Did you know that common cold and flu medications can impair your ability to fly or work safely in aviation—and even cause you to fail a drug or alcohol test? As winter sets in, it’s critical for aviation personnel to understand how everyday medications can affect performance and safety.
Alcohol and drug testing in the aviation industry
Aviation is an industry where safety depends on the alertness of its personnel. Alcohol and some drugs can impair human performance, slowing reaction times and decision making. They also impact poorly on flying and can potentially lead to an accident or loss of life.
Regular testing for alcohol and drugs ensures personnel who work in safety sensitive roles are not affected by harmful substances that could put them, colleagues or passengers at risk. People occupying the following safety sensitive roles can be tested at any time:
- flight crew (including private and foreign pilots)
- cabin crew
- ground handlers
- maintenance personnel
- aircraft dispatchers
- aviation security staff
- refuellers
- anyone who works airside.
The Civil Aviation Safety Authority (CASA) is responsible for overseeing policies related to alcohol and drug testing. This includes identifying prohibited substances, establishing regulations for organisational Drug and Alcohol Management Plans (DAMPs), and promoting industry awareness about the importance of regular testing and reporting.
There are 2 types of testing:
- non-notice testing (known as CASA) testing, which is conducted randomly by CASA alcohol and drug testing team; and
- employer testing, as part of an organisation’s Drug and Alcohol Management Plan (DAMP).
Under the regulations, testing can be carried out at any time without notice.
Know before you go
Alcohol and drug testing can detect not only illicit and prohibited substances, but also certain over-the-counter medications we use regularly. Some cold and flu tablets, cough medicines, and antihistamines contain ingredients that act as stimulants or depressants. This can potentially impair your ability to perform your job safely and effectively.
The below highlights some common medications and their side effects.
Cold and flu medication (highest risk: pseudoephedrine, codeine)
Depending on the brand, cold and flu medication can contain various mixes of paracetamol, pseudoephedrine, and codeine compounds and are classified as hazardous substances for working in aviation.
Pseudoephedrine products, such as Codral and Demazin, produce stimulant effects that can lead to headaches, dizziness, insomnia, feeling anxious, or more serious side effects like heart palpitations.
Codeine products, such as Panadeine, Nurofen Plus and Mersyndol, produce depressant effects that can lead to increased drowsiness, dizziness, headaches and confusion. They can only be dispensed by a prescription from a doctor or nurse practitioner.
Cough suppressants (risk of positive test)
Got an itchy throat? Common cough suppressant brands like Duro-tuss and Robitussin should be avoided as they may produce a positive result in urine testing.
If you need to get rid of that scratchy throat, opt to take Difflam instead.
Antihistamines (some sedating)
Antihistamines are commonly used to relieve symptoms of allergic reactions, including itching, sneezing, and a runny nose.
Some over-the-counter antihistamines, such as Phenergan, can cause drowsiness and are not recommended for use in certain situations. However, non-sedating options, such as Zyrtec, Telfast, Claratyne and Aerius contain ingredients that may not impair alertness and are approved for use after a ground trial.
Pain relievers (generally safe)
In general, pain relievers such as paracetamol (Panadol and Panamax), and ibuprofen (Nurofen) are approved to use when conducting aviation activities, provided they are taken as directed.
Expert advice: don’t fly sick
Dr Tony Hochberg, Deputy Principal Medical Officer at CASA says that pilots should avoid flying when experiencing significant cold and flu symptoms, even if they haven’t taken any medication.
‘Cold and flu symptoms have the potential to worsen during flight, affecting a pilot’s ability to equalise pressure in the sinuses and middle ear. This can lead to conditions such as middle ear and sinus barotrauma, which occurs when pressure differences between the body’s internal air cavities and the external environment cause pain and discomfort.’
‘This can impair a pilot’s performance due to distraction from pain and affect balance and situational awareness, leading to impaired performance,’ explains Dr Hochberg.
Dr Hochberg reiterates that before taking any medications for the first time, people working in safety critical roles should consider consulting their doctor or a Designated Aviation Medical Examiner (DAME) for further information and advice.
Quick checklist before taking medication
- Check the ingredients.
- Avoid sedating or stimulant compounds.
- Consult a DAME or aviation medical professional.
- Trial new medications on the ground.
- Stay informed with CASA’s approved medication list.
Further information
- Visit the CASA website for more information on Drug and Alcohol Management Plans (DAMPs) and other aviation medicine-related resources.
- Download the DAMP Contact Officers and Supervisors key personnel guide on the CASA Online store.
- Find a complete list of acceptable, hazardous and prohibited medicines on our medication webpage.
- Give CASA a call on 131 757 or find a Designated Aviation Medical Examiner (DAME) near you for any aviation medicine queries.
