FAA Drug Use Policy Update: What Pilots Need to Know About Medical Certification

The FAA updated its drug use disposition table and introduced a new substance use disorders disposition table on September 30, 2026. These tables guide Aviation Medical Examiners (AMEs) in deciding whether to issue a pilot’s medical certificate or defer the application to the FAA. Under the updated guidance, pilots with any history of drug use (including medical or recreational marijuana and psilocybin use) may only receive an in-office medical certificate if they have previously reported that history and can provide an FAA eligibility letter confirming that monitoring is not required. Without that documentation, the AME must contact the FAA for verification, potentially delaying certification.

A history of drug use that has not been previously reported or cleared generally requires deferral and additional documentation, which may include a personal statement, 10 years of driving records, relevant police or court records, prior treatment records and drug testing results. Depending on the circumstances, the FAA may request further evaluations, including a HIMS aeromedical evaluation. Pilots with a history suggesting substance abuse, dependence or a substance use disorder may face additional review, monitoring requirements or possible denial of certification. Matthew Bulow discusses concerns that these changes could discourage honest reporting and create additional barriers for pilots. He recommends speaking with an aviation attorney before completing MedXPress or meeting with an AME if you have a history of substance use.