Addressing sedative dependence: Principles for practice

The misuse of sedative hypnotic medications is associated with a wide variety ofrisks, ranging from acute harms to the long-term risk of dependence. The management ofsedative dependence necessitates a comprehensive assessment of the specific risks andharms arising from medication misuse, and an individualised multi-disciplinary plan to address these risks. Pharmacological treatment usually involves a gradual withdrawal of long-acting sedative medication over weeks to months, with psychological therapy focussing on ameliorating withdrawal symptoms and the treatment of underlying or comorbiddisorders. A robust therapeutic rapport, and timely communication betweentreatment providers, is essential to effective treatment. Sedative dependence commonlyoccurs in individuals who are prescribed these drugs long-term. A collaborative multidisciplinary management plan needs to address both the factors that underpin and drive sedative misuse, as well as the best-practice treatment of co-morbid substance use, mental health and physical co-morbidities