Dr McLachlan & Partners

Our policy Dr McLachlan and Partners does not prescribe diazepam or other benzodiazepines solely to manage fear of flying. This applies to one-off requests as well as requests for a trial dose before travel.

We understand that fear of flying is real

Fear of flying can be extremely distressing and may prevent people from travelling. Our decision is not intended to dismiss that distress. It is based on the balance of likely benefit and risk, and on the treatments most likely to help in the longer term.

A medicine may make someone feel sleepy or less aware of anxiety without treating the phobia itself. For a specific phobia, approaches based on cognitive behavioural therapy (CBT) and gradual, supported exposure address the fear more directly.

Why we do not prescribe diazepam for flying

1. It can impair your response in an emergency

Diazepam can cause drowsiness, slowed reactions, dizziness, poor coordination, muscle weakness and reduced concentration. On an aircraft, passengers may need to understand instructions and move quickly in an unexpected situation. Sedation may make this more difficult.

2. Reactions can be unpredictable

Although diazepam is usually sedating, benzodiazepines can occasionally cause the opposite response, including restlessness, agitation, irritability, aggression, disinhibition, nightmares or hallucinations. The effect of a first or occasional dose cannot be predicted with certainty.

3. It can affect memory and judgement

Diazepam can cause short-term memory loss (anterograde amnesia), confusion and impaired judgement. These effects may be especially problematic when travelling alone, supervising children, navigating an unfamiliar airport or responding to disruption.

4. Lower cabin oxygen and sedation can affect breathing

Aircraft cabins are pressurised, but not to sea-level pressure. At cruising altitude, the cabin is usually equivalent to being about 5,000-7,500 feet above sea level, where less oxygen is available. The body

normally adapts by increasing breathing. Diazepam can depress breathing, and a small controlled study found that even a low dose reduced this normal breathing response to mild low-oxygen conditions at moderate altitude.

Most healthy passengers tolerate the cabin environment without difficulty, and this evidence does not mean that one tablet will routinely cause dangerous breathing problems. However, the concern is greater in people with sleep apnoea or lung disease, and when diazepam is combined with alcohol, opioid painkillers or other sedatives. These combinations can cause much more profound drowsiness and respiratory depression.

5. Reduced movement may add to the risks of a long journey

Long periods of immobility during travel are a recognised risk factor for venous thromboembolism (a blood clot). Diazepam may make a person sleep more deeply or move around less. We cannot say that a single tablet directly causes a clot, but additional sedation is not helpful when regular movement is advised on longer journeys.

6. Dependence and tolerance are recognised risks

Benzodiazepines can lead to psychological or physical dependence, and repeated use can lead to tolerance. Risk is greater with higher doses and longer use, but dependence is a recognised property of the medicine. Prescribing a sedative for each flight may also reinforce the belief that flying cannot be managed without medication, rather than helping the phobia improve.

7. Diazepam is a controlled medicine

Diazepam is a controlled drug in the UK. Rules for carrying controlled medicines differ between countries, and some destinations require documents or advance approval. A UK prescription does not guarantee that the medicine can legally be brought into another country.

What can help instead?

· CBT and graded exposure: these help you understand the anxiety response and gradually practise facing feared situations in a planned, supported way.

· Airline fear-of-flying courses: several airlines provide structured courses combining education about aviation with anxiety-management techniques and, in some cases, a supported flight.

· Practical preparation: learn about turbulence and aircraft safety from reputable sources; practise slow breathing or grounding techniques; allow extra time; and tell your travel companion and cabin crew that you are anxious.

· Avoid alcohol or non-prescribed sedatives: combining these with travel fatigue can worsen impairment and does not treat the underlying fear.

· Seek help early: treatment works best when arranged well before a planned journey, rather than in the final days before departure.

If anxiety affects more than flying Please contact the practice if anxiety is persistent, occurs in several settings, causes significant impairment, or is accompanied by low mood, panic attacks or thoughts of self-harm. We can assess the wider problem and discuss appropriate treatment. This policy only concerns sedatives requested solely for flying; it does not automatically stop established treatment for a separate medical indication. We will not substitute another sedative for diazepam for a flight.

PLEASE NOTE WE DO NOT ACCEPT SAMPLES UNLESS A CLINICIAN HAS PREVIOUSLY REQUESTED THEM AND THEY MUST BE HANDED IN BY 1PM TO ENSURE THEY ARE READY TO GO TO THE LAB.

If you think you have a urine infection and have already tried your local pharmacy, please ask for an appointment or call back to discuss your symptoms before handing in a sample as we will be unable to accept it.

Thank you for your co-operation. 

Our practice is now using Heidi AI, a secure medical documentation assistant, to help our clinicians record consultation notes.

Heidi listens to the consultation and creates a draft clinical note for the doctor. This allows your GP to spend more time focusing on you and less time typing, helping consultations feel more natural and efficient.

Your GP always reviews and approves the notes, and your information is handled in line with NHS data protection standards.

If you would prefer Heidi not to assist during your consultation, please let your clinician know at the start of the appointment.

We are excited to use this technology to help us spend more time listening to patients and delivering high-quality care.