• Skip To Content
  • Select Language
    • Afrikaans
    • Albanian
    • Arabic
    • Armenian
    • Azerbaijani
    • Basque
    • Belarusian
    • Bengali
    • Bulgarian
    • Catalan
    • Chinese (Simplified)
    • Chinese (Traditional)
    • Croatian
    • Czech
    • Danish
    • Dutch
    • Esperanto
    • Estonian
    • Filipino
    • Finnish
    • French
    • Galician
    • Georgian
    • German
    • Greek
    • Gujarati
    • Haitian Creole
    • Hebrew
    • Hindi
    • Hungarian
    • Icelandic
    • Indonesian
    • Irish
    • Italian
    • Japanese
    • Kannada
    • Korean
    • Lao
    • Latin
    • Latvian
    • Lithuanian
    • Macedonian
    • Malay
    • Maltese
    • Norwegian
    • Persian
    • Polish
    • Portuguese
    • Romanian
    • Russian
    • Serbian
    • Slovak
    • Slovenian
    • Spanish
    • Swahili
    • Swedish
    • Tamil
    • Telugu
    • Thai
    • Turkish
    • Ukrainian
    • Urdu
    • Vietnamese
    • Welsh
    • Yiddish
  • Font Size
    • Increase Font Size
    • Decrease Font Size
    • Reset Font Size
Plas Meddyg Surgery
Search
Show Main Menu
  • Home
  • Practice Information
    • The Team
    • Opening Times
    • CQC Rating
    • Friend & Family Test
    • Practice Area Map
    • Patient Participation Group
    • Named GP
    • Out of Hours
    • Complaints Procedure
    • Data Sharing and Privacy Notices
    • Data Choices
    • GP Earnings
    • Newsletters
    • Practice Policies
    • Summary Care Record
  • Appointments
    • Appointments Information
    • Home Visits
  • Services
    • Bexley MSK Service
    • Change of Details
    • Clinics
    • Communication Consent
    • Enhanced Access Appointments
    • Fit Notes & Sickness Certificates
    • Flu Clinics
    • Maternity Self-Referral
    • New Patient Registration
    • Non-NHS Services & Fees
    • Repeat Prescriptions
    • Test Results
    • Update Clinical Record
    • Vaccinations
  • Online Services
    • eConsult
    • Patient Access & NHS App
  • Self Referrals
    • Abdominal Aortic Aneurysm Screening
    • Abortion Advice
    • Chlamydia & Gonorrhoea Testing Kits for 16-24 year-olds
    • Condoms & Lube for 16-24 year-olds
    • Continuing Healthcare
    • Health & Wellbeing
    • Maternity
    • Muscle, Bone & Joint Pains
    • Samaritans
    • Stop Smoking
    • Young People's Drug and Alcohol Services
  • Health & Wellbeing
    • Blood & Organ Donation
    • Cancer Screening
    • Easyhealth
    • Fear of Flying
    • Over The Counter Products
    • Self-Care & Self-Management Advice
    • Useful Guides
    • When to go to A&E
    • Local Health Services
  • News
  • Contact
Show Side Menu
To view, print or save our practice booklet, click here
NHS 111 symptom checker
NHS reviews and ratings

Key Information

  • Samaritans
  • Condoms & Lube for 16-24 year-olds
  • Chlamydia & Gonorrhoea Testing Kits for 16-24 year-olds
  • Young People's Drug and Alcohol Services
  • Vaccinations
Call 111 - When it is less urgent than 999
BBC Health News
  • NHS plan: £1bn for hospital beds and ambulance fleet30 Jan 2023 07:36Extra capacity will help the NHS in England tackle emergency care delays, the prime minister says.
  • Thousands of NHS staff with long Covid risk losing their pay30 Jan 2023 05:50Analysis by BBC Panorama suggests between 5,000 and 10,000 NHS staff risk losing their pay.
  • Toxic slimming pill drug DNP to be declared poison27 Jan 2023 20:38Families say the government has not acted quickly enough to prevent deaths from diet drug DNP.
  • Woman died after walking out of Priory Hospital Arnold30 Jan 2023 06:42The police are investigating Helen Tarry's death and her partner says the hospital failed her.
  • Bridlington man repairs tooth with plastic and super glue30 Jan 2023 06:19Antony Watson says he resorted to drastic measures after being unable to find an NHS dentist.
  • Wynter Andrews: NHS trust fined £800k over baby's neglect death27 Jan 2023 15:45Wynter Andrews' parents Gary and Sarah say the fine "demonstrates the seriousness" of the failings.
Tweets
  • Need medical help? Use 111 online to get assessed and directed to the right place for you, like an urgent treatment… https://t.co/Z9ds0WcfZu

    11 hours ago • Follow us
  • It can be tricky deciding whether or not to keep your child off school when they are unwell. Follow this advice on… https://t.co/G0HK8GmrEB

    19 hours ago • Follow us
  • It’s #CervicalCancerPreventionWeek Cervical screening is one of the best ways to protect yourself from cervical ca… https://t.co/rfXUsXdlgW

    23 hours ago • Follow us
  • If you are unwell or injured, it’s important to choose the right service to make sure you get the best treatment as… https://t.co/VdomKfBU1b

    2 days ago • Follow us
  • If you need medical help fast, use 111 online to get assessed and directed to the help you need. ➡️… https://t.co/iAyaVJ6B1z

    2 days ago • Follow us
  • Use 111 online to get assessed and directed to the right place for you, like a consultation with a pharmacist. ➡️… https://t.co/e5hmMNf3z7

    2 days ago • Follow us
  • RT @DHSCgovuk: Cervical screening can stop cancer before it starts by checking for certain types of the human papillomavirus (HPV) that can…

    2 days ago • Follow us
  • Need medical help? Use 111 online to get assessed and directed to the right place for you, like an urgent treatment… https://t.co/GemlDkr5ZT

    3 days ago • Follow us
  • If something in your body doesn’t feel right, don’t carry the worry of cancer with you. Tests could put your mind a… https://t.co/DCaAp9sjWF

    3 days ago • Follow us
  • RT @NHSEngland: Do something amazing and help save up to three lives. Whether it’s used for someone who’s been in an accident, or saving…

    3 days ago • Follow us
Follow @nhsuk

Fear of Flying

Use of Benzodiazepines (and related medications) for flying

Benzodiazepines (e.g. Diazepam/ Lorazepam/Temazepam/Alprazolam/ Clonazepam) are drugs which have been in use since the 1960s for treatment of a wide range of conditions including alcohol withdrawal, agitation and restlessness, anxiety, epilepsy and seizures, neurological disorders. muscle spasms, psychiatric disorders and sleep disturbance

Initial use of benzodiazepines, including the well-known Diazepam also known as ‘Valium’, was enthusiastic and they were hailed as a wonder drug. However, it became increasingly clear that, as well as having short term deleterious effects on memory, co-ordination, concentration and reaction times, they were also addictive if used for a long time, with withdrawal leading to fits, hallucinations, agitation and confusion, and further had long-term effects on cognition and balance. Unfortunately benzodiazepines have also become a widely used drug of abuse since they first came on the market. Because of these reasons the use of benzodiazepines has been a lot more controlled around the world since the 1980-90s, especially in the UK. Diazepam in the UK is a Class C/Schedule IV controlled drug. The following short guide outlines the issues surrounding its use with regards to flying and why the surgery no longer prescribes such medications for this purpose.

People often come to us requesting the doctor or nurse to prescribe diazepam for fear of flying or assist with sleep during flights. Diazepam is a sedative, which means it makes you sleepy and more relaxed. There are a number of very good reasons why prescribing this drug is not recommended.

  • According to the prescribing guidelines doctors follow (British National Formulary) diazepam is contraindicated (not allowed) in treating phobic states.[i] ;It also states that “the use of benzodiazepines to treat short-term ‘mild’ anxiety is inappropriate.”[ii] Your doctor would be taking a significant legal risk by prescribing against these guidelines. They are only licensed short term for a crisis in generalised anxiety. If this is the case, you should be getting proper care and support for your mental health and not going on a flight.
  • NICE guidelines suggest that medication should not be used for mild and self-limiting mental health disorders[iii]. In more significant anxiety related states, benzodiazepines, sedating antihistamines or antipsychotics should not be prescribed. Benzodiazepines are only advised for the short term use for a crisis in generalised anxiety disorder in which case they are not fit to fly. Fear of flying in isolation is not a generalised anxiety disorder.
  • Although plane emergencies are a rare occurrence there are concerns about reduced awareness and reaction times for patients taking Diazepam which could pose a significant risk of not being able to react in a manner which could save their life in the event of an emergency on board necessitating evacuation.
  • 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 won’t 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. This risk is even greater if your flight is greater than 4 hours, the amount of time which has been shown to increase the risk of developing DVT whether in an aeroplane or elsewhere.
  • Whilst most people find 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 which can pose a risk on the plane. This could impact on your safety as well as that of other passengers and could also get you into trouble with the law. A similar effect can be seen with alcohol, which has led to people being removed from flights.
  • A study published in 1997 from the Stanford University School of Medicine[iv] showed that there is evidence 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 used repeatedly.
  • Diazepam and similar controlled drugs are illegal in a number of countries[v]. They may be confiscated or you may find yourself in trouble with the police. The passenger may also need to use a different strategy for the homeward bound journey and/or other legs of the journey.
  • 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.
  • 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.

Given the above we will no longer be providing Diazepam or similar drugs for flight anxiety and instead suggest the below aviation industry recommended flight anxiety courses.

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 for this. Patients who still wish to take benzodiazepines for flight anxiety are advised to consult with a private GP or travel clinic.

For further information:

https://thefearofflying.com/programs/fly-and-be-calm/

https://www.fearlessflyer.easyjet.com/

https://www.britishairways.com/en-gb/information/travel-assistance/flying-with-confidence

https://www.flyingwithoutfear.com/

[i] British National Formulary; Diazepam - https://bnf.nice.org.uk/drug/diazepam.html

[ii] British National Formulary; Hypnotics and anxiolytics - https://bnf.nice.org.uk/treatment-summary/hypnotics-and-anxiolytics.html

[iii] Generalised anxiety disorder and panic disorder in adults: management. NICE Clinical guideline [CG113] Published date: January 2011 Last updated: July 2019 https://www.nice.org.uk/guidance/cg113

[iv] Acute and delayed effects of Alprazolam on flight phobics during exposure. Behav Res Ther. 1997 Sep;35(9):831-41

[v] Travel Health Pro; Medicines and Travel; Carrying medication abroad and advice regarding falsified medication - https://travelhealthpro.org.uk/factsheet/43/medicines-abroad

Share

  • Print
  • Facebook
  • Twitter
Local Services
Back to top

Site

  • Home
  • Practice Information
  • Appointments
  • Services
  • Online Services
  • Self Referrals
  • Health & Wellbeing
  • News
  • Contact

About

  • Sitemap
  • Sign In
  • Disclaimer
  • Website Privacy
  • Website Accessibility
  • Cookies
  • Content Attribution
  • Back To Top

Contact

Plas Meddyg Surgery

40 Parkhill Road, Bexley, Kent, DA5 1HU

  • 01322 470595
  • plas.meddyg@nhs.net
© Neighbourhood Direct Ltd  2023
Website supplied by Oldroyd Publishing Group

Loading...

Local Services