Why We Do Not Prescribe Diazepam for Flying or Medical Procedures

At our practice, we understand that situations such as flying or undergoing medical procedures can cause significant anxiety. It is not uncommon for patients to request medications like diazepam (a benzodiazepine) to help manage these feelings.

However, following current clinical guidance and with patient safety as our priority, we do not prescribe diazepam for fear of flying or for medical or dental procedures.

Below, we explain why this decision has been made and how we can support you with safer alternatives.

Why Is Diazepam Not Prescribed?

1. It Is Not Recommended by National Guidelines

Diazepam belongs to a group of medicines called benzodiazepines. According to national prescribing guidance:

• Benzodiazepines are not recommended for phobias, including fear of flying 
• They are only licensed for short-term use in severe anxiety crises, not situational anxiety 
• NICE guidance advises against their use for mild or short-term anxiety conditions 

Fear of flying or anxiety about a procedure is considered a specific phobia, meaning diazepam is not an appropriate or effective treatment.

2. Safety Risks – Especially in Emergencies

Diazepam works by causing sedation, which can:

• Slow reaction times and impair decision-making 
• Reduce coordination and awareness 
• Make it harder to respond in an emergency situation

In rare but serious situations (e.g., aircraft emergencies or procedural complications), this could put both the patient and others at risk.

3. Increased Physical Health Risks

Taking diazepam can lead to additional medical risks, including:

• Deep vein thrombosis (DVT) due to reduced movement during sedation, particularly on longer flights 
• Breathing suppression, which can worsen in low-oxygen environments such as aircraft cabins 
• Unpredictable reactions, including agitation or aggression (paradoxical effects) 

For procedures, sedation should only be given in a monitored clinical setting by trained professionals, not prescribed for unsupervised use. 

4. Risk of Dependence and Side Effects

Benzodiazepines carry well-documented risks:

• Short-term effects include memory problems, poor concentration, and reduced coordination 
• Long-term use can lead to dependence, tolerance, and withdrawal symptoms 

These risks mean they are tightly controlled medications and are no longer routinely used for situational anxiety.

5. Legal and Travel Considerations

Diazepam is a controlled drug in the UK, and:

• It is illegal in some countries, risking confiscation or legal issues 
• Use during travel may not be covered by GP indemnity or insurance policies 

Prescribing for these situations could therefore expose both patients and clinicians to unnecessary risk.

What Are the Alternatives?

We are committed to supporting patients with safe and effective options.

✔ Evidence-Based Treatments

• Cognitive Behavioural Therapy (CBT)
  A highly effective treatment for phobias, helping you understand and manage anxiety triggers.

• Fear of Flying Courses
  Many airlines offer structured programmes combining education and coping strategies.

✔ Self-Help Techniques

Simple strategies can make a significant difference:

• Breathing and relaxation exercises
• Distraction techniques (music, reading, puzzles)
• Speaking to cabin crew or healthcare staff about your anxiety
• Gradual exposure and preparation

These approaches are safer and more effective long-term than medication.

✔ Support for Medical Procedures

If you are anxious about a procedure:

• Speak to the hospital or specialist team arranging it
• They can provide appropriate support or clinically supervised sedation if required
• Many departments offer reassurance, information, and tailored care plans

How We Can Help

We recognise that anxiety is real and can be distressing, and we are here to support you.

At our practice, we can:

• Discuss your concerns and assess your needs
• Signpost to appropriate therapies (such as CBT)
• Provide guidance on coping strategies
• Help you access specialist support services

In Summary

While diazepam may seem like a quick solution, it:

• Is not recommended under national guidelines
• Carries significant safety and health risks
• Does not treat the underlying cause of anxiety

Instead, we focus on safer, evidence-based approaches that provide long-term benefit and support your overall wellbeing.

If you would like support with anxiety related to flying or procedures, please contact the practice—we are here to help.