GP refused me Valium for a long flight

[MinesaBottle]

DH and I are flying to Australia next week for a family funeral. I don’t cope well with flying at all, and for the last few years I’ve gone to the GP and been prescribed a few 2mg Valium for the flights (we’ve already been to NZ this year - another funeral) and last year (dsd’s wedding). Which is a way of saying I’ve taken it on long flights before with no issues. I don’t drink alcohol on flights either.

I went to the GP today to ask for some Valium or similar and she flat out refused! She said she won’t prescribe Valium for flights because ‘you won’t move around and you’ll be at risk of DVT’. How much did she think I’d take?! I’ve flown on it before and always been conscious (I can’t sleep on planes anyway) and moved around; I always get an aisle seat so I can get up. She prescribed propranolol instead; I’ve never had it and it only calms physical symptoms of anxiety, not mental ones (is what she said). I’m also worried it might interact with paroxetine; she said not but didn’t actually look it up!

Weirdly I was in tears when I got in—I think because of the disruption to my usual routine when flying. I feel like she was judging me too. But regardless, should I see a private GP (there’s one near work) and see if they would prescribe five or six Valium or similar? I need the mental calming too. I have ADHD and my thoughts race at the best of times, never mind on a long flight heading to a funeral!

What about adhd meds? Changing the dose just enough to zone you out slightly more than you'd want day to day might be an easier solution. Obviously getting professional advice first.

I don't use medication in daily life, but long haul flights are the one area I do see an advantage. Alternatively lots of caffeine. Not quite sure how well that would go with the anxiety/ other meds, but personally I find valerian etc don't work the same for me, but most things that hype the average person calm me down.

Also, are you sure whatever anxiety meds you're on, and/or Valium are genuinely helping the adhd? Your experience might not be the same, but I find anything of that nature makes adhd symptoms harder to manage. Despite the fact I usually see them as a positive. My brain is still trying to herd 5000 cats, but is going too slow to cope with anything more than one elderly sheep.

The NHS is extremely paternalistic. 2mg of Valium is nothing and given that you know it doesn’t cause you to fall into a coma for 12 hours thus developing a DVT it seems ludicrous to refuse to prescribe it.
I would see a private doctor OP.

Why should the NHS (ie us) pay to help you take a flight?

Every few months we have a thread like this - just goes to show that the tighter restrictions of benzo prescription is necessary I think!

A drug and alcohol service worker I know told me it's harder to get clients off benzodiazepines than it is to get to them off heroin! People really don't want to give them up.

It’s not an NHS policy The issue is the risk to the prescriber, that is nothing to do with the NHS. The same issue applies if they prescribe it privately.

What about adhd meds?

. You usually have to see a consultant psychiatrist for those. It's a serious neurological condition.

I went to my GP several years when I was due to fly long haul after not having flown for many, many years (and that was only short haul) because I could no longer bring myself to get on a plane. I was prescribed 2 x 2mg valium tablets (for there and back). The only time I've ever used them and not exactly enough to get me hooked or suffer withdrawal symptons. It seems a bit mad that GPs are no longer able to do that very limited prescribing, but I appreciate that guidelines change.

Somebody mentioned Holland and Barrett. I read a comment from someone who has a newspaper column and suffered from anxiety that she'd started taking passion flower tablets for anxiety. Holland and Barrett sell Passion Flower Stress Relief tablets. I now take these and I can't say it's not psychological but they do seem to help me. They're not a food supplement so you don't need to make sure you've eaten before you take them. I take them to help with anxiety but they may well be of benefit when it comes to flying.

@cdtaylornats by that rationale, why should the NHS pay for IVF? or for alcoholics to get treatment and rehab? or for people with type 2 diabetes (surely if they had just moderated their diet they wouldn't have it!) or provide help for people to stop smoking? or pay for BCP prescriptions for people to not get pregnant when they have sex (why cant they buy their own condoms?!!). OP has paid her taxes (presumably!) so she has just as much right to have access to medical help/advice as you do and seeking help for situations that cause anxiety is perfectly appropriate.

I just wanted to add that the gp is not being unreasonable, years ago I knew someone who had a near death lung blood clot after taking a small dose of diazepam on a 12 hour flight, a very fit, slim and healthy 25 year old. They survived but only after emergency treatment after the plane was diverted, it might not have ended that way. We were all traumatised by happened. So yes the risk of that is slim, but not zero, and a big price to pay. Hope you sort it by other means

She is absolutely right not to prescribe it. It's best avoided altogether for many reasons. For flights, most of us GPs now don't prescribe it - risk outweighs benefit, some localities aren't actually allowed to and there are better alternative ways of handling flying phobia (guidelines advise us not to and we'd have no defence legally and with the GMC if we prescribe then something goes wrong). We don't need to look up everything - SSRIs and propranolol are used together frequently and any GP knows this is safe without having to refer to anything - it's bread and butter day top day stuff - we store a lot of info in our heads from training and experience . I would say the main issue here was the way the consultation was managed and communication skills that didn't come across well. Believe me, we practice putting the best interests of the patient first without hidden agendas...we are on your side.

Propanlol (sp?) is the biz for anxiety and you can function very well on it. There are side effects long term but taking it for a bit before you fly will be fine.

Do get some valium from the private GP if you can.

donttalk

Thanks for clarifying that for me, I had no idea what adhd was and thought op could just pick up some meds off the shelf at Tesco.

Ffs.

Op said she has adhd, so quite possible she already uses them, and you'll have noticed I also mentioned not changing the dose before getting advice.

Also from a selfish point of view if you’ve prescribed something against guidelines your insurance doesn’t cover you. I don’t know what would happen if someone got a clot and the plane had to be diverted in these circumstances but even if the patient / their family didn’t sue you I wouldn’t put it past an airline to take legal action against the prescriber - proving that the low dose diazepam didn’t contribute would be impossible

Another GP here who no longer prescribes for flights (under orders of CCG).

Maybe there isn’t enough time before this flight, but maybe consider reading BA’s Fly with Confidence book. It’s based on the course you can take at various U.K. airports. I got my self into an ever narrowing ability to cope with flying. In retrospect It started when I was having to make frequent flights abroad to support my grandparents, who inevitably got older, iller and then died. Flying became associated with doom. To cap it off I was on one of my mercy visits on 9/11 and watched the whole thing on wide screen tv at stanstead before boarding. The book helped me understand it all and develop strategies to deal with it, I now fly with barely a second thought. Although I still dislike turbulence.

benzos,diazapam valum etc all being stopped now.even for people with major anxiety.they SHOULD not be prescribing them at all.
big court case.big conferance of doctors council.and its been deicing they dont want to prescribe it at all.unless case by case it absolutely calls for it.
they used to give it when people came in having tough weeks.or flight etc.
its a very dangerous drug now and they do not want to give it.this has been going on for at least a year though.im not sure how filtered down through all surgeries it has become yet.

Besides, prescribing for flight anxiety has never been in the GP contract, so NHS GPs have never been obliged to do so.

@viasacra I work for a CCG in medicines optimisation and wondered whether that’s where this was coming from!

My doctor had absolutely no problem with prescribing me about 20 5mg diazepam last week for use as required. Mind you, I had some left from the previous prescription 26 months ago so I'm not exactly addicted to them.

We're in Scotland though so guidelines may be different as health is controlled by Holyrood.

Why do you doubt your GP?

Maybe, since your last flight, a paper has been published highlighting the dangers of taking Valium-type substances for long haul flights.
Does she think that you keep asking for them?
They are highly addictive and GPs are shying away from them in favour of other methods.

These threads pop up every 6 months or so and people always claim the guidelines have recently changed. They haven’t. Many GP’s still prescribe it. And if you’ve taken it before with no problems you’re not going to suddenly go into respiratory coma and death and more than if you read the dangerous side effects of any number of common drugs - including propranolol

Be prepared for the fact you'll have to pay private prices for the prescription. It will be more than NHS prices. You might want to ask your pharmacist how much they'll cost first. Also make sure you have a letter from the doctor for your medication.

If you aren't flying direct to Aus check your transfer airport's rules on medications too.

Try a propanol beforehand. I find them useless for anxiety, but they do work for other people. I don't really get side effects, but I can't tell I've taken anything at all and still get just as anxious.
If you're the same, try a private doctor for Valium. It isn't something to be taken regularly, but for very occasional situations it's very effective and I find I have a really clear head with them.