After careful consideration and in line with current medical guidelines, our practice has established a policy not to prescribe benzodiazepines (including diazepam) or other sedatives to patients for fear of flying. Many other GP Practices have a similar policy. There are several reasons for this decision, primarily concerning the safety and well-being of our patients.
Risks of Benzodiazepines on Flights:
- Sedation and Impairment:Benzodiazepines can cause sedation and impair cognitive and motor functions, with adverse effects on memory, co-ordination, concentration, balance and reaction times, which may be exacerbated in the pressurised environment of an aircraft. This leads to a significant risk of incapability to act in a manner which could save one’s own life, or someone else’s life in the event of a safety critical incident. Incapacitation from benzodiazepines is a risk to the lives of all on board the aircraft in the event of an emergency requiring evacuation.
- Respiratory Depression:These medications can depress breathing, which can be particularly risky in a high-altitude environment.
- Increased Risk of Deep Vein Thrombosis (DVT):Sedation leads to a higher chance of falling sleep and prolonged immobility, increasing the risk of DVT (a blood clot in the leg which can travel to the lungs) during flights. These are dangerous, and can be fatal.
- Paradoxical Effects:In some cases, benzodiazepines can cause increased agitation and anxiety, counteracting their intended calming effect,l leading 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.
Other considerations and risks:
Benzodiazepine use added to alcohol consumption causes an increase in the risk posed by the points above.
According to the prescribing guidelines doctors follow (British National Formulary) diazepam is contraindicated (not allowed) in treating phobic states. Your doctor would be taking a significant legal risk by prescribing against these guidelines.
It is illegal to bring these drugs into some countries, and so the passenger would need to use a different strategy for the homeward bound journey and / or any subsequent legs of the journey; 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.
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.
In light of the above, we will no longer be providing benzodiazepines such as diazepam, or other sedatives for flight anxiety. We understand that fear of flying can be distressing, and we are committed to supporting you in managing this anxiety. We recommend exploring non-pharmacological options, such as fear of flying courses, many of which are recommended and run by the aviation industry and which have been shown to be effective for many individuals.
Resources for Fear of Flying:
Thank you for your understanding and cooperation