Posted: August 7th, 2023

A Comprehensive Examination of Sedative, Hypnotic, or Anxiolytic Use Disorder and Cannabis Use Disorder

Compare and Contrast
Compare and contrast sedative, hypnotic, or anxiolytic use disorder from cannabis use disorder (without the aid of a drug screen). For this discussion, you will need to emphasize how comprehensive assessment could help us arrive at the correct diagnosis and what the signs and symptoms of each are.

A Comprehensive Examination of Sedative, Hypnotic, or Anxiolytic Use Disorder and Cannabis Use Disorder: A Comparative Analysis

The prevalence of substance use disorders (SUDs) has risen significantly in recent years, presenting a challenge to healthcare professionals seeking accurate diagnoses and appropriate treatment plans. Among the various SUDs, sedative, hypnotic, or anxiolytic use disorder (SHAU) and cannabis use disorder (CUD) are two prominent conditions with distinct clinical manifestations and consequences. In this discourse, we shall undertake a comparative analysis of SHAU and CUD, highlighting the significance of comprehensive assessment in facilitating accurate diagnoses and elucidating the characteristic signs and symptoms of each disorder.

Sedative, Hypnotic, or Anxiolytic Use Disorder (SHAU)

SHAU involves the chronic and excessive use of sedative, hypnotic, or anxiolytic medications, leading to various impairments and negative consequences in an individual’s life. Commonly prescribed substances in this category include benzodiazepines, barbiturates, and certain non-benzodiazepine anxiolytics. SHAU shares a close association with addiction, tolerance, and withdrawal symptoms upon cessation or reduction of drug intake.

Diagnostic Indicators of SHAU:

Tolerance: Individuals with SHAU exhibit an increased tolerance to the effects of the sedative drugs, necessitating higher doses to achieve the same level of relief or euphoria.

Withdrawal: Withdrawal symptoms such as anxiety, insomnia, tremors, and seizures may emerge upon abrupt discontinuation of the drug or during inadequate dosing.

Unsuccessful Attempts to Quit: Persistent and unsuccessful attempts to reduce or discontinue drug use despite recognition of the adverse consequences on physical, mental, and social well-being.

Impairment in Functioning: SHAU impairs an individual’s social, occupational, and personal functioning, leading to disruptions in various spheres of life.

Cannabis Use Disorder (CUD)

CUD involves the chronic and excessive use of cannabis, which encompasses marijuana and hashish, leading to impairments and negative consequences. The psychoactive compound responsible for these effects is delta-9-tetrahydrocannabinol (THC), which interacts with the brain’s endocannabinoid system.

Diagnostic Indicators of CUD:

Cannabis Craving: Individuals with CUD experience intense cravings and compulsions to use cannabis, leading to frequent usage patterns.

Social Impairment: CUD can adversely impact an individual’s interpersonal relationships, leading to conflicts and withdrawal from social activities.

Neglected Activities: A defining characteristic of CUD is the neglect of important activities, such as work, school, or recreational pursuits, due to excessive cannabis use.

Tolerance and Withdrawal: Similar to SHAU, CUD may lead to the development of tolerance and withdrawal symptoms upon cessation or reduction of cannabis use.

Comprehensive Assessment for Accurate Diagnosis

A comprehensive assessment is crucial for distinguishing between SHAU and CUD, as both disorders may present with overlapping symptoms, such as impaired social functioning and tolerance. A multidimensional approach is essential, involving detailed clinical interviews, standardized screening tools, and collateral information from family or significant others.

The assessment should encompass:

Substance Use History: A detailed history of substance use, frequency, duration, and methods of consumption can provide valuable insights into the individual’s pattern of drug use.

Co-occurring Disorders: Identifying co-existing mental health disorders is essential, as individuals with SHAU or CUD may suffer from comorbid conditions, such as anxiety or depression.

Family and Social History: Exploring the individual’s family and social environment can help identify potential contributing factors to substance use, including genetic predispositions and environmental stressors.

Conclusion

In conclusion, distinguishing between sedative, hypnotic, or anxiolytic use disorder (SHAU) and cannabis use disorder (CUD) requires a comprehensive assessment, considering the distinctive characteristics of each disorder. While SHAU involves the chronic and excessive use of sedative medications with accompanying withdrawal symptoms, CUD entails the chronic and excessive use of cannabis, leading to social impairment and craving. Understanding the nuances of each disorder aids in providing accurate diagnoses and formulating appropriate treatment plans to address the unique challenges presented by these substance use disorders.

References:

NIDA. (2021). Drug Facts: Marijuana. National Institute on Drug Abuse. https://www.drugabuse.gov/drug-topics/marijuana.
Schulte, M. T., & Hser, Y. I. (2016). Substance use and associated health conditions throughout the lifespan. Public Health Reviews, 37(1), 3.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
Substance Abuse and Mental Health Services Administration. (2016). Clinical Drug Testing in Primary Care. HHS Publication No. (SMA) 16-4932. Rockville, MD: Substance Abuse and Mental Health Services Administration.