Prescribing Medication for Anxiety Surrounding Flying

The practice does not provide diazepam, temazepam, zolpidem, or any other anxiolytic medications for use on flights or during travel. This decision is based on the well-documented risks of using these medications while traveling, as outlined in various online medical resources.

Use of Benzodiazepines (and related medications) for Flying

Benzodiazepines (such as Diazepam, Lorazepam, Temazepam, Alprazolam, and Clonazepam) are medications that have been used since the 1960s to treat conditions like anxiety, alcohol withdrawal, seizures, muscle spasms, and sleep problems.

When benzodiazepines like Diazepam (also known as 'Valium') were first introduced, they were widely praised as a breakthrough medication. However, over time, it became clear that these drugs can cause memory problems, coordination issues, and impaired reaction times. Long-term use can also lead to addiction, withdrawal symptoms like seizures and hallucinations, and lasting cognitive and balance issues. These medications have become commonly abused, leading to stricter regulations worldwide, including in the UK, where Diazepam is classified as a controlled drug.

This guide outlines why the practice no longer prescribes these medications for flying.

Why Not Prescribe Diazepam for Flying?

People sometimes ask for diazepam to help with fear of flying or sleep during flights. While it is a sedative that can make you feel more relaxed and sleepy, there are several reasons why prescribing it is not recommended.

  • According to the British National Formulary (BNF), diazepam is not recommended for treating phobias or mild anxiety. Prescribing it for such conditions would put the doctor at legal risk, as these drugs are only licensed for short-term use in severe anxiety situations. If you have significant anxiety, proper care and support are needed, not medication for a flight.
  • The NICE guidelines also advise against using medication for mild, short-term anxiety, and suggest that benzodiazepines should only be used in a crisis situation, which would not apply to fear of flying alone.
  • Although plane emergencies are rare, using diazepam could impair your reaction time, putting you at risk of not being able to respond in an emergency, such as an evacuation.
  • Additionally, while diazepam might help you fall asleep, it causes unnatural, non-REM sleep, which reduces movement. This increases the risk of developing a dangerous blood clot (Deep Vein Thrombosis – DVT), especially on flights longer than 4 hours. DVT can be fatal.
  • While most people feel sedated by diazepam, a small number may experience agitation or aggression, which could be problematic on a plane. This could jeopardize your safety and the safety of other passengers and might lead to legal trouble. This effect is similar to alcohol, which has led to some passengers being removed from flights.
  • A study from Stanford University (1997) showed that using benzodiazepines may interfere with the natural process of gradually reducing anxiety, potentially making it worse over time.
  • Diazepam and other controlled drugs are illegal in some countries and may be confiscated, or you may face legal trouble. If you're traveling internationally, you may also need to find alternatives for the return journey or other legs of your trip.
  • Diazepam stays in your system for a long time. If your job requires random drug testing, taking diazepam may cause you to fail.
  • It’s important to declare any medications you take to your travel insurer, as failing to do so could void your policy.

For these reasons, we no longer prescribe Diazepam or similar drugs for flight anxiety. Instead, we recommend the following aviation industry-approved courses to help manage flight-related anxiety:

For more information:

References: