Sedative, Hypnotic, or Anxiolytic Use Disorder 555
agents in the body). Urine tests are likely to remain positive  for up to approximately 1 week
after the use of long-acting substa nces, such as diazepam or flurazepam.
Functional Consequences of 
Sedative, Hypnotic, or Anxiolytic Use Disorder
The social and interpersonal co nsequences of sedative, hypnot ic, or anxiolytic use disorder
mimic those of alcohol in terms of the potentia l for disinhibited behavior. Accidents, interper-
sonal difficulties (such as argume nts or fights), and interference  with work or school perfor-
mance are all common outcomes. Physical examinat ion is likely to reveal evidence of a mild
decrease in most aspects of autonomic nervous system functioning, including a slower pulse,
a slightly decreased respiratory rate, and a slight  drop in blood pressure (most likely to occur
with postural changes). At high doses, sedative, hypnotic, or an xiolytic substances can be le-
thal, particularly when mixed with alcohol, al though the lethal dosage varies considerably
among the specific substances. Overdoses may be associated with a deterioration in vital signs
that signals an impending medical emergency (e .g., respiratory arrest  from barbiturates).
There may be consequences of trauma (e.g., internal bleeding or a subdural hematoma) from
accidents that occur while intoxicated. Intraven ous use of these substances can result in med-
ical complications related to the use of contaminated needles (e.g., hepatitis and HIV). 
Acute intoxication can result in accidental injuries and automobile accidents. For elderly
individuals, even short-term use of these sedati ng medications at prescr ibed doses can be as-