In the new movie Flight, Denzel Washington plays an intoxicated pilot who performs a miraculous inverted flight to save an airliner from crashing. PM looked into plausibility of the sequence and found that at least theoretically a pilot could have pulled off the feat, even if it would've taken an almost superhuman reaction time. But there was another detail in the movie we didn't address: Since the pilot wakes up hungover and snorts cocaine to cut through his fatigue, could the coke have helped him land the plane?
A pilot on drugs is the last thing passengers want. But the hypothetical question is a valid one: Scientists are investigating whether drugs like cocaine really could lead to a performance or reaction time enhancement. Gary Wadler, a doctor with the World Anti-Doping Agency and expert on narcotics, argued several years ago that cocaine use by athletes should be policed because of some positive aspects on performance. "The acute effects of cocaine probably, overall, would impair and not enhance performance," he said. "But within a two-hour window, you may actually have some enhancement—overcoming fatigue, reaction time, and so on."
One National Institutes of Health study shot up various animals with cocaine and judged their reactions. A strict read of this study might argue that a snort before flying really could have an effect—if it was a big one: "Consistent reductions in reaction times were frequently observed over the cocaine dose range of 0.32 to 1.0 mg/kg," the study says. "At higher doses, either decreases or increases in reaction times were observed, depending upon the animal."
The National Highway Traffic Safety Association notes that "most laboratory-based studies have been limited by the low doses of cocaine that were allowed." However, they list some advantages: "At these single low doses, studies have shown performance enhancement in attentional abilities and increased behavioral and cortical arousal, but have no enhancement of effects on learning, memory, and other cognitive processes. Faster reaction times and diminished effects of fatigue have been observed."
Most pertinent to Flight is the fact that, according to an NHTSA study, a person like Denzel's character would be in the best position to receive a benefit from coke—if he was exhausted. "Improvements were greatest in behaviorally-impaired subjects (e.g. sleep deprived, fatigued, or concurrent use of ethanol)and least improvements were observed in well-rested, healthy subjects." The drug also causes recklessness, which in most cases would be bad for a pilot. But flipping an airliner is a reckless maneuver, so the movie pilot may have an argument that the drug helped him make a bold, crazy choice that saved lives.
And pilots are known to reach for a boost; the U.S. Air Force uses stimulants to fight fatigue. Their speed of choice is Dextro-amphetamine (Dexedrine). The Air Force says that in low doses the speed can help pilots handle heavy workloads. (Here's a good, if dated, history of their adoption.) Of pilots who used amphetamines, 58 to 61 percent considered the drug's use beneficial or essential to operations.
But cocaine is a different animal. While it's possible to construct an argument that one-time use could've helped the Flight pilot with his impossible maneuver, cocaine addiction plays hell on frontal cortical function. Information processing that is so vital to pilots would be damaged. And while recklessness might have saved the day in the movie, in reality it's a terrible trait in a pilot. Thankfully there aren't many stats on flying under the influence of cocaine, but we know that reckless driving on cocaine contributes to plenty of driving accidents. The Emergency Medical Services Authority says "an analysis of accidents in which the driver used cocaine proved that use of the drug resulted in speeding, loss of control of the vehicle, and inattentive driving."
Lastly, even if Denzel did just enough coke at just the right time to get a bump in reaction speed, he probably would have blown any edge that gave him by drinking a strong screwdriver during the flight as well. Coke and booze are stronger when taken together—the chemicals form a cocetylene metabolite, which builds up to intoxicate a user. This would have rendered Washington's character less able to conduct the maneuvers necessary to land an airplane.