Travel Vaccinations 

 

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If you require any vaccinations relating to foreign travel you need to complete the form below and return it to the surgery. This will include which countries and areas within countries that you are visiting to determine what vaccinations are required.

It is important to complete this form between 6 and 16 weeks before you travel as any vaccinations required need to be completed at least 2 weeks before you travel. Please do not submit your form more than 16 weeks in advance as travel guidance can change with little notice.

Only the following vaccines are available on the NHS.  You will need to attend a private health clinic for anything else required.

* UK childhood vaccinations

* Tetanus/Diphtheria/Polio boosters

* Hepatitis A

* Typhoid

* MMR catch up

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image representing travel vaccinations

 

Travel Vaccination procedure for Ryeland Surgery

Ryeland Surgery Policy on Prescribing Benzodiazepines for Fear of Flying

Ryeland Surgery has reviewed its benzodiazepine prescribing and established the policy not to prescribe benzodiazepines (such as diazepam) to patients for fear of flying.  

People often come to us requesting that we prescribe diazepam for fear of flying or to assist with sleep during flights.

Initially in the 1960s benzodiazepines including Diazepam (also known as ‘Valium’) were hailed as a wonder drug. However, it became increasingly clear that, as well as having short term deleterious effects on memory, co-ordination, concentration and reaction times, they were also addictive, with withdrawal leading to fits, hallucinations, agitation and confusion.  Furthermore, they were found to have long-term effects on cognition and balance. Unfortunately, benzodiazepines have also become a widely used drug of abuse since they first came on the market. Because of these reasons the use of benzodiazepines has been a lot more controlled around the world since the 1980-90s; especially in the UK. Diazepam in the UK is a Class C/Schedule IV controlled drug. The following short guide outlines the issues surrounding its use with regards to flying and why the surgery no longer prescribes such medications for this purpose.

There are a number of very good reasons why prescribing this drug is not recommended.

  • The use of any sort of benzodiazepines causes longer reaction times & slowed thinking. During a flight may put the passenger at significant risk of not being able to act in a manner which could save their life, or that of a loved one or co-passenger, in the event of a safety critical incident. Incapacitation from benzodiazepines is a risk to the lives of all on board the aircraft in the event of an emergency requiring evacuation.
  • The use of such 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 an increased risk of developing a blood clot (Deep Vein Thrombosis – DVT) in the leg or even the lungs. Blood clots are very dangerous and can even prove fatal. This risk is even greater if your flight is greater than 4 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.
  • Benzodiazepine use added to alcohol consumption causes an increase in the risk posed by the points above
  • 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.
  • NICE guidelines suggest that medication should not be used for mild and self-limiting mental health disorder. In more significant anxiety related states, benzodiazepines, sedating antihistamines or antipsychotics should not be prescribed
  • In some countries it is illegal to import these drugs, e.g. in the Middle East, 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
  • 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.
  • You may not be able to drive on reaching your destination.

Given the above we will no longer be providing Diazepam for flight anxiety and instead suggest the below aviation industry recommended flight anxiety courses which are easily accessible for those who wish to fly & conquer their fear of flying, eg:

  1. Easy Jet www.fearlessflyer.easyjet.com Tel 0203 8131644
  2. British Airways www.flyingwithconfidence.com  Tel 01252 793250
  3. Virgin www.flyingwithoutfear.co.uk  Tel 01423 714900
  4. https://thefearofflying.com/programs/fly-and-be-calm/
  • 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. 
  • 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.

FIND OUT MORE ABOUT TRAVEL VACCINATIONS