POLICY ON PRESCRIBING SEDATIVES FOR FEAR OF FLYING
We understand that fear of flying can be very distressing. However, in line with current clinical best practice and national guidelines, from 1st August 2025 we will no longer be prescribing diazepam or similar sedative medications for flight-related anxiety.
- This decision is based on important medical, safety, and legal considerations, which we outline below:
- Safety Risks During Emergencies: Sedatives slow reaction times and impair judgment, which can significantly reduce a passenger’s ability to follow safety instructions or respond appropriately in an emergency, potentially endangering themselves and others.
- Risks of Combining Benzodiazepines and Alcohol: The combination greatly increases the risk of excessive sedation, respiratory failure, overdose, and even death.
- Increased Risk of Blood Clots (DVT): Benzodiazepines reduce movement by causing unnaturally deep sleep, increasing the risk of deep vein thrombosis on long flights, particularly those exceeding 4 hours which can be life threatening.
- Addiction and Withdrawal: Benzodiazepines carry a risk of dependence with prolonged use. Withdrawal symptoms can be severe, including seizures and hallucinations.
- Paradoxical Reactions: A minority experience increased agitation, aggression, or disinhibition—behaviour that can threaten safety onboard and may result in legal action or removal from a flight.
- Long-Term Exacerbation of Anxiety: Regular use may prevent patients from adapting to anxiety triggers, potentially perpetuating or worsening anxiety over time.
- Impairment and Drug Testing: The effects of benzodiazepines (drowsiness, coordination problems, memory impairment) can persist for hours and lead to failed workplace or sports drug tests after flying.
- Legal and Regulatory Restrictions: National guidelines state these drugs should not be prescribed for situational phobias, including fear of flying; prescribing them can expose doctors to legal risks. In some countries, carrying benzodiazepines is illegal, risking confiscation or arrest abroad.
- Travel Insurance Implications: Failing to disclose use of anxiolytics may void travel insurance in the event of an incident.
- Guideline Compliance: British National Formulary and NICE recommend against prescribing these drugs for non-generalised or mild anxiety and stress that is self-limiting or situational, such as a fear of flying.
Alternative Support Options
Support Programmes
We recognise that fear of flying is very real and challenging. Rather than medication, the recommended approach is to address this anxiety through specialised support programmes offered by several airlines, including:
Virgin Atlantic
https://www.flyingwithoutfear.co.uk/
Tel: 01423 714900 1252250
Easy Jet
www.fearlessflyer.easyjet.com
Te:1203 8131644
British Airways
https://www.britishairways.com/en-gb/information/travelassistance/flying-with-confidence
Tel: 01252 793250
Private Consultation Options
Please note that flight anxiety management does not fall under the NHS General Medical Services (GMS) contract, so we are not obliged to prescribe anxiolytics for this purpose. If you wish to explore medication options such as benzodiazepines, you may wish to consult a private GP for further advice.
Thank you for understanding our commitment to your safety and wellbeing.