Flying and Benzo Diazepam

Medications for Fear of Flying

 

Purpose

This document sets out the practice policy on the prescribing of benzodiazepines for fear of flying.

 

Introduction

Benzodiazepines have in the past been prescribed to patients upon request to help individuals manage a fear of flying prior to and during flights.

 

Policy

Portishead Medical Group will no longer be prescribing benzodiazepine medications for patients who request this for the management of fear of flying.

 

Benzodiazepines are indicated for the short-term relief (two to four weeks only) of anxiety that is severe, disabling, or causing the patient unacceptable distress, occurring alone or in association with insomnia or short-term psychosomatic, organic, or psychotic illness.(1). The practice feels prescribing benzodiazepines for fear of flying is no longer recommended practice.

 

Prescribing or providing medicines or appliances on an NHS prescription, which a patient requires solely in anticipation of the onset of an ailment while outside the UK but for which the person is not requiring treatment when the medicine is prescribed is not allowed (2).

 

The practice recommends patients consider attending a fear of flying courses to help them conquer their fear of flying. Currently available courses include:

https://fearlessflyer.easyjet.com/; 

http://flyingwithconfidence.com/; 

 

All medications carry risks in use and benzodiazepines are no exception. The following are a list of risks and repercussions which have contributed to the development of our practice policy:

 

  • CNS depressants cause longer reaction times and slowed thinking, which during a flight can put a passenger at significant risk of not being able to act in a manner which could save their life in the event of a safety critical incident. (3)

 

  • Benzodiazepine users may present a risk to others as a result of heightened aggression or slower reaction times in the event of an emergency. (3)

 

  • Sedated individuals may move less during the flight, which could put them at increased risk of a venous thromboembolism (a blood clot). (3)

 

  • Respiratory depression may be caused due to sedating effects resulting in lower oxygen saturations in an aircraft cabin environment, this may be further exacerbated leading to further reduction in oxygen saturations. (3)

 

  • It is illegal to import Benzodiazepines into some countries thus patients may be at risk of prosecution. Patients may find medication confiscated at their destination country and thus without the medication for the flight home.

 

 

 

 

Definitions

Benzodiazepines are GABA receptor agonists which have hypnotic, anxiolytic, anticonvulsant, and muscle relaxant properties.

 

Responsibilities

It is the responsibility of all prescribers to be aware of and follow this policy.

 

References

 

  1. BNF Accessed online 24-02-2023

https://bnf.nice.org.uk/treatment-summaries/hypnotics-and-anxiolytics/#:~:text=Benzodiazepine%20indications,%2C%20organic%2C%20or%20psychotic%20illness.

 

  1. Standard General Medical Services Contract

https://www.gov.uk/government/publications/standard-general-medical-services-contract

 

  1. Cambs LMC

https://cambslmc.org/2022/08/19/lmc-guidance-on-requests-for-benzodiazepines-for-travel/