Here is another reason why you don't take drugs and fly. People die.
http://ntsb.gov/ntsb/brief.asp?ev_id=20010816X01703&key=1
The toxicological examination revealed that 0.049 ug/ml of codeine, in conjunction with 1.658 ug/ml of morphine, was detected in the pilot's urine. Morphine is an inactive metabolite of codeine. No codeine or morphine was detected in the pilot's blood. Codeine is a narcotic painkiller, used for control of moderate to severe pain. Codeine is found in various prescription painkillers, as well as in some over-the-counter cough suppressants.
Additionally, the toxicological examination revealed that 0.355 ug/ml of paroxetine was detected in the pilot's blood, and unspecified levels of paroxetine were detected in liver tissue and urine samples. Paroxetine (trade name Paxil) is a prescription antidepressant medication commonly prescribed to patients suffering from social anxiety disorders, and panic attacks.
During a telephone conversation with the National Transportation Safety Board investigator-in-charge on January 3, 2002, the pilot's personal physician reported that he had prescribed the accident pilot's prescription for Paxil, but had not prescribed any medication that contained codeine. The physician added that he first started treating the accident pilot on May 9, 2001, after the pilot complained of ongoing chest and throat tightness. According to his physician, the pilot explained to him that he had a longstanding history of anxiety that was previously treated with other anxiety medication. The pilot told the physician that he had to discontinue use of the medication since he was a pilot.
The NTSB medical officer reviewed the medical records obtained from the accident pilot's physician, and extracted, in part, the following information.
May 9, 2001, the physician wrote in the pilot's medical records, in part: "26-year-old male comes in today for "years" of ongoing chest and throat tightness. ... He says it often comes on when there is bad weather and he has to fly, or when he has to give his briefing talk to several people." The medical records note that the pilot was scheduled for an Upper GI Series, to be conducted within the next two weeks. Additionally, the physician prescribed 10 mg of Paxil to be taken once per day, and provided the pilot with a one-month supply of Paxil sample packages.
On May 23, the accident pilot underwent an Upper GI Series examination. According the physician's notes, the examinations findings were, in part: "There is moderate large distal sliding hiatal hernia with minor gastroesophageal reflux." Additionally, the physician writes: "...He [the pilot] also says he feels slightly better on Paxil 10 mg, so tomorrow he is starting 20 mg per day. He says he'll phone when he needs more meds."
On June 19, the accident pilot visited the physician for a follow-up appointment. The physician's notes state: "... comes in with progress report on his Paxil trial... He notices that he has less anxiety while flying his plane and less subjective shortness of breath while speaking to people in the airplane. It was getting to be enough of a bother that he was real unhappy with his job. Now he says that's being reversed. ...He complained of a little grogginess upon waking in the morning, but feels that it clears rapidly and is not present at the time of his going to work. ... will increase the Paxil from 20 mg to 30 mg a day. Told him again to expect a subtle increase in his early morning grogginess. He understands that he's not to work if he feels that this is impairing him at all. I also was clear that his records would have to be surrendered if an employer requested them. He agrees and understands. He'll increase to 30 mg for next three weeks and see if he feels in optimal control of anxiety. If not, he'll increase to 40 mg and notify me - samples given today for about 6 weeks."
On July 25, five days before the accident, the pilot's physician made the following entry in the pilot's medical records: "By the way - Request for refill of samples today. Feels 30 mg is good dose of Paxil..."
The FAA's 1999 Guide for Aviation Medical Examiners states, in part: "The use of a psychotropic drug is considered disqualifying. This includes all sedatives, tranquilizers, antipsychotic drugs, antidepressant drugs , analeptics, anxiolytics, and hallucinogens." The drug Paroxetine (Paxil) is considered a mood-ameliorating drug and requires a review by the FAA's medical certification division before being used by pilots. The prescribing physician was not an FAA certified medical examiner.