Forres GP Practices

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Fear of flying

Who do I see?

The Practices provide the following advice and do not prescribe sedatives for this

Advice:

Following a review of the prescribing policies by doctors at the Practices, as of 1/8/2023, the decision has been made not to prescribe sedatives (such as diazepam and temazepam) for ‘fear of flying.’

We provide the following information which gives the background and strong reasons to implement this decision. We hope that you will understand our stance on this. Many other GP practices have similar policies across the UK. We also provide the following advice to patients with worries about flying.

The reasons behind this decision:

  1. Although emergencies are very rare in aviation, taking sedatives like diazepam reduces your awareness and reaction times. This risks you not being able to react to save your life if you have to escape the aircraft quickly. You may also put other people at risk by getting in their way or necessitating the help of another.
  2. The use of these drugs can make you sleep in an unnaturally deep sleep. This means you won’t move around as much as during natural sleep so you will have a greater risk of getting a blood clot in the leg (deep vein thrombosis – DVT) or lungs (pulmonary embolus). Blood clots such as these can be dangerous and occasionally life-threatening. This risk is further increased if your flight is longer than 4 hours.
  3. The prescribing guidance for doctors says that using diazepam (and similar medicines) to treat short-term ‘mild’ anxiety is inappropriate. They are recommended for short-term use for a ‘crisis in generalised anxiety’. But if you are having such a crisis you are not likely to be fit to fly. Fear of flying in isolation is not a generalised anxiety disorder.
  4. Some people get agitated and aggressive after taking diazepam and similar drugs. They can behave in a way that they would not normally and may appear to be ‘drunk,’ which can pose a risk on a plane. This affects everyone’s safety and could get you into trouble with the law. A similar effect can be seen with alcohol. Such effects have also led to people being denied boarding or removed from flights.
  5. There is evidence that the use of these drugs stops the normal adjustment response that would gradually lessen anxiety over time and may increase anxiety in the long term, especially if used repeatedly.
  6. Sedative use added to alcohol consumption (a common thing to do before or during a flight) causes an amplification in all the risks posed by the points above.
  7. Diazepam and similar controlled drugs are illegal (even if prescribed) in many countries. They may be confiscated or you may find yourself in trouble with the police if found at Customs.
  8. Diazepam stays in your system for some time. If your job or sport needs you to have random drug testing you may fail this having taken diazepam.

 

What are the alternatives?

We kindly refer patients to the following resources from the aviation industry. These resources and courses are useful for people that still wish to fly and want to conquer their fear of flying.

easyJet www.fearlessflyer.easyjet.com
British Airways www.flyingwithconfidence.com
Virgin Atlantic https://flywith.virginatlantic.com/gb/en/wellbeing-and-health/flying-without-fear.html

 

Further points for consideration

Flight anxiety does not come under the remit of General Medical Services as defined in the GP contract and so GPs are not obliged to prescribe for this.

Patients who still wish to take a prescribed sedative for flight anxiety are advised to consult with a private GP or travel clinic. Be aware that they may also strongly discourage its use.

If you do take a sedative medication, it is important to tell your travel insurer about your medical conditions and the medications you take. If you do not, there is a risk of your insurer not paying if you try to make a claim.