1 Introduction
Policy statement
Sixways Clinic acknowledges the level of risk involved when prescribing Benzodiazepines, especially for use when flying.
This policy has been created to ensure safe prescribing and consistency.
2 Prescribing (not for flying)
The license for Benzodiazepines in anxiety is for short term use, should be used sparingly as high risk of dependence. Tolerance, if continues use, becomes ineffective. Severe risk if overused.
The practice will therefore issue an acute prescription for a minimal amount and also book a Structured Medication Review with a Clinical Pharmacist at the same time.
3 Prescribing (for flying)
Fear of flying
In Britain an estimated nine million people suffer from a fear of flying. There is no single personality type, prone to fear of flying it may develop following a bad experience such as a rough flight, or after a worrying news report. Fear of flying can be linked to the fear of airplanes, or it could be an aspect of other psychological problems such as panic attacks, claustrophobia, or post-traumatic stress disorder. People suffering from fear of flying often suffer increased anxiety and panic attacks at the thought of flying and many avoid air travel because of this.
Advice for Travellers who are Afraid of Flying
- Fear of flying is common despite flying being safer than road or rail travel
- Try distraction by talking with other passengers, watching a film, listening to music or reading.
- Tell the cabin crew. Reassurance about routine aircraft sounds and in-flight activities can help.
- Identify what triggers you fear and do your research on statistics relating to your phobia.
Treatment options
Fear of Flying Course
A number of airlines run courses aimed at alleviating travellers’ fears, such as:
Talking treatments
Talking treatments, such as cognitive behavioural therapy (CBT) and mindfulness, have been found to be highly effective for treating phobias. CBT is a type of counselling that can help you manage your problems by changing the way you think and behave. It can be used to develop practical ways of dealing with your phobia. Find out more here nhs.uk/conditions/cognitive-behavioural-therapy-cbt/
Medications
Medication is not usually recommended for treating phobias, because other options are usually effective and don’t have any side effects. Medications, such as diazepam, are sometimes used on a short-term basis at a low dose to treat severe anxiety. Diazepam, a benzodiazepine, is categorised as a minor tranquilliser. There are a number of reasons why prescribing benzodiazepines is not recommended for fear of flying.
· Benzodiazepines are sedatives, which means it makes you sleepy and more relaxed. This means it may impair your ability to concentrate, follow instructions and react to the situation. This could have safety consequences for you and those around you.
· Sedative drugs can make you fall asleep, however when you do sleep it is an unnatural non-REM sleep. This means you will not move around as much as during natural sleep. This lack of movement could increase your risk of developing a blood clot (DVT).
· Whilst most people find benzodiazepines sedating, a small number have increased agitation and aggression. This could lead you to behave in a way that you would not normally. Which may impact on your safety as well as that of other passengers.
· Benzodiazepines are illegal in some countries. If found in your possession they may be confiscated, or you may find yourself in trouble with the police.
See also