Why GPs Do Not Prescribe Benzodiazepines (e.g. Diazepam) for Fear of Flying

Introduction

Many people experience anxiety or fear when flying. While this is completely understandable, NHS GPs in the UK do not routinely prescribe benzodiazepines—such as diazepam (Valium)—to manage this fear.

This page explains why that decision is made and explores safer, evidence-based alternatives to help you manage a fear of flying.

Why Aren’t Benzodiazepines Prescribed for Flying Anxiety?

1. Safety Risks

– Impaired Response: Benzodiazepines can cause drowsiness, dizziness, and confusion, which may reduce your ability to respond in an emergency during a flight.

– Breathing Risks: They can slow breathing (respiratory depression), which is especially dangerous at high altitudes and in low-oxygen environments.

– Blood Clots (DVT): Sedation and immobility during long flights increase the risk of deep vein thrombosis.

2. Paradoxical Effects

In some people, benzodiazepines can cause:

– Increased agitation or aggression

– Unpredictable behavior

These effects can make anxiety worse rather than better.

3. Addiction and Dependence

– Even short-term use of benzodiazepines carries a high risk of dependence.

– Over time, the body builds tolerance, leading to the need for higher doses and an increased risk of addiction.

4. Legal and Ethical Concerns

– Prescribing these medications for flying anxiety is not in line with NHS guidelines or General Medical Council (GMC) regulations.

– Many countries have strict laws about carrying benzodiazepines, and possessing them could lead to legal issues abroad.

5. Short-Term Fix, Not a Long-Term Solution

– These medications do not address the root cause of flying anxiety.

– They may reinforce avoidance behaviors, making it more difficult to overcome the phobia in the future.

What Can I Do Instead?

1. Cognitive Behavioural Therapy (CBT)

CBT is a proven, evidence-based treatment that helps you:

– Identify and change negative thought patterns

– Build practical coping strategies for anxiety

2. Fear of Flying Courses

Many airlines and organizations offer specialist courses, including:

– Psychological support

– Flight simulations to gradually reduce fear and increase confidence

Conclusion

While it may seem that benzodiazepines offer a quick fix for flight anxiety, the risks outweigh the benefits.

NHS GPs follow guidelines that prioritise patient safety and long-term wellbeing. If you experience a fear of flying, there are many safer and more effective ways to manage it. Speak to your GP about alternative treatments and resources that can help you feel more confident when flying.

Useful Websites

– NHS: Anxiety and Panic Attacks – https://www.nhs.uk/mental-health/conditions/anxiety/

– No Panic – https://www.nopanic.org.uk

– Fearless Flyer (EasyJet) – https://www.fearlessflyer.easyjet.com

– British Airways Flying with Confidence – https://flyingwithconfidence.com

– Mind UK – https://www.mind.org.uk