✈️ Practice Policy: Diazepam Prescribing for Fear of Flying

Policy Statement

Addington Road Surgery does not prescribe diazepam or other benzodiazepines for the purposes of flying, including flight-related anxiety (aerophobia). This decision is based on clinical safety, ethical prescribing standards, and national prescribing guidance.

Clinical Rationale

  1. BNF Contraindication: The British National Formulary (BNF), hosted by NICE, explicitly states that:
    “Phobic states” are a contraindication for benzodiazepines
    🔗 BNF Diazepam – NICE
    Fear of flying is classed as a phobic state, and thus benzodiazepines such as diazepam are not appropriate treatments.
  2. Safety Risks During Flights:
    o Diazepam can cause excessive sedation, impairing the ability to respond in emergencies.
    o It increases the risk of deep vein thrombosis (DVT) due to immobility and sedation.
    o It may result in paradoxical reactions such as agitation or aggression.
  3. Legal and Ethical Concerns:
    o Diazepam is a controlled drug and may be illegal or restricted in several countries.
    o Patients may be at risk of legal penalties or detention at international borders.
    o Prescribing a controlled drug for a non-licensed, non-clinical indication may violate GMC Good Medical Practice standards.

Alternative Management of Flight Anxiety

We recommend the following non-drug approaches:

Review & Exceptions

This policy will be reviewed annually. Exceptions will only be made under specialist care and with formal psychiatric assessment for complex anxiety disorders where benzodiazepines are clinically indicated.

Addington Road Management Team