Prescribing of Benzodiazepines or any sedative medication for Fear of Flying
The Glen Medical Practice has reviewed its benzodiazepine prescribing at a practice meeting on 19/09/2023 and established a new policy not to prescribe benzodiazepines or sedatives (such as diazepam) to patients for fear of flying. There are a number of reasons for this that are set out below:
Diazepam is a sedative, which means it makes you sleepy and more relaxed. The use of any sort of benzodiazepines causes longer reaction times and slowed thinking. If there is an emergency during the flight it may impair your ability to concentrate, follow instructions and react to the situation. This could have serious safety consequences for you and those around you.
Sedative drugs can make you fall asleep. However, when you do sleep, it is an unnatural non-REM sleep which means you won’t move around as much as during natural sleep. This can cause you to be at increased risk of developing a blood clot (DVT) in the leg or even the lung. Blood clots are very dangerous and can even prove fatal. This risk is even greater if your flight is greater than 4 hours.
Whilst most people find benzodiazepines like diazepam sedating, a small number of people experience the opposite effect and may become agitated or aggressive. Benzodiazepines can also cause disinhibition and lead you to behave in a way that you would not normally. This could impact on your safety as well as that of other passengers and could also get you into trouble with the law.
Benzodiazepine use added to alcohol consumption causes an increase in the risk posed by the points above.
According to the national prescribing guidelines that doctors follow (the British National Formulary, or BNF) benzodiazepines are not allowed to be prescribed in cases of phobia. Thus, your doctor would be taking a significant legal risk by prescribing diazepam for fear of flying as it is going against these guidelines. Benzodiazepines are only licensed short term for a crisis in generalised anxiety. If this is the case, you should be getting proper care and support for your mental health and not going on a flight.
Diazepam and similar drugs are illegal in a number of countries. They may be confiscated, or you may find yourself in trouble with the police.
Diazepam stays in your system for quite a while. If your job requires you to submit to random drug testing, you may fail this having taken diazepam.
We appreciate that fear of flying is very real and very frightening. A much better approach is to tackle this properly with a Fear of Flying course run by the airlines. We have listed a number of these below:
Easy Jet www.fearlessflyer.easyjet.com Tel 0203 8131644
British Airways flyingwithconfidence.com/courses/venues/glasgow Tel 01252 793250
See Fit for Travel for information on how to stay safe and healthy abroad
Please note:
Flight anxiety does not come under the remit of General Medical Services as defined in the GP contract and so we are not obliged to prescribe for this.
Patients who still wish to take benzodiazepines for flight anxiety are advised to consult with a private GP or travel clinic.
It is important to declare all medical conditions and medications you take to your travel insurer. If not, there is a risk of nullifying any insurance policy you may have.
Whilst we recognise that Diazepam has historically been prescribed for fear of flying, it should be noted that medical practice and policies change over time with updated guidance, and many other GP practices have instituted a similar policy on the prescribing of this medication. We always aim to prescribe safely, and we hope that the information given above explains the change in our policy.