What is Sedative Use Disorder?

Sedative, hypnotic, and anxiolytic drugs are anti-anxiety medicines that treat anxiety, sleep disorders, or both. Examples of these drugs include prescription medicines such as alprazolam, diazepam, phenobarbital, pentobarbital, and zolpidem.

Having sedative, hypnotic, or anxiolytic use disorder means that you take these medicines in ways that hurt your health or well-being. A person with this disorder may take the medicines in larger amounts or for a longer period than they should be taken.

This can lead to drug dependence as the body becomes used to a given dosage. This disorder often disrupts life at home, work, or school. It can cause mental and physical problems.

What are the causes?

This condition is caused by misusing sedative, hypnotic, or anxiolytic medicines. Many people develop the condition because they decide on their own to increase the amount of the medicine they take in order to manage high levels of stress and anxiety.

What increases the risk?

The following factors may make you more likely to develop this condition:

• Having high stress levels and having these medicines available to you.
• Feeling overwhelmed by social and personal situations, such as arguments with friends, financial concerns, or work-related stress.
• Starting use of these medicines at an early age, such as during your teen or early adult years.
• Having a family history of the disorder.

What are the signs or symptoms?

Symptoms of this condition include:

• Taking more medicine than your prescription recommends or for a longer period of time.
• Trying several times to cut back on use of the medicine.
• Having a strong urge to use the medicine.
• Having problems at work, at school, at home, or in a relationship because of use of the medicine.
• Giving up or cutting down on important life activities because of use of the medicine.
• Using the medicine when it is dangerous, such as when driving a car.
• Continuing to use the medicine even though it has led to physical or mental problems.
• Needing more and more of the medicine to get the same effect that you want from it (building up a tolerance).
• Having symptoms of withdrawal when you stop using the medicine. Some symptoms of withdrawal are:
  • Anxiety.
  • Trouble sleeping.
  • Shakiness.
  • Sweating.
  • Movements that you do not choose to make (involuntary movements), changes in consciousness, or uncontrollable shaking (seizures).
  • Seeing, hearing, or feeling things that do not exist (hallucinations).
  • Confusion.

How is this diagnosed?

This condition is diagnosed with an assessment. During the assessment, your health care provider will ask about your medicine use and how it affects your life. To help find out the cause of your medicine use, the health care provider may ask about lifestyle, drug and alcohol use, anxiety levels, and behavioral problems.

Your health care provider may do a physical exam or do lab tests to see if you have health problems resulting from your medicine use. Your health care provider may also screen for drug use and refer you to a mental health professional for evaluation.

How is this treated?

Treatment for this condition is usually provided by mental health professionals with training in substance use disorders. Your treatment may involve:

• Stopping use of the medicine and being treated for withdrawal symptoms as needed (detoxification).
• Counseling or talk therapy to address the underlying anxiety or sleep problems that led to your drug use. This may involve a type of talk therapy to help change your patterns of thinking (cognitive behavioral therapy). The goals of therapy are to:
  • Find healthy activities and ways to cope with stress.
  • Identify and avoid what triggers your drug use.
  • Help you learn how to handle cravings.
• Group therapy or addiction therapy, such as a 12-step drug program in your local community.
• Addiction treatment. This may be recommended for people who have multiple drug or substance abuse disorders at the same time.
• Medicines. In some cases, you may be asked to take another medicine in place of your current medicine.

Follow these instructions at home:

• Take over-the-counter and prescription medicines only as told by your health care provider.
  • Follow instructions from your health care provider for correct medicine dosage.
  • Do not stop taking medicine unless your health care provider tells you to stop. This will help you avoid withdrawal symptoms.
• Pay attention to stress levels, and talk with your health care provider if your stress and anxiety are not getting better.
• Find healthy ways to deal with stress and anxiety, such as:
  • Exercise.
  • Meditation.
  • Deep breathing or progressive muscle relaxation.
• After stopping your medicine, whenever you stand up from a sitting position, do it slowly so you do not get dizzy.
• While taking sedative, hypnotic, or anxiolytic medicines:
  • Do not drink alcohol, because this may cause breathing problems.
  • Do not drive or use machinery unless you have talked about that with your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You are having strong urges to use sedative, hypnotic, or anxiolytic medicines.
• You are struggling with more than one substance use disorder.
• You are pregnant or think you may be pregnant.
• You are unable to sleep (have insomnia).

Get help right away if:

• You are having trouble breathing.
• You are having trouble staying awake or waking up.
• You have taken medicine that was not prescribed for you.
• You have accidentally taken too much of your medicine (overdosed).
• You are having seizures or hallucinations.
• You have trouble keeping your balance.
• You are having serious thoughts about hurting yourself or others.

If you ever feel like you may hurt yourself or others, or have thoughts about taking your own life, get help right away. You can go to your nearest emergency department or call:

• Your local emergency services (911 in the U.S.).
• A suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255. This is open 24 hours a day.

Summary

• Sedative, hypnotic, or anxiolytic drugs are anti-anxiety prescription medicines that are used to treat anxiety, sleep disorders, or both.
• A person with this disorder may take the medicines in larger amounts or for a longer period than they should be taken. He or she may continue to use the medicine even though it has led to physical or mental problems.
• Find healthy ways to deal with stress and anxiety, such as exercise, meditation, or deep breathing.
• Follow instructions from your health care provider for correct medicine dosage.