Diazepam in the UK is a Class C/Schedule IV controlled drug.

We as an LMC support practices declining to prescribe such medications for this purpose.

Diazepam is a sedative and as per BNF is contraindicated for treating phobias. It also states that “the use of benzodiazepines to treat short-term ‘mild’ anxiety is inappropriate.” They are only licensed short term for a crisis in generalised anxiety and fear of flying in isolation is not a generalised anxiety disorder. It would come with significant legal risk prescribing against these guidelines.

Although rare, in flight emergencies are a possibility and the potential of reduced awareness, less able to follow instructions and reaction times for patients taking Diazepam could pose a significant risk to the safety and lives of themselves and others in the event of an emergency on board necessitating evacuation.

The use of such sedative drugs can cause deep sleep with less natural movement increasing the risk of developing a blood clot. This risk is even greater if the flight is greater than 4 hours.

Diazepam can cause paradoxical agitation and aggression, disinhibition and lead patients to behave in a way that they would not normally which can pose a risk on the plane- both from a safety and legally perspective and could lead to the removal from a flight.

Diazepam and similar controlled drugs are illegal in a number of countries. The drug driving legislation which came into effect in recent years would also potentially prohibit onward driving from an airport.

Diazepam can remain within the body’s system for some time and should patients be required to submit random drug testing (for work or other purposes) they may fail if having taken diazepam.

It is not within the remit of the NHS to render someone fit to travel on a voluntary holiday or business trip, and due to the enormous demands currently facing general practice, we make no apology for prioritising NHS care for patients on the basis of their clinical need.

We can suggest the below aviation industry recommended flight anxiety courses:

Fear Of Flying Online Course | Scared Of Flying?

https://www.britishairways.com/en-gb/information/travel-assistance/flying-with-confidence

Flying Without Fear | Courses to Conquer Your Fear of Flying