Mental standards for a first-class airman medical certificate are:
(a) No established medical history or clinical diagnosis of any of the
following:
(1) A personality disorder that is severe enough to have repeatedly
manifested itself by overt acts.
(2) A psychosis. As used in this section, "psychosis" refers to a
mental disorder in which:
(i) The individual has manifested delusions, hallucinations, grossly
bizarre or disorganized behavior, or other commonly accepted symptoms of
this condition; or
(ii) The individual may reasonably be expected to manifest delusions,
hallucinations, grossly bizarre or disorganized behavior, or other
commonly accepted symptoms of this condition.
(3) A bipolar disorder.
(4) Substance dependence, except where there is established clinical
evidence, satisfactory to the Federal Air Surgeon, of recovery, including
sustained total abstinence from the substance(s) for not less than the
preceding 2 years. As used in this section --
(i) "Substance" includes: Alcohol; other sedatives and hypnotics;
anxiolytics; opioids; central nervous system stimulants such as cocaine,
amphetamines, and similarly acting sympathomimetics; hallucinogens;
phencyclidine or similarly acting arylcyclohexylamines; cannabis;
inhalants; and other psychoactive drugs and chemicals; and
(ii) "Substance dependence" means a condition in which a person is
dependent on a substance, other than tobacco or ordinary xanthine-containing
(e.g., caffeine) beverages, as evidenced by --
(A) Increased tolerance;
(B) Manifestation of withdrawal symptoms;
(C) Impaired control of use; or
(D) Continued use despite damage to physical health or impairment of
social, personal, or occupational functioning.
(b) No substance abuse within the preceding 2 years defined as:
(1) Use of a substance in a situation in which that use was physically
hazardous, if there has been at any other time an instance of the use of a
substance also in a situation in which that use was physically hazardous;
(2) A verified positive drug test result acquired under an anti-drug
program or internal program of the U.S. Department of Transportation or
any other Administration within the U.S. Department of Transportation; or
(3) Misuse of a substance that the Federal Air Surgeon, based on case
history and appropriate, qualified medical judgment relating to the
substance involved, finds --
(i) Makes the person unable to safely perform the duties or exercise
the privileges of the airman certificate applied for or held; or
(ii) May reasonably be expected, for the maximum duration of the airman
medical certificate applied for or held, to make the person unable to
perform those duties or exercise those privileges.
(c) No other personality disorder, neurosis, or other mental condition
that the Federal Air Surgeon, based on the case history and appropriate,
qualified medical judgment relating to the condition involved, finds --
(1) Makes the person unable to safely perform the duties or exercise
the privileges of the airman certificate applied for or held; or
(2) May reasonably be expected, for the maximum duration of the airman
medical certificate applied for or held, to make the person unable to
perform those duties or exercise those privileges.