Fear of Flying Policy

 

BACK TO MAIN INDEX

 

Use of Benzodiazepines (and related medications) for flying

After careful consideration Orchard End Surgery will no longer be prescribing benzodiazepines or sedatives (such as Diazepam or Zopiclone) for flight anxiety, or to assist with sleep while flying.

Flight anxiety does not come under the remit of General Medical Services as defined in the GP contract so we are not obliged to prescribe for this. Instead we suggest flight anxiety courses that are recommended by the aviation industry (links are at the end of the page).

Patients who still wish to take benzodiazepines when flying are advised to consult with a private GP or travel clinic.

travel

 

Policy

Diazepam is a Class C controlled drug in the UK. Due to its risk of addiction and abuse its prescribing is controlled by UK regulatory bodies. Although it may make you sleepy and more relaxed, there are a number of reasons why prescribing this drug is not recommended:

  1. According to the prescribing guidelines doctors follow (British National Formulary), diazepam is not allowed in treating phobias or mild anxiety. Your doctor would be taking a medico-legal risk by prescribing against these guidelines. They are only licensed for short term use in a generalised anxiety crisis. Obviously if this were the case, you would need proper support for your mental health and you would not be fit to fly. Fear of flying on its own is not a generalised anxiety disorder.
  2. The use of sedative drugs can make you fall asleep, however when you do sleep it is an unnatural non-REM sleep. This means you won’t move around as much as during natural sleep. In turn, this can increase your risk of developing a blood clot (Deep Vein Thrombosis - DVT) in the leg or even lungs. Blood clots are dangerous and can prove fatal. This risk is even greater if the flight is longer than 4 hours.
  3. Whilst most people find Diazepam/Zopiclone sedating, a small number have paradoxical agitation and aggression. They can also cause disinhibition and lead you to behave in a way that you would not normally which can pose a risk on the plane. This could impact your safety as well as that of other passengers. A similar effect can be seen with alcohol, which has led to people being removed from flights.
  4. Diazepam and similar controlled drugs are illegal in a number of countries. They may be confiscated by immigration with possible legal consequences. The passenger would then need to use a different strategy for the homeward bound journey.
  5. 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.
 

Further information

Thank you,
Orchard End Surgery
February 25