Doctor won't give me diazepam ..aibu?

[lucyhar]

I've been getting diazepam off my doctor for around 4 years now for when I have to travel by plane.
I normally get 7 tablets a year.
My doctor has retired now and I'm travelling to Australia in may to see my aunt and uncle.
I've just got out of the doctors (new doc) and he refused any.
Now I understand people get addictive but I get 7 tablets a year!
I have a massive fear of flying,I've tried CBT,hypnotherapy,kalms,I did a fear of flying course and nothing.
Before I was prescribed diazepam I didn't go on holiday for 7 years.
They gave me my life back (without being dramatic)
Aibu to speak to the practice manager?

Also it's the anxiety of going somewhere strange but really wanting to go.
Getting to the place and feeling like I've achieved that by getting there sometimes helps my anxious thoughts.
It's hard to explain and understand if you haven't felt like this.

The night before travelling I worry incase I don't sleep then I would maybe pass out on the plane.
If I didn't have the diazepam to relax me the night before I wouldn't sleep and would feel ill the next day which would make me feel something awful might happen on the plane..which brings on a panic attack etc etc

I get a big box every couple of years - for those rare days when my psychiatric condition is out of control... but close enough to control that remembering to take a special sweetie will get me through - i.e., a very fucking small window. I'd be the world's worst smack head because I keep forgetting to take the addictive stuff.

I choose not to drive for at least 6 hours after taking one - I am however more than capable of walking to the car, sitting and fastening a seatbelt. OP isn't planning to fly the fucking thing, just sit in it and frankly if it comes plummeting into the Ganges from 40,000 feet the aviation authority has bigger fish to fry than checking OP's medical records.

I hope you can get some help lucy and get the meds you need to get you through a tough few hours.

I have to fly for my job. Any suggestions for me?

People who are saying the OP will be unfit to act responsibly clearly don't understand what 2 or 4 mg of diazepam does to you.

You can be prescribed 10mg pills! 4mg of diazepam removes anxiety and makes you as out of it as a couple of glasses of wine. Less so in fact. Perfectly able to function normally.

Sounds like you need a different job @fazackerley.

I’ve had this before but I saw another GP at the surgery who was fine with it.

I take quite a bit - only way I can get on a plane!

PS I'm not blaming GPs for this daft ruling - but the NHS/GMC/whomever is in charge should've told the aviation authority to "give their heads a little wobble" instead of just blindly accepting their decree. I'm also a little shocked to hear a GP is required to buy indemnity insurance from a private provider - that should be state-provided, government backed - and another 10,000 nobs told to wind their necks in. Not sure it's "Kate, GP, mother of 3 from Bracknell's" fault.

new GP actually offered me some after dad's death and I stupidly said no because I wasn't thinking straight (was in the GP for something else, didn't go because of the bereavement).

now I'm wondering why I didn't take them when they were offered...but yes, wasn't thinking straight. Pfft.

but the NHS/GMC/whomever is in charge should've told the aviation authority to "give their heads a little wobble" instead of just blindly accepting their decree.

I am stunned to learn that doctors prescribe based on what the CAA says. Who next? The Egg Marketing Board?

I haven't seen the alert and I'm not a gp but if it's like other warnings that come out then the only thing that makes sense is the CAA will have published research/statistics on the effects of benzodiazepines when flying the GMC or Nice possibly would then have taken the decision based on that information what guidelines should be offered to gps and other prescribers.

That's how all alerts I have seen have been put out research then governing body decision. As I said I have no knowledge of this exact one it's not my field.

Act in a manor???? Eh??

What I find shocking is the the amount of gp's who've happily come on to this thread to berate the op for to my mind a perfectly acceptable low risk reason to have a short dose of a well known drug prescribed.

Especially the posts having a go at op for not listening.

Yet I've recently started threads discussing gp's & primary care from different perspectives, with many posters describing appalling situations where Gp's didn't listen and not ONE GP responded. 🤔

Op I think your request is a perfectly reasonable one.

"when you are a responsible adult
The law does not absolve the GP of responsibility because someone believes they are a responsible adult and chooses to tolerate any risks. The GP is still responsible for what they sign." If there was still continuity of care and people able to see their own GP when needed and the GP therefore KNEW their patients this would be far less of a concern.

"The easy targets are punished yet addicts and people that abuse them wouldn't dare be challenged (I'm well placed to talk on this one)" so true!

"Op can you go for hypnotherapy to reduce/remove your phobia of flying

Or if you google online there is lots of natural alternative remedies for fear of flying that you could try

What is it that you are afraid of op?..is it the actual flying part or is it being enclosed for so long?..or confined to your seat ? Or being in a busy airport and not knowing where to go?...if you could narrow it down to what part actually scares you then you have a better chance of working towards overcoming your phobia" this type of post on mn really annoys me AT LEAST read the op's posts! All your queries have already been clarified!

"The only other thing the OP could try would be a referral to a psychiatrist from the GP." Are you for real? I'm housebound with a combo of OCD & agoraphobia & a ton of other mh shit, took 8 months till I saw a psychiatrist!

"This is an example of mental health not being treated seriously imo." Completely agree. If op had a physical condition that made flying slightly trickier for her than most that could be remedied by a low dose of a medication she has a proven track record with they wouldn't hesitate!

"People with mental health issues shouldn't be effectively banned from going on holiday." Exactly - more discrimination against the mentally ill which we REALLY don't need!

"If you can afford a foreign holiday, you can afford a fear of flying course." Classic example of GP "deafness" - she's already tried that!!

"So you are saying, seriously, that if you prescribe a patient a drug, and they take it abroad, and something goes wrong, your indemnity insurance would refuse to cover you? So you tell every patient to whom you prescribe a drug not to leave the country for the duration? How does that work for you in the summer? Are insulin-maintained diabetics under your care unable to travel (to cite an example of people with long-term, chronic conditions requiring continuous treatment but with the potential for things to go wrong?) What about older patients taking statins?" I'd like to know too. I've travelled while taking various mh meds never had a problem with legalities or insurance.

"What if one of these people who was taking diazepam for back spasms boarded a plane then?
They tripped and fell could they then sue the GP?" Another excellent question

"Well, they could try. But the GP would be in a defensible position because it was prescribed for a medical problem and is established for use in that circumstance. If it was prescribed for fear of flying, that is a use against guidance and therefore not a defensible position for the GP." Even if the GP hadn't told them not to use during flying?

"and now AUSTRALIA but say you can’t find £80/£90..." NOT what she said, she's REPEATEDLY said she's willing to consider and pay for private BUT in the post you're referencing she says NOT EVERYONE can afford to

"Wow, that's 3 GPs who are now posting on this thread. I can't get an appointment with one in real life for two weeks, ironically to discuss my anxiety issues. Maybe I'll start my own thread here for advice..." Good luck getting a response! I notice middle of the day when you'd THINK they'd be working too.

"Because...rules" argh! Godwins law comes to mind - not ALL rules are right!

What happened to gp's acting FOR patients? Advocating for them? Arguing against rules or even guidelines that DON'T correctly meet patient need?

Sorry but I am increasingly thinking gp's are politically cowardly and apathetic and are letting patients down as a result!

"my NHS GP said she was unable to prescribe them on an NHS prescription. But she happily prescribed on an private prescription, at the same NHS appointment"

Which strongly suggests it IS a funding issue!

I just googled "GP sued by patient using diazepam for fear of flying" not ONE hit that properly matched or even close!! Articles postulating on the HYPOTHETICAL of it happening but no actual cases!!

"PS I'm not blaming GPs for this daft ruling - but the NHS/GMC/whomever is in charge should've told the aviation authority to "give their heads a little wobble" instead of just blindly accepting their decree" there are 1000's of gp's if they wanted to they could influence the guidelines, their reporting of side effects etc do just that, no reason they couldn't do the reverse and collectively say "we are the ones treating patients and this drug is a safe, known drug when prescribed to the right patient in the right circumstances"

"I don't really care if no one has been sued yet in this situation, I don't want to be the first." Sorry but that's a shit reason for letting patients down.

"There seems to be a problem with drugs where they're overprescribed and then to overcompensate they start taking them off everyone" yep!

Interestingly in my google results was an article about gp's warning that a drug I am being PRESSURED to take (despite my reservations based on the research I've done on it in relation to my condition) is becoming the "new Valium" in terms of addiction issues. ONE of the reasons I've said I'm not keen is the addiction side given I'm from a family full of addicts and that analgesics & aesthetics have little effect on me. Yet they want me to take these daily and at a decent wack too!

When did Drs STOP listening to patients?!

"if indeed they are GPs" also possible.

"I am stunned to learn that doctors prescribe based on what the CAA says. Who next? The Egg Marketing Board?" Likewise, their primary responsibility & consideration should be for patients needs. Not avoiding a highly unlikely spurious lawsuit!

You're female. That already puts you on the 'Don't prescribe' list.

I wouldn't normally yell sexism, but when I've been systematically refused anything for insomnia that has genuinely had me working three days without any sleep on a regular basis, only get about 3 hours sleep on a normal night and I end up with flashing images in front of my eyes by the time I eventually go to sleep for 3 and a half hours to resume the entire cycle again - apart from antihistamines that don't work for me and Amitryptiline, which sends me batshit crazy - but my OH can wander into the same surgery after a week of only sleeping from 1-7am and 10-4pm every day and come out with a month of benzos, I'm less than impressed.

Thing is, when they are concerned about addiction/inappropriate prescribing/insurance/already primed to refuse meds to women, wanting something for an entirely optional activity such as a holiday isn't going to make them want to shut their eyes and refer to it as 'short term anxiety' on your records. It could also have an effect upon any future job applications you make if they were to do so, as Occupational Health or an Insurer could see 'anxiety' and refuse to approve your employment.

You've saved for a long time to find the money I still wouldn't ever be able to afford for this holiday. It looks like you'll just have to find the money to see whether a private doctor will give you a prescription as well.

It's annoying, but you can't get it otherwise if your GP won't prescribe it, no matter how upset or panicky you get.

If there was still continuity of care and people able to see their own GP when needed and the GP therefore KNEW their patients this would be far less of a concern.

This so much. I hate not having continuity.

Jesus I’m stunned at the stupidity on here.

No one is saying that 2mg diazepam will knock you out.
No one is saying that people who suffer with anxiety shouldn’t have full and varied lives.
No one is saying diazepam should never be prescribed ever.

GPs are just practising accordingly to guidelines, and defensively, for good reason. Guidelines are there, we can’t ignore them. Lawyers acting against us sure as hell won’t. “So Dr Minty, you prescribed my client diazepam for flying, even though you knew the British Aviation Authority medics advise against it? My poor innocent client asked for your help in good faith, trusting that your knowledge would keep them safe, and you prescribed something that the EXPERTS advise against? Why would you do this Dr Minty? Surely this is indefensible “

You only have to read the case histories in the MDU/MPS magazine to see how this sort of thing plays out.

It doesn’t matter what my personal view is, or what I know about an individual patient - if my defence union won’t cover me for a certain action, I won’t do it.

All this stuff about no one caring about anxiety is irrelevant to the issue being discussed.

"You're female. That already puts you on the 'Don't prescribe' list."

Yep

https://www.mumsnet.com/Talk/amiibeingunreasonable/3402449-Aibu-to-ask-you-to-tell-me-your-experiences-of-being-dismissed-by-medics-as-a-sick-woman-I-promise-to-listen

How come when it's guidelines prescribing diazepam doctors adhere strictly to it yet when nice guidelines state any woman can have an elective cesarean many doctors outright refuse? A slightly different issue but it's interesting.

I’m not a gynaecologist but I’d be surprised if a defence union would cover a doctor who did a caesarean because a woman wanted it, when a vaginal delivery would have carried less risk, and the woman went on to die of a pulmonary embolism.

And I can guarantee cost has nothing to do with this. Diazepam costs pennies.

I got my elective approved no problem but I know other women who have so much trouble trying to get them signed off. I wonder if it is to do with insurance.

Phenegran My new username 😁

So Dr Minty, you prescribed my client diazepam for flying, even though you knew the British Aviation Authority medics advise against it?

There is no such organisation as the British Aviation Authority. On the assumption that you mean the Civil Aviation Authority, then they don’t do medical research, and have no remit to give advice to doctors or the NHS. They have no powers or staff to collect statistics on passenger medical incidents, and their safety bulletins explicitly do not include such incidents. A search of the CAA’s publications since 2010 confirms they have not issued anything even remotely approximating what you claim. There are no CAA safety bulletins, accident investigations or other publications talking about drugs other than in the context of pilots being incapacitated. Pubmed throws up precisely one article about the effects of diazepam on aircraft passengers, a 23 year old article from the BMJ that could not be less relevant (it involves the intravenous sedation of a passenger who was drunk and had taken substantial amounts of other drugs, who later died after being restrained: www.ncbi.nlm.nih.gov/pmc/articles/PMC1115861/).

So where is this “advice” from “experts”?

Graphista I agree with every word you said. Hope you feel better soon
Minty If you prescribe Diazepam for muscle spasms, tell the patient that it is not advisable to take it shortly before or during a flight and document this, presumably you’re covered if they don’t take this advice?
I totally agree that the lack of continuity in care is a problem. I’m a perinatal CPN and we have a number of surgeries who won’t issue repeat scripts for ADs, presumably due to some kind of perceived risk, and insist that women have to be seen by a doctor before they will issue a script.
This is a massive faff for patients who are working or have preschool age children as well as being pregnant/having a baby.
This has led to a number of women abruptly stopping ADs and experiencing huge problems.
I have had a repeat script for years but then my GP knows me really well

Thank you. I've lost over a year due to this bastard stupid illness and I don't want to lose another but I'm having real trouble getting my cpn & psychiatrist & GP surgery to LISTEN to my concerns re meds.

They seem fixated on me taking pregabalin which I don't want to for a number of reasons and they're now starting to make crappy "patient won't engage" noises which ISN'T true!

I have GAD with flight anxiety and am currently in Australia. I flew here a week ago.
My doctors wouldn't prescribe anything for the flight and I don't live in the UK so it wasn't due to the NHS.
It took a lot of coaching (CBT) and my mantra is that it is ok to be scared and I don't need to like it!
And I don't. But I want to be here so I do it. Actually the panic cycles get boring and stop eventually, I can't think of a better way to describe it. The coaching has taught me that during a panic attack, my blood pressure is so hight that I can't faint and that any attack can only last 45 minutes at the most. There msy be cycles, it can be (is) horrible, they do end. And I got here.
Desensitization has been the only thing that has worked for me.
Working for an airline didn't. Wine didn't (but is still delicious). Meditation helped a bit. Meds aren't a given. It can be done!

If you don't get the drugs what will you do? Will you cancel the holiday? I'm sorry I can't help re drugs I just wondered what your plan b is.