Sedative, Hypnotic, or Anxiolytic Intoxication
A. Recent use of a sedative, hypnotic, or anxiolytic.
B. Clinically significant maladaptive behavioral or psychological changes (e.g., inappro- priate sexual or aggressive behavior, mood lability, impaired judgment) that developed during, or shortly after, sedative, hypnotic, or anxiolytic use.
C. One (or more) of the following signs or symptoms developing during. or shortly after, sedative, hypnotic. or anxiolytic use:
Slurred speech.
Incoordination.
Unsteady gait.
Nystagmus.
Impairment in cognition (e.g., attention, memory).
6. Stupor or coma.
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D. The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication with another sub- stance.
Coding note: The lCD-9-CM code is 292.89. The |CD-10-CM code depends on whether there is a comorbid sedative, hypnotic, or anxiolytic use disorder. It a mild sedative, hyp- notic, or anxiolytic use disorder is comorbid, the ICD-10-CM code is F13.129, and if a mod- erate or severe sedative, hypnotic, or anxiolytic use disorder is comorbid, the |CD-10-CM code is F13.229. If there is no comorbid sedative, hypnotic, or anxiolytic use disorder, then the |CD-10-CM code is F13.929.
Note: For information on Development and Course; Risk and Prognostic Factors; Culture-
Related Diagnostic Issues; Diagnostic Markers; Functional Consequences of Sedative,
Hypnotic, or Anxiolytic Intoxication; and Comorbidity, see the corresponding sections in sedative, hypnotic, or anxiolytic use disorder.
The essential feature of sedative, hypnotic, or anxiolytic intoxication is the presence of clini- cally significant maladaptive behavioral or psychological changes (e.g., inappropriate sexual or aggressive behavior, mood lability, impaired judgment, impaired social or occupational functioning) that develop during, or shortly after, use of a sedative, hypnotic, or anxiolytic (Criteria A and B). As with other brain depressants, such as alcohol, these behaviors may be ac- companied by slurred speech, incoordination (at levels that can interfere with driving abilities and with performing usual activities to the point of causing falls or automobile accidents), an unsteady gait, nystagmus, impairment in cognition (e.g., attentional or memory problems), and stupor or coma (Criterion C). Memory impairment is a prominent feature of sedative, hyp- notic, or anxiolytic intoxication and is most often characterized by an anterograde amnesia that resembles ”alcoholic blackouts,” which can be disturbing to the individual. The symptoms must not be attributable to another medical condition and are not better explained by another
Sedative, Hypnotic, or Anxiolytic Withdrawal 557 mental disorder (Criterion D). Intoxication may occur in individuals who are receiving these substances by prescription, are borrowing the medication from friends or relatives, or are de- liberately taking the substance to achieve intoxication.
Associated features include taking more medication 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.