Sedative prescribing for fear of flying
Three Villages Medical Practice does not prescript sedatives for fear of flying. This policy decision has been made by the GP Partners and is adhered to by all prescribers working in the practice. The reasons for this can be found below:
Diazepam is a sedative, which means it makes you sleepy and more relaxed. If there is an emergency during the flight it may impair your ability to concentrate, follow instructions and react to the situation. This could have serious safety consequences for you and those around you.
Sedative drugs can make you fall asleep, however when you do sleep it is an unnatural non-REM sleep. This means you won’t move around as much as during natural sleep. This can cause you to be at increased risk of developing a blood clot (DVT) in the leg or even the lung. Blood clots are very dangerous and can even prove fatal. This risk is even greater if your flight is greater than four hours.
Whilst most people find benzodiazepines like diazepam sedating, a small number have paradoxical agitation and in aggression. They can also cause disinhibition and lead you to behave in a way that you would not normally. This could impact on your safety as well as that of other passengers and could also get you into trouble with the law.
According to the prescribing guidelines doctors follow (BNF) Benzodiazepines are contraindicated (not allowed) in phobia. Your doctor is taking a significant legal risk by prescribing against these guidelines. They are only licensed short term for a crisis in generalised anxiety. If this is the case, you should be getting proper care and support for your mental health and not going on a flight.
Diazepam and similar drugs are illegal in a number of countries. They may be confiscated or you may find yourself in trouble with the police.
Diazepam stays in your system for quite a while. If your job requires you to submit to random drug testing you may fail this having taken diazepam.
We appreciate that fear of flying is very real and very frightening. A much better approach is to tackle this properly with a Fear of Flying course run by the airlines and we have listed a number of these below.
Easy Jet www.fearlessflyer.easyjet.com Phone: 0203 8131644
British Airways www.flyingwithconfidence.com Phone: 01252 793250
Virgin www.flyingwithoutfear.co.uk Phone: 01423 714900
Medication in nurseries and schools
Prescribing over the counter medicines in nurseries and schools
GPs are often asked to prescribe over-the-counter medication to satisfy nurseries and schools. This is a misuse of GP time, and is not necessary.
Non-prescription or over-the-counter medication does not need a GP signature or authorisation in order for a school, nursery or childminder to give it.
Clarification on prescription medicines
The Government’s early years foundation stage statutory framework, which governs the standards of institutions looking after children, used to include the paragraph: ‘Medicines should only be taken to a setting when this is essential and settings should only accept medicines that have been prescribed by a doctor, dentist, nurse or pharmacist.’
This resulted in some parents making unnecessary appointments to seek a prescription for a non-prescription medicine so that it could be taken in nurseries or schools.
It has now been amended to refer to ‘prescription medicines’. The Department for Education has confirmed to the BMA that an FP10 is not required and non-prescription medication can be administered where parents have given written consent.
Unnecessary GP appointments
It is a misuse of GP time to take up an appointment to get a prescription just to satisfy the needs of a nursery or school.
The MHRA (Medicines and Healthcare products Regulatory Agency) licenses medicines and classifies them as over-the-counter, based on their safety profiles.
This is to enable access to those medicines without a GP. The classification also applies in the educational setting.
Giving medicines to children
It is appropriate for over-the-counter medicines to be administered by a member of staff in the nursery or school, or self-administered by the pupil during school hours, following written permission by the parents.
The early years foundation stage statutory framework outlines the policy for administering medicines to children aged up to five in nurseries, pre-schools and playgroups.