Fear of Flying Policy

 

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Use of Benzodiazepines (and related medications) for flying

After careful consideration, Orchard End Surgery will no longer prescribe benzodiazepines or other sedatives (such as Diazepam or Zopiclone) for flight-related anxiety or to aid with sleep during air travel. Instead, we recommend exploring flight anxiety courses offered by aviation industry professionals (see resources listed below).

Why We No Longer Prescribe These Medications for Flying

Flight anxiety is not classified as a medical condition that falls under General Medical Services as defined in the NHS GP contract. Therefore, we are not obliged to prescribe medications for this purpose. Patients who still wish to use benzodiazepines while flying are advised to consult a private GP or travel health clinic. 

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Important Medical and Legal Considerations

Diazepam is a Class C controlled drug in the UK. Due to its risk of addiction and abuse its prescribing is controlled by UK regulatory bodies. Although it may make you sleepy and more relaxed, there are a number of reasons why prescribing this drug is not recommended:

  1. Not Approved for Flight Anxiety - According to the British National Formulary (BNF), Diazepam is not licensed for treating phobias or mild anxiety. Prescribing it in these cases would go against national medical guidelines and place doctors at legal risk. Diazepam is only indicated for short-term use in acute anxiety crises. Flight anxiety on its own does not meet this definition and would suggest the need for broader mental health support—flying in such a state would not be advisable.
  2. Increased Risk of Blood Clots (DVT) - While sedatives may induce sleep, they lead to non-REM sleep, which reduces natural movement. This immobility increases the risk of developing deep vein thrombosis (DVT), especially on flights longer than four hours. DVT can be life-threatening if a clot travels to the lungs.
  3. Unpredictable Side Effects - Although, generally sedating, Diazepam and Zopiclone can cause paradoxical reactions in some individuals, including agitation, aggression, or disinhibition. These side effects can pose serious safety risks during a flight, both to the individual and fellow passengers. Similar issues have been observed with alcohol use on board.
  4. Legal Restrictions Abroad - Diazepam and similar medications are classified as Class C controlled substances in the UK and are illegal in many other countries. Bringing them into certain destinations could result in confiscation or legal penalties. This also creates complications for the return journey if alternative medication arrangements are required.
  5. Impact on Travel Insurance - It is essential to declare all medications and medical conditions to your travel insurer. Failure to do so may invalidate your insurance policy. 
 

Further information

Thank you for your understanding and cooperation. 
Orchard End Surgery
February 25