Following a review of our benzodiazepine/sedative prescribing, as of 14/7/2025 Acle Medical Centre have made the decision to no longer prescribe benzodiazepines or sedatives (such as Diazepam/Lorazepam/Temazepam or Clonazepam) to patients for the following reasons:
- Medical procedures and Radiology procedures (such as for MRI)
- Fear of flying
- Dental procedures
We appreciate some patients can find undergoing a scan or a medical procedure a daunting process. However, we must continue to prioritise patient safety and there is a growing amount of evidence that these medications have short term negative effects on memory, co-ordination, concentration and reaction times as well as concern they can cause longer term issues with cognition (including possible links to dementia) and balance. This decision has been made by the GP Partners and is adhered to by all prescribers working in the practice.
| Issue | Explanation |
| Addictive | Benzodiazepines are highly addictive medications and withdrawal can lead to fits, hallucination, agitation and confusion. |
| Abused | Sadly they are known to be abused and so there are tighter controls regarding their prescription. In the UK Diazepam is a Class C/Schedule IV controlled drug. This means it is illegal to possess, supply or produce Diazepam without an appropriate prescription. |
| Dosage | GPs are not trained to provide the correct level of sedation for a specific procedure/scan. Providing too little sedation will not help you, providing too much sedation can cause excessive drowsiness which can slow your breathing rate which can be dangerous, especially with certain common medical conditions such as COPD. |
| Agitation | For most people medications such as Diazepam can make them sleepy. However, rarely it can have the opposite effect and make people aggressive, agitated or disinhibited. It is not possible to predict who will react in this way. |
| Timing | Scans/hospital procedures/dental procedures and flights may be delayed and so it is not possible to always know the correct timing for administering the medication. |
| Monitoring | The Royal College of Radiologists have strict guidance on the safe sedation of patients during investigations such as CT and MRI scans. It is unsafe for us to prescribe a sedative that we are unable to monitor. If you were to become unwell during a scan, after taking a sedative that the Radiology team did not know about, this could be very dangerous. |
| Reaction times | People often request diazepam for fear of flying. Using these medications can result in slower reaction times and slowed thinking. If a mid-air emergency were to occur, being under the influence of a sedative could put the passenger at risk of not being able to act in a manner which could save their life or that of a loved one or co-passenger especially in the event of an emergency requiring evacuation. |
| DVT/PE | These drugs can make you fall asleep, however, when you do sleep it is often unnatural non-REM sleep. This means you don’t move around as much as during natural sleep and this can increase the risk of developing a blood clot (DVT) in the legs or even in the lungs (PE). Blood clots are dangerous and can even be fatal. This risk is increased if your flight is longer than 4hours. |
| Alcohol | When combined with alcohol they pose a greater risk of a negative outcome. |
| Contra-indicated | According to the BNF (British National Formulary- a prescribing guideline that doctors follow) diazepam is contra-indicated (not allowed) in treating phobic states. It also states that the use of benzodiazepines to treat short-term ‘mild’ anxiety is inappropriate. This means there is a significant legal risk to the prescriber if they chose to prescribe against these guidelines. These drugs are only licensed for short term use in a crisis in generalised anxiety (this does not include phobias). NICE guidelines suggest that medication should not be used for mild and self-limiting mental health disorders. |
| Illegal | In some countries it is illegal to import these drugs and so the passenger will need to use a different strategy for the homeward bound journey and/or any subsequent legs of the journey. They may be confiscated or you may find yourself in trouble with the police. |
| Occupation | Benzodiazepines such as Diazepam can stay in your system for quite a while. If your job requires you to submit random drug testing, you may fail this. |
| Exacerbation of anxiety | A study published in 1997 from the Stanford University School of Medicine showed evidence that using benzodiazepines stops the bodies normal adjustment response that allows anxiety to gradually lessen over time and therefore it perpetuates and may increase anxiety in the long term, especially if used repeatedly. |
| Insurance | You must declare all medical conditions and medications you take to your travel insurer. If you don’t there is a risk of nullifying the insurance policy. |
Solutions:
- If your medical procedure or scan has been requested by secondary care then you are welcome to contact the team who requested it as they are responsible for deciding if they feel it is clinically necessary to prescribe anything. Before doing so please take into account the information above.
- For dental procedures it is the responsibility of the dentist to prescribe any sedation if they feel you require it.
- There are a number of Aviation Industry recommended Flight Anxiety Courses which are easily accessible for those who wish to fly and conquer their fear of flying.
fearlessflyer.easyjet.com (Easy Jet)
flyingwithconfidence.com (British Airways)
flyingwithoutfear.co.uk (Virgin Airways)
Alternatively, patients can consult with a private GP or travel clinic, however, please remember the above reasons for not taking a sedative whilst flying/undergoing a medical procedure/scan.
Medication isn’t usually recommended for treating phobias because talking therapies are usually effective and these don’t have any side effects. For more information of phobia treatment pathways, please review the NHS website and you are welcome to discuss phobias and talking therapies further with us.