We are often asked to prescribe sedative drugs, such as diazepam (Valium), for fear of flying. We have recently agreed a practice policy that we will no longer prescribe these drugs for fear of flying. There are a number of good reasons why prescribing of drugs such as diazepam is not safe or recommended:
Diazepam and similar drugs are not recommended for treatment of phobias because other treatments are safer and more effective.
Diazepam is a sedative, which means it makes you sleepy and slows reaction times. If there is an emergency during the flight it may affect your ability to concentrate, follow instructions and react to the situation. This could have serious safety consequences for you and others.
The sedative effects of these drugs can affect breathing and cause low oxygen levels, which could be life threatening, especially with the lower circulating oxygen levels on an aeroplane, in people with breathing problems or when combined with alcohol.
Sedative drugs can make you fall asleep, however this is not a natural sleep. This means you won’t move around as much as during natural sleep and this can increase your risk of developing a blood clot (DVT) in your leg or lung. Blood clots are dangerous and can be fatal. This risk is greater if your flight is longer than four hours.
Whilst most people find medicines such as diazepam sedating, a small number of people become agitated, aggressive or confused. These medicines can also cause disinhibition and lead to abnormal behaviours. This could impact on your safety as well as that of other passengers.
Diazepam and similar drugs are illegal or controlled drugs in some countries so they may be confiscated or you may be subject to legal proceedings. Diazepam in the UK is a controlled drug. The prescribing guidelines doctors have to follow say that to treat short term ‘mild’ anxiety is inappropriate. They are only to be used short term for a ‘crisis in generalised anxiety’. But if you are having such a crisis, you are not likely to be fit to fly. Fear of flying in isolation is not a generalised anxiety disorder.
Diazepam stays in your system for quite a while. If your job requires you to submit to random drug testing you may fail this test if you have taken diazepam.
We recognise that fear of flying is real and frightening and we don’t underestimate the impact it can have. We recommend tackling this properly by using self-help resources or considering one of the ‘Fear of Flying’ course run by many airlines. We do not recommend any specific course but you may find the following links useful.
Self help options