To ask how possible it is to get a prescription for a fear of flying?

[doyouhavefaithingodabove]

I have always been a nervous flier and nervous traveller in general. It makes me very stressed and I tend to not relax until I’ve landed.

I usually fly BA since they’ve introduced WiFi because I can then connect to it and text my dad, who is the only one who’s able to explain things in a way that calms me down. He doesn’t mind it.

This summer I’m flying with Ryanair and the recent news about the window shattering has genuinely made me so anxious I feel sick. I don’t fly for another eight weeks but I can already feel panic building whenever I think of it.

I know this is commonplace in America but does this type of thing ever happen in the UK? Would I need to see a private GP?

Again, I will say that your point is irrelevant to mine. I did not write the clinical guidance, nor did I express an opinion one way or the other with regard as to whether I personally agree with the guidance. I was simply explaining why doctors are now unlikely to prescribe benzodiazepines for flying- that being because clinical guidelines are very clear that it is contra-indicated. I was trying to be informative (and potentially saving OP from wasting her money on a private GP).

As to your point re alcohol-related flight disruption, I agree that it is indeed an issue which I think the airlines need to resolve. I would very surprised if there is not a safety issue there too. However, I don’t think that nullifies the risk of other things. If medication is a safety issue, it should be addressed regardless of other safety issues that are also present.

Clinical guidelines have no bearing on alcohol use when flying. It’s not something clinical prescribing guidelines have any influence over. Therefore, is irrelevant with regards to whether or not benzodiazepines should be used. That alcohol is problematic is a separate matter- but that does not mean that benzodiazepine use during flight is fine because alcohol is allowed. If it is true that there is a sufficient risk that the conclusion drawn is that it should just not be used during flight, then that should stand without reference to the question of whether alcohol should be prohibited before and during flights.

I always have, and still get prescribed diazepam for flying.

They only give me a prescription of 10 tablets maybe 3 times a year so no worry that I’m addicted or overusing!

Factually incorrect.

If a Doctor prescribed a medication for a use which is contra-indicated /against guidance and something goes wrong, then yes we can be held professionally liable.

it is true that if you were prescribed diazepam for something else- for example, muscle spasm- and you then took it before flying, and the prescribing doctor had no knowledge (or could not reasonably have been expected to know) that you were planning on doing so when they issued the prescription, then they would not be held accountable.

You might not but sadly those around you who could be blocked from exiting if you were sedated and in the way would!

Even a private GP won’t prescribe it. Don’t mention flying at all. I know from bitter experience.

Yet they will happily sell you large amounts of alcohol.
Flying BA recently I asked for a G and T and was handed two 60 ml bottles of high strength gin with a can of tonic.
So the diazepam analogy doesn’t wash.

I've certainly known cabin crew having problems waking up pax at the end of Long Haul flights, and the reason more often as not has turned out to be sedatives rather than booze, so IMO there is certainly potential for problems if an emergency arose on arrival.

As I mentioned upthread UK at least this directive seems to have come from the regulator. They have access to some fairly heavy specialist expertise (both in house and external) and also get to see any incident reports raised by crew as a result of incidents on flights..

I can only speculate they've perceived that there is a problem here and have taken steps to try and minimise the risks as best they can.

Some airlines do fear of flying courses. Book yourself onto one of those. Apparently it’s meant to be very good.

Then ban alcohol on flights. Simple.

I was prescribed them by a psychiatrist OP. I have a crippling fear of flying (and have done the fear of flying course which helped a bit). I don’t think people can really understand how irrational and debilitating it can be - it’s a phobia not a choice. It’s also not true to say it was the airline industry pushing for a change in prescribing - it’s part of a general push to reduce the prescribing of benzos etc (for lots of sensible reasons but there are some people and conditions where they are genuinely warranted).

Well you'd best run that past the regulator.

Diazepam isn't massively sedating for most people. I find it removes the anxiety while keeping a clear head. For me it needs to be at least 5mg to have a noticeable effect and I still feel mentally alert at that dose. It doesn't knock me out. Alcohol is the sedating drug.

It's massively unhelpful for people to sneer at those who fear flying and telling them they just shouldn't fly if that's their problem. It's very limiting and has the effect of limiting the travel options of whole families and restricting careers too

Sorry if I've already replied.

I don't fly unless it's necessary but my GP always prescribes diazepam.

It does, because the medical profession aren't selling you booze and the airlines aren't prescribing you diazepam.

Different needs, wants and responsibilities.

Speak to Ryanair - what's his face who owns it wants alcohol banned at airports.

Given the behaviour of some people maybe they should but that's not going change the situation as is or get you a prescription is it.

Unfortunately it looks like your options are limited.

Also not helpful when I’ve said that I’m usually able to control it, but this latest incident has really scared me. I can’t afford to lose this much money

No, they have decided to stop prescribing very heavy duty drugs which are often abused, and which mean you are too out of it to follow cabin crew instructions.

Cancel your flights. Or spend the next 8 weeks booking a fear of flying course.

Well, you have three choices.

Suck it up and lose the money (sunken costs is a fallacy by the way - presumably you'll, still spend more money by going ie food, drinks, shopping etc).

Suck it up and fly without help.

Attempt to get urgent help with the phobia in the interim. I include trying for a private prescription in that, but also therapeutic options.

I'm not being dismissive - DH is terrified of flying and we've spent a decade going bloody nowhere because of it, but now he has a job where flying a couple of times a year is required he can fucking manage it... 🙄

The more you focus on it the worse it is. He seems to have discovered that me trying to make it easier for him made it worse. I take the lead on everything tbh like booking it all, driving, parking, navigating the airport, blah blah blah but if he has to do it himself, he has less time to get wound up and is even able to sleep on the plane now.

I can’t spend the £1000 I’ve already spent and not get anything for it. It’s an entirely unhelpful comment.

You honestly have no idea what you're talking about.

First of all, if it was about them being abused, they should stop prescribing them altogether. Because the people being give a sleeve of like six tablets for use a few times a year are hardly the most likely culprits for that.

which mean you are too out of it to follow cabin crew instructions

You know they come in different dosages, right? And that it's possible to take a small dose that takes the edge off anxiety but doesn't leave you remotely out of it, right?

Things that would make me too out of it to be efficient at following cabin crew instructions: otc antihistamines (like Benadryl), more than one glass of wine.

Things that do not make me too out of it to be efficient at following cabin crew instructions: a small dose of diazepam.

Of course you can.

You don't want to but you CAN.

Framing it as though you have no choice is not helpful to your panicking mind. You absolutely have the choice not to travel at all.

https://www.fearlessflyer.easyjet.com/

Ok, fine. But a Dr is not prescribing you Benadryl or wine, and given the clinical guidance only covers prescription medication, not over the counter medication and alcohol, I think it is rather a moot point. It’s irrelevant to the argument- that alcohol is an issue is true, but if there is evidence to back up the guidance (which I think there likely is, given the existence of the guidelines), then that is all that matters when looking at this particular guideline. That there is a separate issue with regards to flight safety and alcohol does not negate other risks which are being mitigated against, does it?

FWIW, not everyone just gets pleasantly relaxed with diazepam. Just like not everyone tolerates alcohol the same way.

Doctors should prescribe according to guidance (or be able to justify not doing so- though there is no guarantee that justification will be accepted if there was an adverse outcome).

I agree, it does seem odd that alcohol use is not controlled, given the problems it can cause. I doubt airlines could prevent people taking over the counter medication. But that is a matter for the regulators and airlines, not a clinical prescribing guideline.

I am not doubting there are some doctors who don’t adhere to the guidance and will prescribe against guidance. I think it is rarer than it was, but I imagine not impossible.

that is somewhat foolhardy, imo- I’m not a GP but I do have friends who are and one told me when discussing this earlier today that they had a session with their indemnity organisation as part of a training day and that organisation is quite clear that if one of their clients prescribes sedatives for fear of flying and an adverse event occurs causing costs claimed by the airline that they (the indemnification organisation) will not pay out. It’s in their contract- because there was a case which was extremely costly and it was not accepted that the Dr’s decision to prescribe off guidance was justified. The airline claimed costs back- the travellers insurer (successfully) argued that the brunt of costs should be borne by the prescriber because it was going against all official guidance and the patient took the medication as prescribed, so could be argued that they acted responsibly with the information given to them by the doctor. So, I think it’s a big risk to ask if someone. I imagine private doctors who work for an organisation would be just as reluctant, but perhaps some independent ones might.

Similarly, if the Dr prescribed benzodiazepines but does not give guidance around driving or operating machinery when taking these medications, and something happens, we can be held liable for clinical negligence but our indemnity organisation may well not pay any costs we incur as a result. I imagine this i

Okay, would you give me £1000? To cover what I’d lose? Of course you wouldn’t. Because that’s a hell of a lot of money to spend and not get anything in return

Do a fear of flying course. Either do one of the ones Ba runs or simply do an online course. Years ago I bought some CD’s done by an ex BA pilot and I found them in self useful. I even wrote to him to say what a help they had been. Am I cured? Not even close, but can I get through it without crying and semi relax for the most part, yes. I’ll take that and it means I have been able to fly around the world albeit with white knuckles.