Sedative Use Disorder: Understanding What Leads to Addiction

Sedative use disorder is a condition where a person has difficulty controlling their use of sedatives and continues to take them despite them having negative effects on their life. It is also sometimes referred to as an addiction. 

According to a 2020 National Survey, 1.2 million Americans over age 12, or 0.4%, had sedative use disorder in the past year. The rates were highest among young adults ages 18 to 25, with around 235,000 people (0.7%) in the age group experiencing sedative use disorder. 

Sedative use disorder is a dangerous condition that can lead to long-term health problems, dependence, tolerance, and withdrawal. Treatment for sedative use disorder includes detox, therapy, and support.

Read on to learn more about sedatives, sedative use disorder, and how to get help for you or someone else.

What are sedatives?

Sedatives are a class of medications that slow down activity in the brain. They can treat anxiety and sleep disorders. Sedatives include:

• Benzodiazepines (also called “benzos”), such as alprazolam (Xanax) and diazepam (Valium)

• Barbiturates, such as phenobarbital (Luminal) 

• Z-drugs, such as zolpidem (Ambien) 

Sedatives can cause euphoria and a sense of calm and relaxation. Some people may misuse these medications to feel these effects. If a person misuses their prescription or takes these medications without a prescription, they may develop sedative use disorder. 

How dangerous is sedative use disorder?

Sedative use disorder is a dangerous condition because using these medications can lead to health problems and even death. Long-term benzodiazepine use may also be connected to cognitive impairments, including difficulty forming new memories. However, it’s not clear if these changes are reversible. 

Because benzos can cause drowsiness and slowed reaction time, people who use them are at risk for accidents and falls. 

There is also a risk of overdose when taking benzos, especially when combined with alcohol or opioids. In 2020, benzos were responsible for almost 12,300 overdose deaths.

What causes sedative use disorder?

Addiction is a complex condition that changes the brain. Like other substance use disorders, sedative use disorder is not caused by one single factor. Instead, a combination of factors impact a person’s risk. These include:

• Biology: A person’s genetics, biological sex, ethnicity, and mental health can all affect their risk, with genetics responsible for about 50% of a person’s risk.

• Environment: Factors like stress, peer pressure, exposure to drugs and alcohol, and parental influence impact risk.

• Development: Genetic and environmental factors may affect people at different points in their development. Teenage brains are still developing, so using substances at a younger age increases the likelihood of developing an addiction. 

When it comes to sedatives, most people who are prescribed these medications have anxiety or insomnia. Some people may take more than prescribed as a way of self-medicating, or coping with emotional pain and stress. Continuing this pattern over time can lead to an addiction.

What are the symptoms of sedative use disorder?

There is no specific amount of sedatives that a person must take in order to have sedative use disorder. The symptoms of sedative use disorder are based on how the medication affects a person’s body and their ability to function in life. 

People who have sedative use disorder may experience:

• Tolerance: a need for more medication to feel the same effects over time

• Withdrawal: physical and psychological symptoms that occur when a person stops taking sedatives or reduces the amount they take

Withdrawal symptoms of sedative use disorder

Common withdrawal symptoms include:

• Anxiety

• Tremors

• Difficulty sleeping

• Nightmares

• Increased heart rate and breathing

• Changes in blood pressure

• Fever

• Seizures

Other symptoms 

Other symptoms of sedative use disorder involve:

• Difficulty controlling use

• Cravings

• Problems keeping up with social, work, or recreational activities or giving them up because of substance use

• Using in risky situations

• Continuing to use despite knowledge that it’s causing harm

How is sedative use disorder diagnosed?

Sedative use disorder can be diagnosed by a medical, mental health, or addiction professional. Before making a diagnosis, a professional will evaluate your sedative use by asking questions such as:

• How much and how often do you use sedatives?

• How long have you been using them?

• Have you experienced any physical or psychological effects caused by sedatives?

• What is the impact of sedatives on different areas of your life, like your relationships and work?

• Are you using any other substances, including alcohol?

Depending on the type of provider, your evaluation may also include:

• A physical exam

• Blood work

• Urine toxicology (drug test)

Once a provider gathers enough information, they will make a diagnosis. If you are diagnosed with sedative use disorder, the provider will discuss treatment options or provide a referral to another provider or facility.

How is sedative use disorder similar to other types of substance use?

All substance use disorders share the same symptoms. What differentiates sedative use disorder from other substance use disorders is the specific substance that the person is using. When it comes to sedative use disorder, a sedative ⁠— like a benzodiazepine or barbiturate ⁠— is responsible for a person’s symptoms. With other substance use disorders, another substance causes the symptoms, like an opioid, stimulant, or cannabis.

Sedative use disorder also requires different treatment than other substance use disorders. Most substance use disorders require behavioral therapy to help people: 

• Develop motivation to change

• Modify unhealthy thought patterns

• Learn tools for coping with negative emotions and cravings

Additionally, sedative use disorders typically require detox and medications to help manage withdrawal symptoms and aid in recovery.

How do you treat sedative use disorder?

Treatment for sedative use disorder typically starts with detox. Because sedatives cause withdrawal, people who are taking them should not stop cold turkey. Detox can take place in either an inpatient or outpatient setting. During detox, a medical professional will help a person gradually taper off of the medication, which allows the body to adjust to less of it. This helps prevent dangerous withdrawal symptoms, like seizures. 

Treatment should also include therapy. Sedative misuse may be a form of self-medication, so learning how to cope with negative emotions without substances is important. Therapy may take place individually and/or in a group.

Cognitive behavioral therapy (CBT) is an evidence-based treatment for substance use disorders. This type of therapy focuses on:

• Helping people understand how their thoughts, feelings, and behaviors are related

• Changing negative thought and belief patterns

• Developing coping skills to manage negative emotions and cravings

How can you prevent sedative use disorder?

Healthcare providers can work to prevent sedative use disorder by closely monitoring patients, using prescription monitoring programs, and encouraging patients to take medications as prescribed. 

If you are prescribed sedatives, you can reduce your chances of developing an addiction by: 

• Taking your medication exactly as prescribed

• Being honest with your prescriber

• Not sharing your medication

• Locking it up

How to help yourself or someone else with sedative use disorder 

To get help with sedative use disorder, you can talk to your doctor about your sedative use. They may be able to work with you on safely tapering off of your medication. You can also seek help from an inpatient or outpatient addiction treatment program. 

If you would like to help a loved one, it is best to express your concerns in a compassionate and non-judgemental manner. Avoid shaming and blaming. You can offer to help them find treatment. But if they decline, do not force it. Respect their decision, and let them know you are there if they change their mind. Treatment is most effective when a person agrees to it. 

Having a loved one with sedative use disorder can be difficult. Be sure to take care of yourself and seek your own support. Nar-Anon is a 12-step group for family and friends of people struggling with addictions. SMART Recovery Family & Friends also helps family and friends learn how to support their loved ones without enabling their addictions.

What resources are available to help with sedative use disorder?

To find an addiction treatment center, you can contact the Substance Abuse and Mental Health Services Administration (SAMHSA)’s National Helpline at 1-800-662-HELP (4357). The Helpline is available 24/7 and can assist you in finding local treatment centers, support groups, and community resources. You can also search the online Behavioral Health Treatment Services Locator.

Self-help groups for sedative use disorder are also available, including:

• Narcotics Anonymous

• Pills Anonymous

• SMART Recovery

• Secular Organizations for Sobriety

• Women for Sobriety

Why trust our experts?

Written by:

Emily Guarnotta, PsyD

Emily Guarnotta, PsyD, is a licensed clinical psychologist and certified perinatal mental health professional with over 10 years of clinical experience.

Reviewed by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

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