation, or revocation for an impairment-related cause, or a denial of a driver’s license application for the same reason.²

Each motor vehicle action has to be reported in writing to the FAA’s Security and Hazardous Materials Safety Office in Oklahoma City within 60 days. The notice must include your name, date of birth, certificate number, the type of violation, the date, the state that holds the record, and whether the action stems from a previously reported incident.³ Two motor vehicle actions within three years of each other are independent grounds for denying, suspending, or revoking a certificate.²

Workplace Tests and Database Checks

Employers running FAA drug and alcohol testing programs report verified positive drug tests, alcohol readings of 0.04 or higher, refusals, and any on-duty or pre-duty alcohol use into the Pilot Records Database. Prospective employers holding Part 121, 125, or 135 certificates must check the National Driver Register before hiring.⁴ A pilot who quietly hopes an old DUI will not surface generally finds that it does.

The Medical Application Itself

FAA Form 8500-8 asks, at Item 18.v, whether you have any history of convictions for driving while intoxicated or impaired, or any convictions or administrative actions that resulted in denial, suspension, cancellation, or revocation of driving privileges. That answer is made under 18 USC 1001, which criminalizes false statements to a federal agency.⁵⁶

Substance-related entries in the PRD do not get deleted. They can be edited or suppressed in limited situations, but every future Part 121, 125, or 135 employer will see them when they pull your records.⁷

Which Substances Trigger the Rule

Federal aviation standards override state law. Marijuana remains Schedule I under federal law, and no state legalization changes anything for pilots. A positive marijuana test is disqualifying whether or not you hold a state medical card, and synthetic cannabinoids are treated the same way.⁸

CBD is a common source of ruined careers. The FAA says using CBD is not specifically disqualifying, but CBD products are unregulated for purity or potency, and many contain enough THC to produce a positive DOT drug test. A CBD-caused positive is still a positive.⁹

Alcohol has its own set of rules on top of the medical standard. Under 14 CFR 91.17, no pilot may act as a crewmember within eight hours of consuming any alcoholic beverage or while having a blood or breath alcohol concentration of 0.04 or higher.¹⁰ Eight hours is a floor. Heavy drinking the night before can still put a pilot over the limit well after that window closes.

Prescriptions are not a safe harbor. Sedative-hypnotics, opioids, and anxiolytics all sit inside the dependence and abuse framework of Part 67. Taking a benzodiazepine exactly as prescribed can still draw scrutiny if it impairs cognition, and using a prescription outside its intended purpose, doctor-shopping, or dose-escalating on your own are the patterns the FAA reads as misuse.

What Happens After a Substance Flag

Once something substance-related surfaces at a flight physical, the Aviation Medical Examiner cannot just issue a certificate. The AME defers the application to the Aerospace Medical Certification Division in Oklahoma City for review by federal physicians.¹¹ During the deferral you cannot exercise the privileges that require a valid medical.

The FAA will want a full documentation package: certified court and police records for every arrest, conviction, or administrative action, with disposition records; complete treatment records including admission notes, discharge summaries, and aftercare recommendations; an official state driving record; and a completed Form 8500-8 with accurate answers to every Item 18 subpart.¹² Incomplete packages are the usual reason for long delays.

Most substance cases also require a neuropsychological evaluation by a qualified neuropsychologist with aviation-specific training, covering psychosocial history, employment and legal history, use history, and quality of recovery, together with a standardized test battery and an explicit opinion on aviation safety.¹³

If the reviewers conclude that current impairment or relapse risk is too high, the outcome is a Final Denial with written notice of the regulatory basis.

Getting Recertified Through HIMS

The Human Intervention Motivation Study program is the FAA’s structured route back to flying for pilots with a substance-dependence history, under a Special Issuance medical. It was built for airline pilots but is open to certificate holders at every level. It is expensive, intrusive, and long, and it works when the pilot commits to it.

The starting point is a HIMS-trained AME, who becomes the primary point of contact with the FAA. A HIMS-trained psychiatrist, often an addiction specialist, does the initial forensic-style evaluation and reports to the AME, who then builds the Special Issuance request.¹⁴

Once the Special Issuance is granted, the monitoring plan runs a minimum of seven years. For the first five years, the HIMS AME meets with the pilot every three months, alternating virtual and in-person visits. After five years the interval shifts to six months. After seven, regular AME monitoring visits may end.¹⁵

Abstinence testing runs alongside. For the first four years, pilots typically take 14 urine ethyl glucuronide tests per year, or use periodic daily breath testing where alcohol dependence is the diagnosis. After four years, testing can shift to four blood phosphatidyl ethanol tests annually. After seven clean years, abstinence testing may be discontinued.

Peer and supervisor monitoring are part of the deal. A peer pilot, often from the employer or union, attests monthly to continued abstinence and reports in writing on job performance, crew interaction, and concerns. A company supervisor monitor meets with the pilot monthly and files written reports. Aftercare counseling is required at the start, with quarterly reports to the HIMS AME, and can be dropped after at least a year. The pilot stays with the same HIMS AME for the first seven years.¹⁵

Any positive test or sign of deterioration goes straight to the FAA. The HIMS AME is obligated to call the agency. One relapse can undo years of work.

Appealing a Denial

If an AME denial comes down, a pilot can ask the Federal Air Surgeon to reconsider by writing to the Aeromedical Certification Division in Oklahoma City within 30 days. Miss the window and the application is treated as withdrawn.¹⁶

If the Federal Air Surgeon confirms the denial, the pilot can petition the National Transportation Safety Board for review within 60 days of service. An NTSB administrative law judge takes the case independently.¹⁷ These appeals tend to succeed where the FAA overlooked evidence of recovery or misapplied Part 67, and they usually go better with counsel.

BasicMed Is Not a Workaround

Pilots sometimes ask whether BasicMed lets them skip the substance review. It does not. A pilot with a substance-dependence history in the previous two years must have held at least one Special Issuance medical certificate before operating under BasicMed.¹⁸ The FAA medical process has to happen first.

1
eCFR. 14 CFR Part 67 – Medical Standards and Certification
2
eCFR. 14 CFR 61.15 – Offenses Involving Alcohol or Drugs
3
Federal Aviation Administration. Airmen and Drug- and/or Alcohol-Related Motor Vehicle Actions
4
Federal Aviation Administration. Pilot Records Database – NDR Reporting Requirement
5
Federal Aviation Administration. Application for Medical Certification – FAA Form 8500-8
6
Office of the Law Revision Counsel. 18 USC 1001 – Statements or Entries Generally
7
Federal Aviation Administration. Reporting Drug and Alcohol Records
8
Office of the Law Revision Counsel. 21 USC 812 – Schedules of Controlled Substances
9
Federal Aviation Administration. Controlled Substances and CBD Products
10
eCFR. 14 CFR 91.17 – Alcohol or Drugs
11
Federal Aviation Administration. Guide for Aviation Medical Examiners – Application Review – Item 62
12
Federal Aviation Administration. Guide for Aviation Medical Examiners – Applicant History – Item 18 Medical History
13
Federal Aviation Administration. Guide for Aviation Medical Examiners – Neurocognitive Impairment
14
Federal Aviation Administration. Substances Dependence/Abuse – Guide for Aviation Medical Examiners
15
Federal Aviation Administration. HIMS Drug and Alcohol Initial Certification Aid
16
eCFR. 14 CFR 67.409 – Denial of Medical Certificate
17
National Transportation Safety Board. How to File a Petition for Review of a Certificate Denial
18
Federal Aviation Administration. BasicMed