Sedative Dependence

1. Sedative abuse: A destructive pattern of sedative use, leading to significant social, occupational, or medical impairment.
2. Must have three (or more) of the following, occurring when the sedative use was at its worst:
   1. Sedative tolerance:
      Either need for markedly increased amounts of sedative to achieve intoxication, or markedly diminished effect with continued use of the same amount of sedative.
   2. Sedative withdrawal symptoms:

      Either (a) or (b).

      (a) Two (or more) of the following, developing within several hours to a few days of reduction in heavy or prolonged sedative use:

      • sweating or rapid pulse
      • increased hand tremor
      • insomnia
      • nausea or vomiting
      • physical agitation
      • anxiety
      • transient visual, tactile, or auditory hallucinations or illusions
      • grand mal seizures

      (b) Sedative is taken to relieve or avoid withdrawal symptoms.

   3. Greater use of sedative than intended:
      Sedative was often taken in larger amounts or over a longer period than was intended
   4. Unsuccessful efforts to cut down or control sedative use:
      Persistent desire or unsuccessful efforts to cut down or control sedative use
   5. Great deal of time spent in using sedative, or recovering from hangovers
   6. Sedative caused reduction in social, occupational or recreational activities:
      Important social, occupational, or recreational activities given up or reduced because of sedative use.
   7. Continued using sedative despite knowing it caused significant problems:
      Continued sedative use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been worsened by sedative.

• Learning Problem
• Dysarthria or Involuntary Movement
• Depressed Mood
• Somatic or Sexual Dysfunction
• Addiction
• Sexually Deviant Behavior
• Dramatic or Erratic or Antisocial Personality

Some disorders display similar or sometimes even the same symptom. The clinician, therefore, in his/her diagnostic attempt has to differentiate against the following disorders which he/she needs to rule out to establish a precise diagnosis.

• Nonpathologic sedative use for recreational purposes;
• Repeated episodes of Sedative Intoxication.