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Benzodiazepines are a group of medications including Diazepam, Lorazepam, Temazepam and Clonazepam. These drugs have short term effects on memory, co-ordination, concentration and reaction times, they are also addictive and withdrawal can lead to seizures, hallucinations, agitations and confusion, they can be fatal in overdose. Benzodiazepines have also become a widely used drug of abuse.
Our practice policy will be to use these medications only when they are strictly necessary and in the shortest possible courses at the lowest possible doses, after a discussion with a GP.
Flying
Due to more up to date information and research, we are not able to prescribe Diazepam for those who are afraid of flying. There are many safety reasons for this as explained below.
Reasons
- According to UK prescribing guidelines, Benzodiazepines are contraindicated in treating phobias, including fear of flying.
- Diazepam is a sedative, it can make you feel more sleepy or relaxed. If there is an emergency during the flight it may impair your ability to concentrate, follow instructions and react to the situation. This could have serious safety consequences for you and fellow passengers.
- Sedative drugs can make you fall asleep, however when you do sleep it is an unnatural non-REM sleep. This means you won’t move around as much as you would during natural sleep. This can cause you to be at increased risk of developing a blood clot in the leg (deep vein thrombosis ‘DVT’) or even the lung (pulmonary embolism ‘PE’). Blood clots are very dangerous and can even prove fatal. This risk is even greater if your flight is greater than 4 hours.
- Whilst most people find diazepam sedating, a small number of people have paradoxical agitation and increased aggression. They can cause disinhibition and lead you to behave in a way in which you would not normally. This could impact on your safety as well as that of those around you.
- When you fly, your oxygen levels decrease to as low as 90% from 98%, due to decreased air pressure at high altitude. Normally your body compensates for this by altering the rate and depth of your breathing. Benzodiazepines can depress your breathing rate, leaving you at risk of significantly decreased oxygen levels.
- Diazepam and similar drugs are illegal in a number of countries. They may be confiscated, or you may find yourself in trouble with the police.
Resources for people who are afraid of flying
- How to manage a fear of flying and flying anxiety
- Fear of Flying Course
- Flying with confidence
- Flying Without Fear
Alternatively, you could complete a course of private psychological intervention called ‘CBT’ (cognitive behavioural therapy), or consult with a private GP if you feel Diazepam is the only option.
It is important to declare all medical conditions and medications you take to your travel insurer. If not, there is a risk of nullifying any insurance policy you may have.
Scans and hospital and dental procedures
In some circumstances, people may need a sedating drug to be prescribed to take prior to a detailed scan or procedure, this should be prescribed by the team arranging the scan procedure. The clinical responsibility for this doesn’t rest with your GP.
GPs are not trained to provide the correct level of sedation for a scan or procedure. Providing too little sedation will not help you and being over-sedated includes many risks including risk of the scan or procedure being cancelled.
Scans and dental procedures are often delayed, therefore the team performing he procedure or scan should provide the sedation, to ensure you become sleepy and relaxed at the right time.