Roseworth Surgery has reviewed its Benzodiazepine prescribing and based on current national guidelines will no longer prescribe benzodiazepines or sedatives (such as diazepam) to patients for fear of flying.
Increasing concerns have arisen regrading prescribing benzodiazepines including diazepam (also known as “Valium). As safety issues have become better understood, it is clear that diazepam has a number of unwanted side effects and risks. This includes short term memory impairment, co-ordination issues and reduced concentration and reaction times. They also have significant risks of addiction. Unfortunately benzodiazepines use increased over the past couple of decades and it was historically prescribed for fear of flying.
Considering the information above, there are a number of very good reasons why we don’t prescribe diazepam for fear of flying any longer.
- The use of any sort of benzodiazepine causes longer reaction times & slowed thinking, which during a flight will put the passenger at significant risk of not being able to act in a manner which could save their life, or that of a loved one or co-passenger, 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. In fact there is a risk that you may be unrousable in the case of an emergency.
- The use of such sedative drugs can make you fall asleep, however when you do sleep it is an unnatural non-REM sleep. This means you wont move around as much as during natural sleep. This can cause you to be at an increased risk of developing a blood clot (Deep Vein Thrombosis – DVT) in the leg or even the lungs. Blood clots are very dangerous and can even prove fatal. The risk is even greater if your flight is longer than 4 hours.
- Whilst most people find Benzodiazepines like diazepam 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. 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 with alcohol consumption causes an increase in the risk posed by the points above.
- According to the prescribing guidelines doctors follow the British National Formulary – BNF which indicates diazepam is contraindicated (not allowed) in triatic phobic states. It also states that “the use of benzodiazepines to treat short-term “mild” anxiety is inappropriate”. Your doctor would be taking a significant legal risk in prescribing against these guidelines.
- In some countries it is illegal to import these drugs, so the passenger will need to use a different strategy for the homeward bound journey and/or any subsequent legs of the journey. There is a risk the medication maybe 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.
- Benzodiazepines have been linked to the onset of dementia
- A study published in 1997 from the Stanford University School of Medicine showed there is evidence the use of benzodiazepines stops the normal adjustment response that would gradually lessen anxiety over time and therefore perpetuates and may increase anxiety in the long term, especially if it is used repeatedly.
We do understand despite flying being very safe, it can be a source of concern for some. The aviation industry recommend flight anxiety courses which are easily accessible for those who wish to fly and conquer their fear of flying. Treating the cause of the fear with one of these course is much more favourable than simply masking the symptoms with risky medication. We include a list of resources below:
- Easy Jet www.fearlessflyer.easyjet.com
- British Airways www.flyingwithconfidence.com
- Vigin https://flywith.virginatlantic.com/gb/en/wellbeing-and-health/flying-without-fear.html
- https://thefearofflying.com/programs/fly-and-be-calm/
- 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 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.