Sedative, Hypnotic, or Anxiolytic Withdrawal 557
mental disorder (Criterion D). Intoxication ma y occur in individuals who are receiving these
substances by prescription, are borrowing the medi cation from friends or relatives, or are de-
liberately taking the substance to achieve intoxication.
Associated Features Supporting Diagnosis
Associated features include taking more medi cation than prescribed, taking multiple dif-
ferent medications, or mixing sedative, hypnotic, or anxiolytic agents with alcohol, which
can markedly increase the effects of these agents. 
Prevalence
The prevalence of sedative, hypnotic, or anxi olytic intoxication in the general population
is unclear. However, it is probable that most  nonmedical users of sedatives, hypnotics, or
anxiolytics would at some time have signs or  symptoms that meet criteria for sedative,
hypnotic, or anxiolytic intoxication; if so, then the prevalence of nonmedical sedative,
hypnotic, or anxiolytic use in the general po pulation may be simila r to the prevalence of
sedative, hypnotic, or anxiolytic intoxicati on. For example, tranquilizers are used non-
medically by 2.2% of Amer icans older than 12 years. 
Differential Diagnosis
Alcohol use disorders. Since the clinical presentations may be identical, distinguishing sed-
ative, hypnotic, or anxiolytic intoxication from  alcohol use disorders requires evidence for re-
cent ingestion of sedative, hypnot ic, or anxiolytic medications by  self-report, informant report,
or toxicological testing. Many individuals who misuse sedatives, hypnotics, or anxiolytics may