Diazepam (Benzodiazepines) for fear of flying
We are often asked to prescribe diazepam for the fear of flying or to help assist with sleeping during flights.
The surgery will no longer be able to prescribe Diazepam or such medications for the purpose of flying due to British National Formulary Prescribing Guidelines, which say that Diazepam (a Class C/Schedule IV controlled Drug) is not allowed for treating phobias/fears. It states that ‘the use of benzodiazepines to treat short term mild anxiety is inappropriate’. They are only licensed for short term use for a crisis in generalised anxiety disorder. Fear of flying in isolation is not a generalised anxiety disorder and the Doctors would be faced with significant legal risk by prescribing against these guidelines.
Diazepam is a sedative and could impair your ability to concentrate and/or reduce awareness and reaction times, increasing the risk to yourself or other passengers in an event of an emergency.
Sedative drugs can make you fall asleep; however, it is an unnatural sleep. This results in less movement than when in natural sleep and increases the risk of developing a blood clot (Deep Vein Thrombosis – DVT) in your legs or lungs. Blood clots are very dangerous and can even prove fatal. This risk is proven to be greater if your flight is more than 4 hours.
Although Diazepam is sedating, a small number of people experience paradoxical agitation and aggression. This can lead to you behaving in a manner that you would not normally do, which can impact on your safety and the safety of others. There is also the potential of getting into trouble with the law.
Diazepam and similar controlled drugs are illegal in some countries. They may confiscate the medication, and you could find yourself in trouble with the police for being in possession of an illegal substance. Diazepam will also stay in your system for a significant amount of time. This may cause you to fail random drug testing if subjected to checks. Failure to declare all medical conditions and medications correctly on your travel insurance can also nullify any insurance policy you may have.
Flight anxiety does not come under the remit of the General Medical Services contract, and we are not obliged to prescribe for this. Patients that wish to take benzodiazepines for flight anxiety are advised to consult with a private GP.
Help with overcoming a fear of flying is available on the NHS - please go to NHS Talking Therapies for more information.