Travelling with medication
If you take regular medication(s) and are planning to go abroad, we recommend following these steps to ensure that you have your prescription(s) for the length of the trip.
NHS regulations stipulate that a single prescription should not be for more than 3 months of medication, maximum, at the discretion of your clinician. If you are travelling longer than 3 months, you will need to seek a medical review and/or further supply of medication from a medical service in the country you will be visiting.
Non-urgent advice: Please Note
The prescribing clinician may issue a prescription that is shorter than 3 months if this is deemed to be safer for you. The practice can provide a stamped and signed letter stating your regular medication.
This is particularly important if you have diabetes and use insulin as you will be travelling with needles and lancets for testing your sugar levels.
Carry your medication in labelled packaging. NHS guidelines advise that you carry the majority in your hand luggage in a separate easily accessible bag and then some spare in your suitcase luggage in case of loss or damages.
If you are travelling with liquid medicines over 100mls, contact the airline and airports you are travelling through. This also includes medications such as inhalers. You may need a document to prove the liquid form of the medication is necessary. Carrying over 100mls can sometimes mean this medication needs to be screened separately to your luggage. Inform security before your X-Ray that you have liquid medication with you.
If you need to travel with needles or syringes you will need to carry the relevant medication alongside the equipment. You will not be able to travel with needles and syringes only.
If you are travelling to a warm country, get advice from the pharmacy on how to store your medication or see the NHS website‘s advice for storing your medications.
The country you are travelling to may have restrictions on the medications that they allow into the country. You will want to contact the embassy of the country you are travelling to to confirm the regulations. If any of the medications you are taking are controlled drugs, then you will need to contact the relevant embassy before you travel.
Use of Benzodiazepines (and related medications) for flying
Flight anxiety does not come under the remit of General Medical Services as defined in the GP contract and so we are not obliged to prescribe for this. Patients who still wish to take benzodiazepines for flight anxiety are advised to consult with a private GP or travel clinic.
Additionally, please consider the following information:
According to the prescribing guidelines doctors follow (British National Formulary) diazepam is contraindicated (not allowed) in treating phobic states. It also states that “the use of benzodiazepines to treat short-term ‘mild’ anxiety is inappropriate.” Your doctor would be 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.
NICE guidelines suggest that medication should not be used for mild and self-limiting mental health disorders. In more significant anxiety related states, benzodiazepines, sedating antihistamines or antipsychotics should not be prescribed. Benzodiazepines are only advised for the short-term use for a crisis in generalised anxiety disorder in which case they are not fit to fly. Fear of flying in isolation is not a generalised anxiety disorder.
Although plane emergencies are a rare occurrence there are concerns about reduced awareness and reaction times for patients taking Diazepam which could pose a significant risk of not being able to react in a manner which could save their life in the event of an emergency on board necessitating evacuation.
Whilst most people find Diazepam sedating, a small number have paradoxical agitation and aggression. They can also cause disinhibition and lead you to behave in a way that you would not normally which can pose a risk on the plane. This could impact on your safety as well as that of other passengers and could also get you into trouble with the law. A similar effect can be seen with alcohol, which has led to people being removed from flights.
A study published in 1997 from the Stanford University School of Medicine showed that there is evidence use of Benzodiazepines stops the normal adjustment response that would gradually lessen anxiety over time and therefore perpetuates and may increase anxiety in the long term, especially if used repeatedly.
Diazepam and similar controlled drugs are illegal in a number of countries. They may be confiscated or you may find yourself in trouble with the police. The passenger may also need to use a different strategy for the homeward bound journey and/or other legs of the journey.
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.
It is important to declare all medical conditions and medications you take to your travel insurer. If not, there is a risk of nullifying any insurance policy you may have.
Fear of Flying Courses
Most major airlines offer courses. Please see some examples below.
Easy Jet
British Airways
http://flyingwithconfidence.com/courses
Virgin Atlantic
https://flywith.virginatlantic.com/bb/en/wellbeing-and-health/flying-without-fear.html
Flying without fear