14 units per week — Page 108, Lesson 167

I want to walk you through a topic that is serious and often misunderstood: alcoholism, particularly as it affects aircrew. Let’s start with the definition. Alcoholism is not easily recognized or defined, but the World Health Organization gives us a clear benchmark: it is when the excessive use of alcohol repeatedly damages a person’s physical, mental, or social life. Notice the word “repeatedly” — this isn’t about a single bad night; it’s about a pattern that causes harm over time. Now, the single most important characteristic of an alcoholic’s use of drink is a loss of control. That loss of control leads to a continuing progression — meaning it gets worse — toward more and heavier drinking, or regular binges that can last days or even weeks. I want to stress something here: the alcoholic does not necessarily present the classic picture of a derelict existing on cheap wine or methylated spirits. Most are supposedly sober citizens with responsible jobs — doctors, lawyers, managers, or even clergy. No profession is exempt from this illness. But some professions, and aircrew in particular, have a higher than average risk. Why? Because in their occupation they are exposed to factors known to be associated with its development. Let me list those factors: social isolation, boredom, high income, and an easy access to cheap alcohol. Aircrew tend to live in a ‘drinking culture’ — there’s a need to conform, and they often erroneously use alcohol to unwind and as an aid to sleep. That word “erroneously” is important — it’s a mistaken belief that alcohol helps in those ways. So, what are the signs that may indicate problems with alcohol control? I’ll go through them one by one. Drinking alone. Gulping the first drink. Preoccupation with the next drink. Becoming defensive and angry when criticized about his/her drinking habits. Protection of the alcohol supply — meaning they guard it or hide it. Use of alcohol as a tranquilliser. Loss of memory of events when drunk — that’s a blackout. Requirement to increase the intake to feel good — that’s tolerance building. Morning shakes. High tolerance to alcohol. And loss of control, which is binge drinking. The alcoholic is a danger to himself/herself and other people. That’s a critical point for aviation — we’re talking about safety. The first essential in the treatment of alcoholism is the admission that he or she is an alcoholic and a willingness to accept treatment. Without that admission and willingness, treatment cannot begin. Now, what is the goal? Total abstinence is the only realistic goal. There is no hope of a return to controlled drinking. Once the loss of control is established, you cannot go back to moderate drinking. However, given suitable treatment, a pilot can return to flying duties. That’s important — recovery is possible, and a return to the cockpit is possible with proper treatment. But also note: a high level of social drinking can be damaging, even without alcohol dependence. You don’t have to be an alcoholic for heavy drinking to harm your performance or health. Finally, what should you do if you suspect a crew member is suffering from alcoholism? A prompt, frank and positive approach is required, with the knowledge that help is available. But if the direct approach is felt not to be possible — if you can’t talk to them directly — then you should inform the organization’s aviation medical specialist or fleet manager. That’s the chain of responsibility. So to summarise: alcoholism is defined by repeated damage from excessive alcohol use, driven by loss of control. Aircrew are at higher risk due to factors like isolation, boredom, high income, and easy access. The signs are clear, treatment requires admission and total abstinence, and a pilot can return to duty after treatment. If you suspect a problem, act promptly and positively, or escalate to the medical specialist or fleet manager.