People often contact us requesting that we prescribe diazepam for fear of flying or to assist with sleep during flights. After careful review, we have adopted a policy not to prescribe benzodiazepines (e.g. diazepam) for fear of flying. This approach is in line with many other GP practices and national guidelines.

In the UK, diazepam is a Class C/Schedule IV controlled drug. The following short guide outlines the issues surrounding its use with regards to flying and why we no longer prescribe such medications for this purpose:

• Safety risk in emergency:  In the event of an in-flight emergency, Benzodiazepines can cause delayed reaction times. This may impair your ability to respond appropriately, putting your safety—and that of others—at risk.
• Increased Risk of Blood Clots: Although Diazepam may help you fall asleep during a flight, it induces non-REM sleep, which reduces natural movement. This immobility increases the risk of blood clots (deep vein thrombosis, or DVT), particularly on flights longer than four hours. Such clots can be life-threatening.
• Paradoxical Reactions: While Diazepam is usually sedating, a small percentage of individuals experience the opposite effect: agitation, aggression, or disinhibition. These behaviours could endanger yourself and others and may lead to legal consequences.
• Increased Risks with Alcohol: The combination of Benzodiazepines and alcohol magnifies all the risks outlined above.
• Guideline Restrictions: The British National Formulary (BNF) advises against using Diazepam for treating phobic states and discourages its use for short-term, mild anxiety. Prescribing against these guidelines may expose your doctor to legal liability.
• Legal Risks Abroad: In some countries, including parts of the Middle East, it is illegal to import Benzodiazepines. Medications may be confiscated, and you could face legal repercussions.
• Workplace Drug Testing: Diazepam remains in your system for an extended period. If your job requires drug testing, you could fail a test after taking it.