Diazepam (Benzodiazapines) for Fear of Flying and other Phobic disorders

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Hillside Practice has decided not to prescribe Diazepam to patients who wish to use this for a fear of flying any more.

People sometimes ask for a prescription for diazepam, or other benzodiazepines, for
fear of flying or to help them sleep during a flight. Prescribing these drugs is not
recommended any more for these reasons:

  1. Although plane emergencies are rare, taking Diazepam reduces awareness and reaction times for patients so you risk not being able to react to save your life if you have to escape quickly. This may also put your loved ones or other passengers and staff in danger by getting in their way or making them help you.
  2. The use of these drugs can make you sleep in an unnaturally deep sleep. This means you won’t move around as much as during natural sleep so you have a bigger risk of getting a blood clot (Deep Vein Thrombosis – DVT) in the leg or lungs. Blood clots are very dangerous and can kill. This risk is bigger if your flight is longer than 4 hours.
  3. They have short term bad effects on memory, co-ordination, concentration and reaction times. They are addictive if used for a long time, with withdrawal leading to fits, hallucinations, agitation and confusion. They have also become widely used drugs of abuse since they first came on the market. Diazepam in the UK is a controlled drug. The prescribing guidelines doctors have to follow say that the use to treat short-term ‘mild’ anxiety is inappropriate. They are only to be used short term for a ‘crisis in generalised anxiety’. If you are having such a crisis you are not likely to be fit to fly. Fear of flying in isolation is not a generalised anxiety disorder.
  4. Some people get agitated and aggressive after taking diazepam or other similar drugs, and behave in a way that they would not normally, which can pose a risk on the plane. This affects everyone’s safety and could get you into trouble with the law. A similar effect can be seen with alcohol, which has led to people being removed from flights. This response can also be exacerbated in the presence of alcohol.
  5. There is evidence use of these drugs stops the normal adjustment response that would gradually lessen anxiety over time, and may increase anxiety in the long term, especially if used repeatedly.
  6. Diazepam and similar controlled drugs are illegal in a number of countries. They may be confiscated, or you may find yourself in trouble with the police.
  7. Diazepam stays in your system for some time. If your job or sport needs you to have random drug testing you may fail this having taken diazepam.
  8. It is important to tell your travel insurer about your medical conditions and medications you take. If not, there is a risk of your insurer not paying if you try to make a claim. So, we have decided as a practice that we will no longer be providing Diazepam or similar drugs for flight anxiety.
    Fear of Flying Courses: We appreciate a fear of flying is very real and very frightening and can be debilitating. However, there are much better and effective ways of tackling the problem. We recommend you tackle your problem with a Fear of Flying Course:
    Easy Jet
    www.fearlessflyer.easyjet.com Tel: 0203 8131644
    British Airways
    https://flyingwithconfidence.com/ Tel: 01252 793250
    Virgin Atlantic
    https://flywith.virginatlantic.com/bb/en/wellbeing-and-health/flying-withoutfear.html Tel: 0344 874 7747
    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 you do not there is a risk your insurance policy will not be valid.