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From: Robert Swotinsky MD
Password: orange
Date: 21 Nov 2006
Time: 18:13:31 -0800
Remote Name: 71.192.169.50
1. Based on Marinol prescribed a little less than a year ago and renewed recently, would the MRO have to downgrade a marijuana-positive drug test? Yes! 2. Would the treating physician's written statement that Marinol does not have CNS effects stop the MRO from disclosing a potential safety risk as required? No, the letter would not necessarily stop the physician from disclosing a likely safety risk. It's unclear, however, that use of Marinol as described in the case poses a likely safety risk or medical unqualification issue. The letter from the treating physician might influence an MRO who's unsure of what to do. 3. How would I treat this case if I was the MRO? I'd report the drug test result as negative and suggest to the MRO that he disclose occasional use of Marinol the next time he has an exam. Realize that the MRO is responsible for determining if there is an alternative medical explanation and is responsible for reporting likely safety or medical unqualification issues. The MRO is not, however, responsible for notifying FAA of pilots who may have withheld information on their aviation medical exams. That is a violation of the law, but fortunately MROs are not in the law enforcement business. 4. As a matter of practice, when the donor has used Marinol does the agency require any additional testing such as THC-V, which can help distinguish Marinol from marijuana? No. DOT does not authorize THC-V testing of urine specimens collected under its authority.