Diazepam in the UK is a Class C/Schedule IV controlled drug. GPs and Practice Pharmacists are sometimes asked by a patient to prescribe them Diazepam to take prior to a flight to help with their fear of flying.
The following policy explains why Brookside Group Practice no longer prescribes Diazepam for fear of flying.
- According to prescribing guidelines for doctors (BNF) benzodiazepines (including diazepam) are contraindicated (not allowed) in patients with phobia. Your doctor would have to take a significant legal risk to prescribe against these guidelines, and risk losing their job. They are only licensed short term for a crisis in generalised anxiety. If this is the case, you should be getting proper support and care for your mental health.
- Diazepam is a sedative, which means it makes you more sleepy and more relaxed. If there is an emergency during a flight or procedure, this may impair your ability to concentrate, follow vital instructions and react to the situation. This could have serious safety consequences for you and those around you.
- Sedative drugs can make you fall asleep, however when you do sleep it is an unnatural form of sleep called non-REM sleep. This means your body does not move around as much as during natural sleep and can increase your risk of developing a blood clot in the leg (DVT) or lung (pulmonary embolism). Blood clots are dangerous, and in some circumstances can be fatal. This risk is even higher for those on flights over 4 hours.
- While most people find diazepam sedating, a small number of people have a differing reaction and can become agitated and aggressive. Diazepam can also cause disinhibition, leading you to behave in a way that you would not normally. These effects can impact on your safety and in some instances can get you in trouble with the law.
- Diazepam, and other similar drugs are illegal in several countries. They may be confiscated, or worse you may find yourself in trouble with the police.
- Diazepam stays in your system for quite a while after taking it. If your job requires random drug testing, you may fail this after taking diazepam. We appreciate that anxiety can be very debilitating, and we urge patients to see us for support with their mental health.
We understand that fear of flying can be very frightening and debilitating. An appropriate approach to treat it is to undertake a fear of flying course such as:
Easy Jet www.fearlessflyer.easyjet.com
British Airways www.flyingwithconfidence.com
Further information can also be found at How to manage a fear of flying and flying anxiety
Policy on the Prescribing of Diazepam for sedation prior to scans and procedures
Diazepam in the UK is a Class C/Schedule IV controlled drug. GPs and Practice Pharmacists are sometimes asked by a patient to prescribe Diazepam for them to take as a sedative prior to a scan, such as an MRI, or a procedure, such as dental work.
The following policy explains why Brookside Group Practice no longer prescribes Diazepam for sedation prior to a scan or procedure undertaken outside of the practice.
- Lack of Regular Involvement and Training: GPs are not regularly involved, skilled, trained, or appraised in sedation skills. Providing too little sedation won’t help you, and providing too much sedation can make you too sleepy, which could lead to the procedure being cancelled. Excessive sedation can also dangerously affect your breathing. After taking a sedative for a procedure or scan, you will need to be closely monitored to keep you safe.
- Unpredictable Effects of Diazepam: Although diazepam makes most people sleepy, in some rare situations, it can have the opposite effect and make people aggressive or agitated.
- Timing of Sedation: Scans and hospital procedures are often delayed. Therefore, the team performing the procedure or scan should provide the sedation to ensure you become sleepy and relaxed at the right time.
- Need for Regular Monitoring: Sedated patients should be regularly monitored as sedative medication can cause a patient’s breathing to become slower and more shallow.
- Guidelines from the Royal College of Radiologists: The Royal College of Radiologists’ guidelines on sedation for imaging make no mention of GP involvement or prescribing and stress the importance of experienced, well-trained staff being involved and the need for monitoring of sedated patients.
Hospital and dental clinics have formal procedures in place for sedation during procedures. If you feel you need sedation prior to a scan or procedure, please speak to the team undertaking the scan or procedure.