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Chapter: Essentials of Psychiatry: Substance Abuse: Sedative, Hypnotic, or Anxiolytic Use Disorders

Phenomenology and Variations in Presentations - Disorders of Sedative–Hypnotics

Long-term use of benzodiazepines can result in physical de-pendence in nondrug-dependent medical patients.

Phenomenology and Variations in Presentations

 

Long-term use of benzodiazepines can result in physical de-pendence in nondrug-dependent medical patients. Withdrawal symptoms “or” return of symptoms suppressed by the benzodi-azepines may make discontinuation difficult.

 

Some patients who are physically dependent on or unable to discontinue a medication do not necessarily have a substance-use disorder. Physical dependence results from neuroadaptive changes resulting from long-term exposure to a medication. In-ability to discontinue the medication may simply mean that pa-tients are unwilling to tolerate the severity of postwithdrawal symptoms that develop. In the absence of medication-produced dysfunction, the continuation of the medication may be an appro-priate choice. Patients who do not have a substance-use disorder take medications in the quantity prescribed. They follow their physicians’ recommendations, and they do not mix them with drugs of abuse.

 

Abusers of alcohol and other drugs rarely present for primary treatment of sedative–hypnotic dependency. From the drug-abusing patient’s point of view, sedative–hypnotic use is an effort to self-medicate anxiety or insomnia, which is often the result of alcohol or stimulant abuse.

 

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Essentials of Psychiatry: Substance Abuse: Sedative, Hypnotic, or Anxiolytic Use Disorders : Phenomenology and Variations in Presentations - Disorders of Sedative–Hypnotics |


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