Internet Mental Health
 
SEDATIVE, HYPNOTIC, OR ANXIOLYTIC USE DISORDER
 

Prediction: Episodic/Chronic For Years

      Occupational-Economic:
  • Works poorly with others (work absenteeism; decreased productivity; increased errors); theft of drugs
  • Impaired cognitive functioning (concentration, memory)
      Social:
  • Negative emotion (anxiety, depression, suicidal behavior)
  • Antagonism (hostility)
  • Disinhibition (irresponsibility, impulsivity, dangerous risk taking) sedative-spiked drinks causing amnesia are used for robbing people or rape
      Medical:
  • Denial of addiction; accidental or deliberate overdoses; withdrawal seizures; automobile accidents; accidental injuries

SYNOPSIS

Dependence Syndrome Due To Use Of Sedatives Or Hypnotics F13 - ICD10 Description, World Health Organization
Repeated use of sedatives or hypnotics that typically includes a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and a physical withdrawal state.
Sedative, Hypnotic, or Anxiolytic Use Disorder - Diagnostic Criteria, American Psychiatric Association

An individual diagnosed with sedative, hypnotic, or anxiolytic use disorder needs to meet all of the following criteria:

  • A problematic pattern of sedative, hypnotic, or anxiolytic use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:

    • Sedatives, hypnotics, or anxiolytics are often taken in larger amounts or over a longer period than was intended.

    • There is a persistent desire or unsuccessful efforts to cut down or control sedative, hypnotic, or anxiolytic use.

    • A great deal of time is spent in activities necessary to obtain the sedative, hypnotic, or anxiolytic, use the sedative, hypnotic, or anxiolytic, or recover from its effects.

    • Craving, or a strong desire or urge to use the sedative, hypnotic, or anxiolytic.

    • Recurrent sedative, hypnotic, or anxiolytic use resulting in a failure to fulfill major role obligations at work, school, or home.

    • Continued sedative, hypnotic, or anxiolytic use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of sedatives, hypnotics, or anxiolytics (e.g. arguments with a spouse about consequences of intoxication; physical fights).

    • Important social, occupational, or recreational activities are given up or reduced because of sedative, hypnotic, or anxiolytic use.

    • Recurrent sedative, hypnotic, or anxiolytic use in situations in which it is physically hazardous.

    • Sedative, hypnotic, or anxiolytic use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the sedative, hypnotic, or anxiolytic.

    • Tolerance, as defined by either of the following:

      • A need for markedly increased amounts of the sedative, hypnotic, or anxiolytic to achieve intoxication or desired effect.

      • A markedly diminished effect with continued use of the same amount of the sedative, hypnotic, or anxiolytic.

    • Withdrawal, as manifested by either of the following:

      • The characteristic withdrawal syndrome for sedatives, hypnotics, or anxiolytics:
        • Cessation of (or reduction in) sedative, hypnotic, or anxiolytic use that has been prolonged.

        • Two (or more) of the following, developing within several hours to a few days after the cessation of (or reduction in) sedative, hypnotic, or anxiolytic use:

          • Autonomic hyperactivity (e.g., sweating or pulse rate greater than 100 bpm).

          • Hand tremor.

          • Insomnia.

          • Nausea or vomiting.

          • Transient visual, tactile, or auditory hallucinations or illusions.

          • Psychomotor agitation.

          • Anxiety.

          • Grand mal seizures.

        • These withdrawal signs or symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning.

        • These withdrawal signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication or withdrawal from another substance.

        • Specify if:

          • With perceptual disturbances: This specifier may be noted when hallucinations with intact reality testing or auditory, visual, or tactile illusions occur in the absence of a delirium.

      • Sedatives, hypnotics, or anxiolytics (or a closely related substance, such as alcohol) are taken to relieve or avoid withdrawal symptoms.

        Note: This criterion is not considered to be met for individuals taking sedatives, hypnotics, or anxiolytics under medical supervision.

    • Specify if:

      • In early remission: After full criteria for sedative, hypnotic, or anxiolytic use disorder were previously met, none of the criteria for sedative, hypnotic, or anxiolytic use disorder have been met for at least 3 months but for less than 12 months (with the exception that the criterion, "Craving, or a strong desire or urge to use sedative, hypnotic, or anxiolytic," may be met).

      • In sustained remission: After full criteria for sedative, hypnotic, or anxiolytic use disorder were previously met, none of the criteria for sedative, hypnotic, or anxiolytic use disorder have been met at any time during a period of 12 months or longer (with the exception that the criterion, "Craving, or a strong desire or urge to use sedative, hypnotic, or anxiolytic," may be met).

    • Specify if:

      • In a controlled environment: This additional specifier is used if the individual is in an environment where access to sedatives, hypnotics, or anxiolytics is restricted.

Effective Therapy

The effectiveness of treatment for this disorder is unknown because there are no randomized controlled trials.

It is possible to stop abusing sedatives. To do this you must: (1) totally divorce yourself from drug-using or drug-supplying people, (2) not use alcohol or any other illegal drugs, (3) keep socially active and help others, (4) talk to other people who have successfully stayed off drugs, (5) devote yourself to important activities that give meaning and purpose to life (e.g., family, friends, sports, work, helping others, church etc.). Therapists know that these 5 steps work, but our therapies are often ineffective in motivating patients to complete these essential steps to recovery.

Top 20 Most Harmful Drugs In Britain In 2008

Professor David Nutt published in the Lancet the following rating of Britain's most dangerous drugs. They are listed in descending order from the most harmful.

1. Heroin

Class A drug. Originally used as a painkiller and derived from the opium poppy. There were 897 deaths recorded from heroin and morphine use in 2008 in England and Wales, according to the Office of National Statistics (ONS). There were around 13,000 seizures, amounting to 1.6m tonnes of heroin.

2. Cocaine

Class A. Stimulant produced from the South American coca leaf. Accounted for 235 deaths -- a sharp rise on the previous year's fatalities. Nearly 25,000 seizures were made, amounting to 2.9 tonnes of the drug.

3. Barbituates

Class B. Synthetic sedatives used for anaesthetic purposes. Blamed for 13 deaths.

4. Street methadone

Class A. A synthetic opioid, commonly used as a substitute for treating heroin patients. Accounted for 378 deaths and there were more than 1,000 seizures of the drug.

5. Alcohol

Subject to increasing concern from the medical profession about its damage to health. According to the ONS, there were 8,724 alcohol deaths in the UK in 2007. Other sources claim the true figure is far higher.

6. Ketamine

Class C. A hallucinogenic dance drug for clubbers. There were 23 ketamine-related deaths in the UK between 1993 and 2006. Last year there were 1,266 seizures.

7. Benzodiazepines

Class C. A hypnotic relaxant used to treat anxiety and insomnia. Includes drugs such as diazepam, temazepam and nitrazepam. Caused 230 deaths and 1.8m doses were confiscated in more than 4,000 seizure operations.

8. Amphetamine

Class B. A psychostimulant that combats fatigue and suppresses hunger. Associated with 99 deaths, although this tally includes some ecstasy deaths. Nearly 8,000 seizures, adding up to almost three tonnes of confiscated amphetamines.

9. Tobacco

A stimulant that is highly addictive due to its nicotine content. More than 100,000 people a year die from smoking and tobacco-related diseases, including cancer, respiratory diseases and heart disease.

10. Buprenorphine

An opiate used for pain control, and sometimes as a substitute to wean addicts off heroin. Said to have caused 43 deaths in the UK between 1980 and 2002.

11. Cannabis

Class B. A psychoactive drug recently appearing in stronger forms such as "skunk". [Since this video was made; there is now conclusive proof that cannabis causes a 6.7 fold increase in the risk of developing schizophrenia.] Caused 19 deaths and there were 186,000 seizures, netting 65 tonnes of the drug and 640,000 cannabis plants.

12. Solvents

Fumes inhaled to produce a sense of intoxication. Usually abused by teenagers. Derived from commonly available products such as glue and aerosol sprays. Causes around 50 deaths a year.

13. 4-MTA

Class A. Originally designed for laboratory research. Releases serotonin in the body. Only four deaths reported in the UK between 1997 and 2004.

14. LSD

Class A. Hallucinogenic drug originally synthesised by a German chemist in 1938. Very few deaths recorded.

15. Methylphenidate

Class B drug. Brand name of Ritalin. A psychostimulant sometimes used in the treatment of attention deficit disorders.

16. Anabolic steroids

Class C. Used to develop muscles, notably in competitive sports. Also alleged to induce aggression. Have been blamed for causing deaths among bodybuilders. More than 800 seizures.

17. GHB

Class C drug. A clear liquid dance drug said to induce euphoria, also described as a date rape drug. Can trigger comas and suppress breathing. Caused 20 deaths and 47 seizures were recorded.

18. Ecstasy

Class A. Psychoactive dance drug. Caused 44 deaths, with around 5,000 seizures made.

19. Alykl nitrites

Known as "poppers". Inhaled for their role as a muscle relaxant and supposed sexual stimulant. Reduce blood pressure, which can cause fainting and in some cases death.

20. Khat

A psychoactive plant, the leaves of which are chewed in east Africa and Yemen. Also known as qat. Produces mild psychological dependence. Its derivatives, cathinone and cathine, are Class C drugs in the UK.

Description

Neuroscientist, Dr. Marc Lewis, Tells Of His Own Addiction And Cure

Stories

Treatment

Crime

Research

Other Web Pages

Internet Mental Health 1995-2014 Phillip W. Long, M.D.