Why we don't prescribe these any more
We are unable to prescribe diazepam and other benzodiazepines to assist with fear of flying. This is a collective decision made by the GP partners and other practices have a similar policy in place. There are several reasons why it is not recommended to prescribe diazepam for fear of flying.
Diazepam is a Class C/Schedule IV controlled drug. It is a sedative, meaning that it will make you feel sleepier and more relaxed. In the rare case of an emergency when flying, people who are under the effect of diazepam will have a reduced awareness, poorer ability to follow instructions and slower reaction times. This could pose a significant risk to themselves or to others in the event of emergency evacuation of the plane.
If you fall asleep under the influence of diazepam, you will fall into an unnatural non-REM sleep. This means that you will move around less than during a natural sleep, which will increase the risk of a blood clot (DVT). The risk is greater if your flight time is longer than 4 hours. Blood clots can be very dangerous and can prove fatal.
Occasionally, although the effects of diazepam tend to be sedating, some people may experience agitation and aggression. It can also cause disinhibition, leading you to behave in a way that you would not normally. This can pose a risk to the safety of you, other passengers, and flight attendants. A similar effect can also be seen with alcohol, which has led to passengers being removed form flights.
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.
According to prescribing guidelines in the British National Formulary, diazepam is not indicated for treating phobias and it states that “the use of benzodiazepines to treat short-term ‘mild’ anxiety is inappropriate.” They are only licensed short term for a crisis in generalised anxiety. Fear of flying in isolation is not a generalised anxiety disorder.
Flight anxiety does not come under the remit of General Medical Services as defined in the GP contract and so there is no obligation for NHS GPs to take a significant legal risk by prescribing outside of the guidelines. Patients who still wish to take benzodiazepines for flight anxiety are advised to consult with a private GP.
We would recommend your consideration of attending a flight anxiety course, recommended by the aviation industry.
For further information, please see the following sites
https://www.fearlessflyer.easyjet.com/
https://www.britishairways.com/en-gb/information/travel-assistance/flying-with-confidence
https://www.flyingwithoutfear.com