Will my doctor give me diazepam for flying?

October 9, 2025 •

5 min read

According to several medical practice guidelines, doctors will now rarely prescribe diazepam for a fear of flying due to significant safety concerns. Patient requests for this medication have become common, but current medical advice has shifted towards prioritizing safer, non-pharmacological alternatives for managing flight-related anxiety.

Quick Summary

Doctors generally will not prescribe diazepam for flying anxiety, citing safety concerns like impaired reaction times, increased DVT risk, and potential paradoxical effects. National prescribing guidelines also advise against this practice, which can hinder the long-term resolution of phobias.

Key Points

Doctor's Policy: Many GPs and medical practices have adopted a clear policy against prescribing diazepam for a fear of flying due to safety and medical guideline conflicts.
Emergency Risk: Diazepam is a sedative that impairs reaction times, potentially incapacitating a passenger during an in-flight emergency and posing a risk to all on board.
DVT Concern: The unnatural, deep sleep induced by sedatives can increase the risk of Deep Vein Thrombosis (DVT), a dangerous blood clot, especially on flights over four hours.
Legal & Insurance Issues: As a controlled drug, carrying diazepam can lead to legal problems in certain countries and may invalidate travel insurance if not disclosed.
Effective Alternatives: Non-pharmacological treatments like Cognitive Behavioral Therapy (CBT), exposure therapy, and airline-run 'fear of flying' courses are considered safer and more effective long-term solutions.
Pharmacological Options: For those with an underlying anxiety condition, doctors may discuss alternative medications like beta-blockers (for physical symptoms) or antihistamines, rather than benzodiazepines.
Long-Term Well-being: Relying on medication for phobias can prevent a person from addressing the root cause, potentially worsening the anxiety over time.

Why Doctors No Longer Prescribe Diazepam for Flying

For many years, some doctors may have issued a small dose of a benzodiazepine, such as diazepam (also known as Valium), to patients with a fear of flying. However, this practice is now widely discouraged across the medical community, with many General Practices and national health bodies adopting specific policies against it. The reasoning behind this shift is based on several crucial medical and safety considerations.

Safety Risks Aboard the Aircraft

Diazepam is a sedative that significantly slows down the central nervous system, affecting reaction times, judgment, and coordination. While this may seem helpful for calming nerves, it poses several serious risks during air travel:

Impaired Emergency Response: In the rare event of an in-flight emergency requiring an evacuation, a sedated passenger may be unable to react quickly, follow crew instructions, or move effectively. This can compromise their own safety and potentially endanger others.
Paradoxical Effects: For a small but unpredictable number of people, diazepam can have the opposite of its intended effect. Instead of causing relaxation, it can lead to paradoxical agitation, aggression, or disinhibition. This behavior is disruptive and a safety risk to all passengers and crew, and could result in legal trouble for the individual.

Increased Risk of Deep Vein Thrombosis (DVT)

Sedative drugs like diazepam induce an unnatural, non-REM sleep. This kind of sleep often results in significantly reduced movement compared to natural sleep, especially on longer flights (over four hours). Immobility is a major risk factor for developing Deep Vein Thrombosis (DVT), a dangerous condition where a blood clot forms in a deep vein, usually in the legs. These clots can be fatal if they travel to the lungs.

Legal and Insurance Complications

Prescribing diazepam for a phobia goes against established national guidelines in many countries, leaving doctors at significant legal risk if an adverse event occurs. For travelers, there are additional risks:

International Legality: As a controlled drug, diazepam is illegal to import in some countries, particularly in the Middle East. Travelers could face confiscation of their medication or serious legal charges.
Travel Insurance: Insurance policies typically require travelers to disclose all medical conditions and medications. Taking diazepam for flying without disclosing it could invalidate a travel insurance policy, leaving the traveler financially unprotected.
Workplace Drug Testing: Diazepam has a long half-life and remains in the system for a significant period. Employees subject to random drug testing could fail their test after a flight.

Long-Term Impact on Anxiety

Experts note that benzodiazepines can interfere with the brain's natural response to overcoming anxiety. Using a sedative for flying provides a temporary fix but does not address the underlying phobia. Over time, it can perpetuate and even worsen the fear, hindering the individual's ability to cope independently.

Safer and More Effective Alternatives for Flying Anxiety

Fortunately, a range of proven and safer alternatives exist to help individuals manage their fear of flying without the risks associated with diazepam. A healthcare provider can recommend a tailored approach based on individual needs.

Cognitive Behavioral Therapy (CBT): This therapy helps individuals identify and challenge irrational, catastrophic thoughts associated with flying. It provides practical tools to reframe thinking and manage anxiety.
Exposure Therapy: Often part of CBT, this involves gradual, controlled exposure to the fear trigger. This can start with watching videos of planes and progress to visiting an airport or even using virtual reality flight simulations.
Mindfulness and Breathing Techniques: Simple techniques like box breathing (inhale for four, hold for four, exhale for four, hold for four) or grounding exercises can help shift focus from anxious thoughts to the present moment.
Pharmacological Alternatives: For those with underlying anxiety disorders, other medications might be suitable. Beta-blockers, for example, target the physical symptoms of anxiety like a racing heart and trembling without affecting cognitive functions. Some providers might consider anti-anxiety antihistamines like hydroxyzine.
Airline and Specialist Courses: Several airlines and independent companies offer structured 'fear of flying' courses that combine educational components with simulated exposure. The aviation industry generally endorses these programs.

Comparative Table: Diazepam vs. Non-Pharmacological Alternatives


Feature	Diazepam for Flying	Non-Pharmacological Alternatives (e.g., CBT)
Effectiveness	Temporary sedation masking symptoms. Does not address the root phobia.	Addresses and resolves the underlying fear for long-term effectiveness.
Safety During Flight	High risk due to impaired reaction times, sedation, and potential aggression.	No safety risk; techniques can be used to maintain alertness and calm.
Physical Risks	Increased risk of DVT, especially on long-haul flights.	Minimal to no physical risk when practiced correctly.
Legal/Travel Issues	Potential for confiscation, legal issues, or insurance invalidation due to controlled drug status.	No legal issues as it involves behavior modification, not controlled substances.
Long-Term Outcome	Can perpetuate or worsen anxiety over time.	Aims for a permanent resolution of the phobia.

What to Discuss with Your Doctor

If you have a fear of flying, the best first step is to have an open and honest conversation with your doctor. They will not judge you and can provide a safer, more sustainable solution. During your discussion, be prepared to talk about:

The severity and specific triggers of your flying anxiety.
Your overall mental and physical health.
Potential non-pharmacological approaches like CBT.
If appropriate, whether alternative medications might be suitable for managing symptoms.

Your doctor will prioritize your safety and long-term well-being, and prescribing a controlled sedative for a one-off situational anxiety is no longer considered best practice. It is crucial to respect their professional judgment and work collaboratively to find a treatment plan that offers both relief and long-term success. You can find more information on flying and health on the NHS website.

Conclusion

The medical community has moved away from prescribing diazepam for fear of flying due to a comprehensive understanding of the risks involved. Impaired reaction times, increased DVT risk, legal complications, and the potential to worsen anxiety long-term all outweigh the temporary calming effects of the drug. Safer, more effective alternatives, including cognitive behavioral therapy and modern flight anxiety courses, offer a better path to managing and overcoming aviophobia permanently. A frank discussion with your doctor is the best way to explore these options and ensure a safer, more positive travel experience.

Frequently Asked Questions

Doctors will not prescribe diazepam for fear of flying because of significant safety risks, including slowed reaction times in an emergency, increased risk of DVT, and potential for agitation. Additionally, national medical guidelines advise against prescribing benzodiazepines for phobias.

Some medical practices note that while they will not prescribe diazepam for flying, patients may be able to consult a private GP or travel clinic. However, the same medical and safety concerns still apply, and a private doctor would also be professionally and legally responsible for the prescription.

The risks of taking diazepam on a flight include impaired judgment and reaction times during an emergency, an increased risk of blood clots (DVT), potential for paradoxical agitation, and legal trouble if entering a country where it is restricted.

Instead of medication, effective options include attending flight anxiety courses offered by airlines, pursuing Cognitive Behavioral Therapy (CBT) or exposure therapy, and practicing breathing or grounding techniques. Addressing the root cause provides a more sustainable solution.

Yes, in many countries, diazepam is a controlled drug, and it is illegal to import without proper permissions. You could face confiscation of the medication or legal consequences, especially in countries with stricter drug laws.

Yes, failing to declare that you are taking diazepam to your travel insurer could invalidate your policy. This would mean they would not pay out if you needed to make a claim.

In a small number of people, benzodiazepines like diazepam can cause paradoxical effects such as agitation, aggression, and disinhibition, rather than the intended calming effect.