The use of over-the-counter (OTC), prescription, and illicit drugs is increasing in the U.S. population. The National Transportation Safety Board (NTSB) is concerned about the possible safety implications of increased drug use in all modes of transportation. Aviation is the one mode in which the regulatory authority, the Federal Aviation Administration (FAA), routinely conducts extensive post-accident toxicology testing on fatally injured pilots. This book used the results from this testing to assess drug use in aviation. The goals of this book are to describe the prevalence of OTC, prescription, and illicit drug usage among fatally injured pilots over time and evaluate the need for safety improvements related to pilots use of drugs. The book also provides studies to determine the extent of drug use in pilots who have died in an aviation accidents from 2004 to 2008 and determines the types of drugs most commonly found.