We have recently reviewed the practice’s benzodiazepine policy and have agreed that we will no longer prescribe benzodiazepines or sedatives (such as diazepam) to patients for ‘fear of flying’ (or other phobias such as dental procedures or MRI scans). Many other GP practices have a similar policy.

There are several good reasons for this:

1) Diazepam is a sedative, which means it makes you sleepy and more relaxed, which may impair your ability to concentrate, follow instructions and react in an emergency situation. This could put yourself, other passengers and aircraft staff at serious risk.

2) Sedative drugs can make you fall asleep; however, it is an unnatural non-REM sleep. This means you will not move around as much as during natural sleep. This can cause you to be at increased risk of developing a blood clot in the leg (DVT) or the lung (PE). This can be serious and in some cases be life-threatening/fatal.

3) Whilst most people find benzodiazepines like diazepam sedating, a small number of people experience 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 and the safety of other passengers, and could also get you into trouble with law enforcement officers.

4) According to the prescribing guidelines doctors follow (BNF), Benzodiazepines are contraindicated (not allowed) in phobia. Your doctor is taking a significant legal risk by prescribing against these guidelines. They are only licensed short term for a crisis in generalised anxiety. If this were the case, you will need proper care and support for your mental health and not be going on a flight.

5) Diazepam and similar drugs are illegal in a number of countries. They may be confiscated or you may find yourself in trouble with the police.

6) 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. They will also impair your ability to drive or operate heavy machinery.

We appreciate that ‘fear of flying’ can be very frightening. It is recommended to tackle this properly with a ‘Fear of Flying’ course run by the airlines listed below:

Easy Jet

British Airways

Virgin 

If you still wish to consider diazepam for fear of flying, we suggest consulting with a private GP or a private travel clinic, who may be able to help you further. These services are private and not offered by the NHS. The private clinics may then liaise with the airlines directly to arrange a medically trained escort for a passenger who is taking sedative medications, which can be expensive.

In addition, we do not provide sedative medications such as diazepam for use in other situations, such as for dental/hospital procedures or scans. The Royal College of Radiologists sets out clear guidance for sedation in hospital radiology departments, which states, “Sedation and analgesia should be administered by a competent and well-trained sedation team and oversight provided by a sedation committee within the institution”.

The Intercollegiate Advisory Committee for Sedation in Dentistry has a similar guideline which states “The monitoring and discharge requirements for oral sedation are the same as for intravenous sedation. Oral sedation must only be administered in the place where the dental treatment is provided and must only be carried out by practitioners who are already competent in intravenous sedation.”

As a result, responsibility for this type of treatment lies with your dentist or hospital staff, and not your GP. If you feel this is required, we suggest consulting with your dentist or the hospital teams in good time before any scans or treatments occur.