How do I talk to my doctor about meds for a plane trip?

December 11, 2008 8:14 AM

I'm flying in a few weeks. I'm scared to death, and I want to try some of those anti-anxiety meds that people say you can get from your doctor. But how do I talk to my doctor about it?

I can't imagine walking in, sitting down, and asking for that kind of prescription. I'm terrified of being called a drug-seeker.

Do doctors really get these kind of requests all the time? And what do I say to the receptionist when she asks why I'm coming in?

(Please don't tell me that I don't really want drugs, that I really want therapy, or deep breathing, or your favorite fear of flying book. Been there, done that. Sometimes I'm nervous about trips, sometimes I'm not ... and this time, I'm starting to freak out weeks in advance, so I think this is going to be a bad one and I want to try something different. Can I blame that recent front-page post about the Mt Erebus crash?)

posted by anonymous to health & fitness (34 comments total)

People do this all the time. You are a drug-seeker, but you are not an abuser; no need to feel like you're doing anything wrong, or that you're weak or something. You want a few pills to help you make it through the flight. Your doctor will not react weirdly to your request; fear of flying is hardly unusual. You just tell him what you've told us here.
I don't know what to tell the receptionist; maybe say you'd like to talk to the doctor about panic attacks? (For some reason, saying "panic attacks" sounds more doctor-y than fear or anxiety.) It may be awkward, but who cares? Again, these are professionals who hear all sorts of crazy stuff all the time. You are not even going to make it onto their top 20 crazy things they've heard this week, I promise.
posted by chowflap at 8:26 AM on December 11, 2008

I'm not sure, but my guess is the doctor can prescribe you a small amount of anti anxiety meds. Like, four or five pills. I think if you just go in and are straight forward with the doctor you shouldn't have any problems.
posted by josher71 at 8:27 AM on December 11, 2008

"Hi, uh, I have to fly and I'm completely panicked about it - do you think I could get a couple of Xanax or something?"
posted by tristeza at 8:27 AM on December 11, 2008

You are not the first person to ask the doctor for such meds for such reasons, not by a long shot. Remember this, and say pretty much what you've already said: "Um, hi, I'm flying in a few weeks. I'm scared to death, and I'd like to talk to the doctor about those anti-anxiety meds that people say you can get."

It's really as simple as that. They get such requests all the time, I'm sure.
posted by MrMoonPie at 8:27 AM on December 11, 2008

When I've needed something like this in the past, anonymous, I've just been honest with my doc (more often, my doc's nurse). I would encourage you to just be upfront and, for lack of a better word, clinical about it. You're not a druggie; you're looking for something which will help you cope with a situation. Something like: "I am scheduled to take a flight in a few weeks, and it's been my experience that my anxiety symptoms skyrocket in this situation. My heart rate increases, I am out of breath, I have panic attacks, etc. What medicines are available to me to help me get through this flight without these symptoms affecting my safety and comfort?"
posted by lucyleaf at 8:29 AM on December 11, 2008

There's no need to tell any receptionist anything. They have no need or right to know why you want to see a doctor.

And as for the doctor, simply stating that you are suffering panic attacks due to your ongoing struggle with fear of flying, and would like anti-anxiety meds to cope with a trip you can't avoid, and you should be gold. Might not be covered by your insurance (am assuming your in the US here) if you need insurance, but there's no reason for the doctor to deny your request.
posted by Happy Dave at 8:29 AM on December 11, 2008

While there is a potential for addiction to the benzodiazepines, this isn't like going in and asking for oxycodone for a headache. Doctors prescribe benzos all the time. Just tell the doctor you have a terrible fear of flying and ask if he/she can prescribe something that will help you relax for a 6 (or whatever) hour flight. This is a pretty common request and you'll probably be prescribed xanax. It's really not a big deal-- according to the DEA there were 100 million prescriptions for benzos in the US 1999.

As for the receptionist, you can tell her the same thing. Or if you're shy, you can say that you want to consult the doctor about medication for an upcoming trip.
posted by justkevin at 8:29 AM on December 11, 2008

Yes, doctors get this kind of thing all the time.

Last time I flew I emailed my doctor, told her I was flying and I was nervous. 1/2 hour later there was either a very small prescription or sample waiting for me in her office (it's been a few years, I don't remember what it was). She gave me 1 or 2 pills per leg of the flight. Not enough to abuse it or sell it to the teenagers.

Seriously, just call them up and tell them what you told us. You probably won't even need a visit, other than to pick up the prescription.
posted by bondcliff at 8:29 AM on December 11, 2008

Drug seekers try to get the highest possible doses of the most powerful narcotics they think the doctor will write for and they want it with refills.
posted by The Straightener at 8:30 AM on December 11, 2008

You are winding yourself up about this just like an overly anxious person! This is absolutely not a big deal for physicians.

anonymous: I'm flying in a few weeks and I'm terrified of flying. I've heard that there are medications that can help with my anxiety.

doctor: (as he thumbs through your chart) Yes there are many such medications, have you ever tried any?

anonymous: No, are they safe?

doctor: Oh yes, they've been tested a lot and are very effective when used in moderation. Do you have anxiety at other times? Would you like a referral to talk to someone about it?

anonymous: No, all I want is to take my flight without panicking.

doctor: Ok, well there's (starts to name different meds, probably decides to recommend the one *he* takes when he's anxious)
posted by jasper411 at 8:30 AM on December 11, 2008

Nthing the above advice. You are not going to come off as a drug seeker, trust me. Drug seekers will be asking for the potent stuff by name, in high doses, with refills. An ativan prescription wouldn't even interest a drug seeker, but will help you with your situation.
posted by cgg at 8:39 AM on December 11, 2008

My doctor prescribes me Valium when I fly. The initial conversation was easy - it happened to coincide with my physical, and I just said "I get incredibly anxious about flying, and I'm taking a trip next month. Is there something I could take for that?" Now, when I need to fly, I call the pharmacy and ask them to call the doctor for authorization for a refill. The doctor gets the call, knows what it's about, and I don't even have to talk to him. Good luck!
posted by Ruki at 8:42 AM on December 11, 2008

When I developed my fear of flying, I made an appointment with my GP. I had no idea that there were drugs for such things, but I was hoping that she could recommend some breathing techniques or refer me to a psychologist. I don't know what I was expecting - I just needed some help. When I mentioned it, she thought it over for a split second and said, "Oh! Yes! I'll give you a small dose of Xanax and that will do the trick!"

I was stunned at how casual and unsurprised she was that I mentioned my fear of flying to her and how easy it was for her to simply write out a prescription like that. Yet, in her own way, she took it seriously and I was incredibly thankful that for the first time ever, someone actually empathized with me on this issue and offered me help.

The Xanax did help, by the way. It really numbs your fears and helps you stay level-headed. It will also make you good and groggy, so if you have a connecting flight, don't take so much that you won't be able to get your ass across the Chicago terminal, etc.

For some people, it will take more than Xanax. I'm a particularly bad case - not the worst you've ever seen, but definitely bad. I require the deep-breathing and therapy tapes in addition to Xanax. If you're sometimes nervous, sometimes not, then I would expect that just the pills will be exactly what you want (as you indicated).

I think doctors really do get requests like this all the time. This is probably one of the more appropriate requests and they won't be silently judging you as you walk out the door. When I got my prescription I just went in for a regular checkup and mentioned it during my examination.

I wouldn't be worried about what the receptionist would think - I'm sure they have heard worse things. I would just say something like, "I am experiencing some anxiety issues, especially regarding fear of flying, and I would like to explore my options with my doctor."

Good luck!
posted by bristolcat at 8:43 AM on December 11, 2008 [1 favorite has favorites]

There's nothing remotely strange about this. I honestly don't know why you're worrying. More than one family member needs anti-anxiety meds when they fly. I do not come from a family of drug addicts. It's totally within the bounds of normality. Just explain your situation and talk about the best drug for you, since there's a bunch of options.
posted by Dasein at 8:47 AM on December 11, 2008

Print out this thread and show it to your doctor. (Seriously, just tell the doc exactly what you wrote above -- you're nervous about flying.)
posted by inigo2 at 8:48 AM on December 11, 2008

When you call for an appt, the nurse/receptionist will ask what "this is in regards to". Simply say, "I'll discuss that with my doctor." No problem - "OK, I'll mark the issue as private."

Write out your first paragraph above, and hand it to your doc. He will understand. No big deal. Really. You don't act a thing like a prescription-abuser. An ex-girlfriend who was a nurse brought home a lot of stories on these wankers; you are not behaving like them.
posted by IAmBroom at 8:51 AM on December 11, 2008

I have a prescription bottle in my travel kit of .5mg lorezapam tablets. The label on it reads "1 tablet on the evening before airflight".

You're not even remotely alone. For those who don't like pharmaceuticals, there's also a reason why every airport in the world has a (very successful) bar.
posted by tkolar at 8:56 AM on December 11, 2008

This is definitely a common request. However, you may run into the same thing I did with my doctor - she was really reluctant to prescribe me any meds without having me spend some time with a counselor working on some sort of relaxation / anti-anxiety / deep-breathing / whatever. So you may want to be prepared for what you'll say if that comes up.

I told her I was willing to consider that but in the meanwhile I had this upcoming trip and was really freaked out about it and did not have time to embark on a course of therapy before then, and she was completely fine with writing me a small prescription on the spot.
posted by Stacey at 9:00 AM on December 11, 2008

Flying is really cool, by the way. Looking out the window, watching the world pass beneath you, gives an idea of just how marvelous and beautiful everything is. Perhaps you can convince yourself to be of the opinion that flying is something to enjoy rather than to fear. You will get through this.
posted by netbros at 9:14 AM on December 11, 2008

Apart from Xanax, beta-blockers are another option. They're usually used for high blood pressure and have a good safety record. They're commonly prescribed for flying anxiety, social anxiety, and public speaking.

You may want to try a dose a week or two before you have to fly. Not everyone reacts the same way to benzo or beta-blockers. Keep a friend close at hand in case you need some help.
posted by jeeves at 9:24 AM on December 11, 2008

It's perfectly normal. My wife needs something like this to fly, and she just simply stated:

"I'm flying in a few weeks. I'm scared to death"

Frankly, (I used to fly alot) - it's far far far better than the other option most people afraid to ask for help do.... "self-medication" via "alcohol", I've seen far too many people getting drunk before/during their flight to naively think this is simply because they are having a "good time".
posted by jkaczor at 9:51 AM on December 11, 2008

The first thing that came to my mind when I read this post is: what's the worst that can happen if the doctor thinks you are a drug abuser? Ignoring the fact that the doctor probably won't bc an abuser would be looking for more that a couple pills, the doctor will just not give you any drugs. Then you could go to another doctor.
posted by Gor-ella at 10:43 AM on December 11, 2008

I can't imagine walking in, sitting down, and asking for that kind of prescription. I'm terrified of being called a drug-seeker.

It's a shame the doctor-patient relationship has come to this, where patients are afraid to ask for help because of fears of being labeled a drug-seeker, and doctors are afraid to prescribe, because of fears of abuse or the DEA.

In this case, don't worry about doctor judging you. Look at it as a chance for you to evaluate your doctor. If you have a good doctor, here's what they should do (with the caveat that IANAD):

1. Reassure you this is a common problem.
2. Write you a small prescription, around 2-8 pills, usually for a benzo like Xanax. If they prescribe a bottle of 90, that's not a good sign. If they won't prescribe anything, it's usually because of the doctors personal opinion that benzos are too dangerous or too often abused, don't interpret it as being your fault.
3. Warn you about driving after taking the medication (benzos usually cause drowsiness).
4. Offer to refer you to a psychiatrist or psychologist for long-term help.
posted by formless at 11:56 AM on December 11, 2008

Honestly, this is going to be fine. (I would not fly without xanax in my pocket.)

"Hi, Dr. I have to fly in a few weeks. I'm absolutely petrified. I've heard about anti-anxiety meds like xanax and would like to see if they help for my flight. I only need 4 pills, 2 for each leg of the trip."

Dr. will see no problem with such a small script and then you'll just be galled by the prescription filling fee actually costing more than that small script.
posted by meerkatty at 12:00 PM on December 11, 2008

yeah, i walked in to my doc's office and didn't even have "airplane" out of my mouth before she started writing a script for xanax (which is awesome). you're too worried about this, just go make an appointment!
posted by misanthropicsarah at 12:17 PM on December 11, 2008

I just did this for the first time 2 weeks ago.
I had previously gone to a therapist, so I said "hi, I'd like some anti-anxiety drugs to take while flying and my therapist thinks it's a good idea."
Then he asked me what kind I wanted and how many. He didn't ask who my therapist was or anything like that. I said I wanted 4 because that is how many flights I had this month, and I think that since I wasn't asking for 20, he trusted it.

Just call and ask to make an appt and tell the receptionist why, and you'll be fine.
posted by rmless at 1:16 PM on December 11, 2008

I asked my doctor, actually the nurse at the office, for Xanax. I told her I was worried about being perceived as drug-seeking, and she said 10 Xanax weren't that big a deal. Xanax can be mis-used, but it acts quickly, and is metabolized quickly, and is very effective for anxiety. I had panic attacks for a while, the therapist recommended a Xanax under the tongue if I needed it to take effect even faster.
posted by theora55 at 2:25 PM on December 11, 2008

I've done exactly this. I just explained I had two long flights and was a nervous flier, and my doctor gave me a prescription for four diazepam (this was years ago) without any funny looks.
posted by The corpse in the library at 2:32 PM on December 11, 2008

I am a doctor.

I ask my doctor for Xanax for plane rides. It is an extremely common request. Once when I ran out on a trip, I went to a pharmacy and prescribed myself enough pills to get home. Pharmacist had no problem with it.

Also, just so you know, the right medicines fix this problem, and that is my favorite 'fear of flying' advice.
posted by ikkyu2 at 6:52 PM on December 11, 2008

Just a tip about flying while drugged. It is likely that at some point you may need to wake up and go to the bathroom. It can be a little confusing and eerie. I don't mean to say this to scare you, but to allow you to prepare for the possibility. If you think this would be a problem for you, see if you can get a nice safe and cozy seat at the back of the plane.
posted by iamkimiam at 10:44 PM on December 11, 2008

Wow, ikkyu2, that's the most direct advice I've ever read you give.

anonymous, think of your anxiety like an allergy: if you were allergic to cats, you might take an antihistamine when around them so as not to have to deal with the annoying phlegm your body produces in response to their presence. Phlegm and anxiety can both be functional and are part of normal human goings-on, but that doesn't mean we can't label the occasions when they aren't functional, and do something remedy them. Some people may find it a deep and probing question why you experience an excess of anxiety around planes, and some people may find that question only as interesting as why you would produce an excess of phlegm around cats--either way, your stated health concern is the anxiety, not its potential causes, and you surely don't have to worry about your ability to label your time on planes as overly anxious: it doesn't make you sound like a drug addict or someone subconsciously seeking therapy; it makes you sound like a person with healthy insight into themselves and their states of mind.
posted by holympus at 1:01 AM on December 12, 2008

Also, if you were an addict drug-seeking, this would be a very dumb thing to do. You'd get 5 mild benzos, maybe 10 if you are lucky. Enough to keep you high for an hour, with the tolerance you probably have. For about $30, plus having to deal with the doctor (and that's if you had insurance).

Cheaper to buy on the street or pretend to have ongoing anxiety. Not a sign of drug seeking.
posted by Maias at 2:03 PM on December 12, 2008

Fuck, man, just go in and ask. If he/she says no get a new fucking doctor. And then just go to an urgent care, tell them your story, and expect you can count on a couple xanax.

Like ikkyu, I take benzos when I fly. Next to my two daughters being born, this was the greatest revelation of my adult life.

Even better than the peace of mind is arriving at my destination not feeling like I've just sat through twelve hours of white-knuckle stress.
posted by docpops at 9:22 PM on December 12, 2008

Plus getting through TSA is like having an un-credited role in a Coen brothers movie.
posted by docpops at 9:23 PM on December 12, 2008