Patients often come to us requesting the doctor or nurse to prescribe benzodiazepines (e.g. diazepam) for fear of flying or to assist with sleep during flights. While we appreciate some of our patients may have a genuine fear of flying or feeling nervous during the flight, Central Surgery does not prescribe diazepam for flying anxiety/fear of flying. When prescribing any medication, we have to consider and balance the benefits against the risks and with benzodiazepines, the risks outweigh the potential benefits.
As this type of medication (tranquilliser/anxiolytic) is a sedating drug there are several safety concerns to consider:
- It can make you sleepy; this medication does not offer natural sleep, but sedates you which means you are going to have less natural body movements. This increases the risk of getting a blood clot (even further to the known risk of a long-haul flight).
- It can make you drowsy; your reflexes and reaction times can be slower which can put you and others at risk in case of an on-board emergency.
- If you have to drive on your arrival destination, you might be putting yourself and others at risk by doing so under the influence of a sedative.
- The sedative effect can reduce the level of circulating oxygen in your body, which can be life threatening especially in people with respiratory problems, given there is already lower oxygen concentration in higher altitudes.
Indications for prescribing this medication:
- According to the prescribing guidelines, diazepam is contraindicated for treating phobias and “the use of benzodiazepines to treat short-term ‘mild’ anxiety is inappropriate.” This would result in the doctor prescribing it taking a significant legal risk by acting against the guidelines.
- It is only indicated for relief of symptoms in those suffering from severe or disabling anxiety (usually only when advised by a specialist/psychiatrist).
Other risks:
- In some countries this medication is illegal so you are at risk of breaking the law by carrying it with you.
- It should not be mixed with alcohol which is usually offered on board.
- If your job requires you undergo drug testing, this medication can stay in your body and make you fail that test.
- In some people, this medication can cause the opposite of ‘desirable’ effect, including agitation, confusion and disinhibition, leading you to behave in ways that you would not normally. This can have an impact on your own safety and that of other passengers and crew, while it might also get you in trouble with the law.
As an alternative, flight companies provide courses which offer support to overcome fear/anxiety of flying, helping also in the long-term alleviation of symptoms. Please see below links to their courses: