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?

Apt at 2 so il report back.
Actually nervous about it.
Worried he is going to think I'm a drug seeker.
Hopefully my notes will show I'm not.

They can get sued because diazepam or not, on flights especially long haul people get dvts, they get injured etc. And if you have been prescribed diazepam they are on the hook legally

So when has this happened? The claim from GPs is that this is happening and that the MDU/etc are refusing to cover them. So where are the cases? MDU refusal to insure is a huge deal, and would leave a paper trail in, if nothing else, the MDU 's warnings to members. So where are they?

If doctors are refusing to prescribe on the basis of a hunch that something might go wrong, then God help anyone who wants treatment that involves a drug with side-effects, such as...well, all of them.

Aren't sleeping tablets a much bigger risk on flights than 2mg of diazepam.
With sleeping tablets you obviously couldn't get up and walk around the plane obviously increasing DVT

Also when I took propranolol it made me very dizzy and lightheaded.
So if the doctor was happy to prescribe this for flying and I took it and had a fall or passed out on the plane due to low blood pressure (off beta blockers ) plus cabin pressure ..could I sue ?

Any time that a drug is having a wanted effect on you, it can also have an unwanted side-effect
Od course, but isn't this the case for a number of medicines? HRT also increases the risk of DVT, do you tell your patients on HRT they can't fly?

I am friends with two GPs, one totally against prescribing valium, the other totally cool about it, so it really is a matter of medical opinion rather than right or wrong.

Agree lucyhar, I suffer from low blood pressure, taking propranolol would be more a risk for me too.

Birth control pills also increase the risk of DVT
Do you the doctors also stop prescribing this to women partaking in a plane journey ?

@swingofthings only 1 40mg tablet made me feel like I was about to pass out ..
Awful

I can imagine. Personally I don't care what medicine I take I just know that I've gone from not flying for over 10 years with implication both professionally and socially to being able to fly 3 or 4 times a year including long haul. I never fly alone though and although I will fall asleep, I've never been so out of it that I couldn't be woken up.

I suspect the threshold that would be used by a court in event of someone suing over a prescribing decision would be that the prescription was one that no reasonable doctor could have made when in possession of the facts available to them. In other words that the risk/reward ratio was unconscionable to the point of incompetence.

And for the MDU to then refuse to cover the doctor it would have to be that, with boots and knobs on, if indeed they can do it at all. If MDU/etc insurance is a statutory obligation in order to practice, I suspect that it is like car insurance. You have to have it, and it is not possible to do anything in your car such that the your insurance company is not liable. They might well refuse to cover you subsequently, of course, but if you cut the brake lines, drink a bottle of scotch, blindfold yourself and drive down the M1, your insurance company is still liable for the carnage: that's the flip side of it being legally compulsory to have cover.

So I simply don't believe doctors here who are claiming they don't prescribe 2mg diazepam because they are worried about being personally bankrupted by the ensuing court case. I don't believe they would be successfully sued, and I believe even less than the MDU would (or, indeed, could) reduce to cover them in the incredibly unlikely scenario of it being necessary.

If there is a flat prohibition on prescribing in these cases, backed by evidence, where is it?

HRT also increases the risk of DVT, do you tell your patients on HRT they can't fly?

No, but I do prescribe HRT in accordance with its licence & NHS guidelines. I do the same with diazepam.

I am not against careful use of diazepam for anxiety. I used occasionally prescribe diazepam for flying; I don't now because the guidance has changed. I am not going to risk being reported to the GMC or sued. Medical indemnity cover is discretionary, meaning that - even though I pay over £10,000 a year for it - my provider may not cover me if I haven't followed NHS rules and then get sued. As a GP partner, I have unlimited personal liability - if my practice gets sued and my indemnity provider won't pay out, I could lose my home.

I doubt whether any of the PPs slagging off GPs on this thread would be prepared to risk losing their career and their home, purely to help someone go on holiday.

Why aren't the Dr's on this thread at work? I've just seen my actual gp and she's run off her feet. I'm finding all the gps on here frankly unbelievable

It's amazing, they're nowhere to be found on threads asking for one, particularly when it comes to HRT matters, but show up in droves on threads like this to ponder hypothetical court cases. It's uncanny.

Only a very recent change in guidance.

ReflectentMonatomism Amazing how someone can be so confident and yet so wrong.

If MDU/etc insurance is a statutory obligation in order to practice, I suspect that it is like car insurance

Totally wrong. Medical indemnity cover is not insurance at all. It is a discretionary indemnity policy - they do not have to cover members, especially if members have deviated from professional norms.

I suspect the threshold that would be used by a court in event of someone suing over a prescribing decision would be that the prescription was one that no reasonable doctor could have made when in possession of the facts available to them.

You clearly don't know much about medical negligence then. Courts are guided by what a reasonable doctor would do (Bolam test) but also by professional norms & guidance (Bolitho test). Both these tests expect doctors to follow national guidance except where there is a good clinical reason to deviate from them.

I simply don't believe doctors here who are claiming they don't prescribe 2mg diazepam because they are worried about being personally bankrupted by the ensuing court case. I don't believe they would be successfully sued

Well, if it's all the same to you, I won't be risking my professional and financial future on the basis of your views, given that you are talking out of your arse.

Fine. There's a secret memo no-one can find which sets this policy on anti-=anxiety drugs for flying, based on evidence that no-one can find. And it's not a moral judgement on people daring to want to go on holiday.

Meanwhile., GPs are happy to prescribe off-label puberty blockers to children without making anything like the same song and dance and risking getting sued. So I'll take your fears for your career as selective: puberty blockers for children clearly don't engage anything like the same legal risk.

Fine. There's a secret memo no-one can find which sets this policy on anti-=anxiety drugs for flying, based on evidence that no-one can find. And it's not a moral judgement on people daring to want to go on holiday

Yup

It's amazing, they're nowhere to be found on threads asking for one, particularly when it comes to HRT matters, but show up in droves on threads like this to ponder hypothetical court cases. It's uncanny

I know. Not a one to be seen in the menopause topic. Funny that!

Only a very recent change in guidance.

Must be! i just got some about 2 weeks ago when panic attacks came out of nowhere and wouldn't stop.

But again, if people can't get hold of them from doctors a lot of them are going to look to dealers for street blues.

Yep I got mine 2 weeks ago for flying. There is nothing I can find online to say they are contraindicated for flying. They are the first thing drs prescribe for panic.

No, but I do prescribe HRT in accordance with its licence & NHS guidelines. I do the same with diazepam
Abd I respect that, but why mention the clinical risks as a decision not to prescribe, risks that are no more than many other prescribe medicines. Thankfully, my GP uses common sense and the fact that having taken valium for now 10 years whilst flying and nothing on towards happening, the chances that it will are extrenely low and indeed significantly lower than if I started knocking down vodka to numb the utter panic I otherwise expérience.

XXcstatic

JOOI then, suppose I came to you as a paitent and told you that I'm shite scared to fly and its sodding up our married life etc, can suppose that other half is a non UK national and likes to go home to see his family etc.

I have been prescribed 2 mg Diaz tabs in the past what would you prescribe in their place now?.

Just got out of doctors.
Was in and out in 2 mins
He gave me 14 2mg diazepam
He wished me a nice holiday
Baffled

Fuck me there is some really unpleasant GP-blaming going on here. It would seem to me that the target for everyone's anger should be the aviation authority that advised this, not the GPs who risk their livelihood if they prescribe these drugs. I speak as someone whose anxiety prevented foreign travel for many years.

Also, people can't have it both ways. People on here want doctors to go onto certain topics and give their time and advice, but god forbid they come on this thread to try to advise and explain - then they are slackers who should be at work.

Delighted for you OP - now you can relax and enjoy your family visit