Prescribing Diazepam

At Bennetts End Surgery, we will not prescribe Diazepam for patients who wish to use this for a fear of flying or for phobias in relation to medical and dental procedures. We have made this decision due to the following reasons:

• Diazepam is a sedative. This means the medication makes you sleepy and more relaxed. If there were to be an emergency during the flight, this could impair your ability to concentrate, follow instructions, make decisions, or react to the situation. This could seriously affect the safety of you and the people around you.
• Sedative drugs can make you fall asleep; however, when you sleep, it is an unnatural non-REM sleep. This means your movements during sleep are reduced and this can place you at an increased risk of developing bloods clots (DVT). These blood clots are very dangerous and can even prove fatal. This risk further increases if your flight is over 4 hours long.
• Although most people respond to benzodiazepines like Diazepam with sedation, a small proportion experience the opposite effect and can become aggressive. They can also lead to disinhibition and make you behave in ways you normally wouldn’t. This could impact on your safety and the safety of your fellow passengers, as well as potentially lead you to get in trouble with the law.
• National prescribing guidelines followed by doctors do not allow the use of benzodiazepines in cases of phobia. Any doctor prescribing Diazepam for a fear of flying or medical/dental procedures would be taking a significant legal risk as this goes against the guidelines. Benzodiazepines are only licensed for short-term use in a crisis in generalised anxiety. If a flying phobia is the problem you suffer with, you should seek proper care and support for your mental health, and it would not be advisable to go on a flight. 
• In the situation of Diazepam for dental or medical procedures, the Medical and Defence Union (MDU) recommends that guidance from the Royal College of Radiologists (2018) is carefully considered. This states that a ‘trained and credentialed team should administer sedation and analgesia’. This means that a GP should not prescribe the medication as they are not the medical professional either performing or monitoring the procedure. 
• In several countries, Diazepam and similar drugs are illegal. They would be confiscated, and you might find yourself in trouble with the local police for being in possession of an illegal substance.
• Diazepam has a long half-life. This means it stays in your system for a significant time and you may fail random drug testing if you are subjected to such testing as is required in some jobs.

We appreciate a fear of flying and/or medical and dental procedures is very real and very frightening and can be debilitating. However, there are much better and more effective ways of tackling the problem. We recommend you attend a Fear of Flying course, which is run by several airlines. These courses are far more effective than Diazepam, they have none of the undesirable effects of medication and the positive effects of the courses continue after they have been completed.

Fear of Flying courses

• Easy Jet: www.fearlessflyer.easyjet.com A free downloadable e-book is available or online courses start from £89. Tel: 0203 813 1644

• British Airways: https://online.flyingwithconfidence.com Online courses are available for £79.99 and a range of in-person courses are also available by visiting: https://flyingwithconfidence.com/courses/primary Tel: 01252 793250

• Virgin Atlantic: https://flywith.virginatlantic.com/gb/en/wellbeing-and-health/flying-without-fear.html

For phobias in relation to medical and dental procedures, patients should consider a self-referral for Cognitive Behavioural Therapy (CBT) via the Wellbeing Service: www.hpft.nhs.uk/services/community-services/nhs-hertfordshire-and-mid-essex-talking-therapies/self-referral/