Discussion board post 5 reply 1

Read the module 5 lecture page (MO1, MO2, MO3, MO4)

  1. Read pages 139 through 214 & pages 543 through 665 in the DSM-5-TR  (MO1, MO2, MO3, MO4)
  2. Read Boland, R., & Verduin, M. (2022). Kaplan  Chapter 6: Mood Disorders(Bipolar)
  3. Read Boland, R., & Verduin, M. (2022). Kaplan chapter 7 (depressive disorder)
  4. Read Boland, R., & Verduin, M. (2022). Kaplan Chapter 4: Substance Related and Addictive Disorders
  5. Read Zuckerman Review Part 1: Chapters 1-3, pg. 35-50 Mental Status Exam Special emphasis on: • Chapters 3: 3.4, 3.10, 3.28, 3.29 • Chapter 9 • Chapter 10: 10.4, 10.5, 10.6, 10.7, 10.9, 10.11 • Chapter 12: 12.31, 12.36, 12.37 5.
  6.  Read Morrison and Flegel: Chapter 13                                                                                                                                                                                                                                                                                                                                                                         Reply to peer post using APA format                                                                                                                                                                                                                       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 place particular emphasis on how comprehensive assessment could help us to arrive at the correct diagnosis.


Sedative, hypnotic, or anxiolytic use disorder (SHAUD) is a diagnosis that incorporates a pattern of use of sedative-hypnotic drugs or anxiolytic drugs (American Psychiatric Association, 2022). Drug classes that are abused in SHAUD patients include benzodiazepines, barbiturates, or barbiturate-like medications, although combined usage of cannabis, illicit drugs, and alcohol to acquire heightened effects are common (Boland et al., 2023). The DSM-V provides a list of 11 diagnostic criteria for SHAUD, where the patient must experience at least 2 symptoms within a 12-month period. A clinician conducting an interview with a suspected SHAUD diagnosis will need to assess current drug use, duration, frequency, and circumstances in which the patient takes the medication (Harvard Health Publishing, 2022). The clinician should ask about craving the substance, significant time and effort placed into acquiring the medication, and build-up of tolerance to the medication (APA, 2022).

Questions within this interview should also address psychological and behavioral issues that arise from this pattern of use. Ask the patient how/if their drug use has caused recurring issues in personal, professional, and everyday life. Patients with SHAUD may fail to meet expectations at work or school, get into repeated interpersonal problems due to the drug use, and give up their hobbies/interests (APA, 2022). One thing to note is how different age groups tend to present within this disorder. Occasional use patterns for this condition are associated with younger people taking oral forms of the medications to enter a temporary, relaxed states, while regular use patterns are associated with middle-aged adults taking often multiple prescriptions from different providers (Boland et al., 2023). However, SHAUD is more common in younger adults with decreasing prevalence past the age of 30 (Boland et al., 2023). Physical manifestations such as slurred speech, motor difficulties, hostility, and emotional lability can indicate SHAUD.

Cannabis disorder, like SHAUD, involves at least 2 out of 11 criteria within a 12-month period that occur due to recurrent and problematic cannabis usage (APA, 2022). These criteria are extremely similar to SHAUD as well. A clinician should ask about tolerance, time spent seeking cannabis, cravings, and withdrawal symptoms. Cannabis use that causes failures to meet expectations in professional or personal life, causes issues in social life, and replaces previous hobbies or interests indicate a cannabis use disorder (APA, 2022). Significant markers for this disorder are continued use, even after experiencing negative impacts within the person’s life. Functional consequences, as well as amotivational syndrome and major depressive disorder can occur with long term cannabis abuse (APA, 2022).

Key differences to help the clinician differentiate between SHAUD and cannabis disorder are severity of withdrawal and overdose symptoms. Cannabis use has milder withdrawal symptoms, with SHAUD withdrawal presenting in a more physical aspect and potentially being fatal. Cannabis overdoses are less common than SHAUD overdoses, but still cause neuroexcitation and tachycardia which can require hospitalization (Noble et al., 2019). In contrast, overdose of SHAUD medications is much more common and much more serious, with irreversible cognitive impairments and respiratory depression occurrences (HHP, 2022).  Assessing the physical versus psychological dependence can differentiate between the two as well. Cannabis use involves a mental dependence on the substance to feel relaxed and sedated, and the psychological impairments of amotivation, paranoia, and anxiety are common.  SHAUD incorporates a physical dependence through the overstimulation of GABA neurotransmitters, with impairments in motor activity and increased risk-taking behaviors (Boland et al., 2023).


American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders, text revision dsm-5-tr (5th ed.)

Boland, R. J., Verduin, M. L., Ruiz, P., & Sadock, B. J. (2023). Kaplan & Sadock’s Concise Textbook of Clinical Psychiatry (5th ed.). Wolters Kluwer.

Harvard Health Publishing. (2022, February 28). Sedative, hypnotic or anxiolytic drug use disorder. Harvard Health. https://www.health.harvard.edu/a_to_z/sedative-hypnotic-or-anxiolytic-drug-use-disorder-a-to-z

Noble, M. J., Hedberg, K., & Hendrickson, R. G. (2019). Acute cannabis toxicity. Clinical toxicology (Philadelphia, Pa.)57(8), 735–742. https://doi.org/10.1080/15563650.2018.1548708


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