Policy on prescribing of Benzodiazepine and related medications for fear of flying, dental work, scans or other investigations
Benzodiazepines are and have been used for the treatment of a wide range of conditions including alcohol withdrawal, anxiety, epilepsy, sleep disturbance and muscle spasms.
Their use can lead to short term effects on memory, co-ordination, concentration and reaction times. They are also addictive, and withdrawal can lead to seizures, hallucinations, agitation and confusion.
Unfortunately, benzodiazepines have also become a widely used drug of abuse. This means there are restrictions as to when and how much can be prescribed.
Patients often come to their GP requesting prescriptions of benzodiazepines to assist with anxiety surrounding fear of flying, to aid sleep during flight, or to help with dental / medical procedures. There are several reasons why prescribing in these situations is not recommended and, as such, Laurel Bank Surgery will no longer continue to prescribe them for these purposes.
- Prescribing benzodiazepines for a fear of flying is against national guidance, thereby posing a legal risk to doctors. They are only licensed for short term use in crisis situations related to generalised anxiety. If this is the problem you suffer with, you should seek proper care and support for your mental health and flying may not be recommended.
- Benzodiazepines are sedatives; this includes drowsiness and relaxation. Taking them before a flight may reduce your ability to focus and ability to follow instructions. This could have serious safety concerns for you and those around you in the event of emergency.
- The use of these drugs can make you sleep unnaturally deeply preventing you from moving around as much as you would during natural sleep. This can cause you to be at increased risk of developing a blood clot in the leg (deep vein thrombosis, DVT) or the lung (pulmonary embolism, PE). Blood clots are very dangerous and can even prove fatal. This risk is greater if you are on a longer flight.
- While most people find benzodiazepines sedating, a small number of people have paradoxical (unexpected and inconsistent) agitation potentially with increased aggression. They can cause disinhibition and lead you to behave in a way in which you would not normally behave. This could impact your safety as well as that of those around you.
- In several countries, benzodiazepines are illegal. They would be confiscated, and you might find yourself in trouble with the police for being in possession of an illegal substance.
- Diazepam has a long half-life; this means it stays in your system for a long time and you may fail a drug test if you were subjected to any testing, for example for a job.
The aviation industry recommends non-medical options for coping with flight anxiety. Information about this and some available courses can be found below:
Easy Jet: https://www.fearless-flyer.com/
British Airways: https://www.flyingwithconfidence.com
Virgin: Tips For Nervous Flyers | Advice For Nervous Flyers | Virgin Atlantic
Alternatively, you can contact your local psychological therapy provider for cognitive behavioural therapy (CBT). Treatment – Phobias – NHS
Please note we do not provide prescriptions in other situations such as dental procedures, prior to scans, or hospital procedures. If you think medication may be required, we advise you contact the dentist or the doctor requesting your procedure or scan. They have responsibility for the investigation/procedure and will be able to decide if such medication is appropriate. Should they deem it so, they can choose to prescribe accordingly.