- F13
- Substance Use Disorders
Mental and Behavioural Disorders Due to Sedatives or Hypnotics (F13)
DSM-5-TR: Sedative, Hypnotic, or Anxiolytic Use Disorder
ICD-10-AM and DSM-5-TR may classify conditions differently. Refer to APA and WHO for complete diagnostic criteria.
Key Facts
- ICD-10 RangeF10-F19
- Subcodes6 subcodes
- Australian PrevalenceBenzodiazepine misuse affects approximately 1–2% of the Australian population. Australia has high rates of benzodiazepine prescribing, monitored via state-based real-time prescription monitoring systems.
- Global PrevalenceApproximately 30 million people worldwide misuse sedatives and hypnotics. Benzodiazepines are among the most commonly prescribed psychoactive medications globally.
- Duration RequirementDependence syndrome (F13.2): three or more features present simultaneously for at least one month, or repeatedly within a 12-month period
Overview
Covers disorders arising from the use of benzodiazepines, barbiturates, and other sedative-hypnotic agents. Withdrawal from sedatives can be life-threatening and requires medical management.
Diagnostic Criteria (ICD-10)
Core Features
- Strong desire or compulsion to use sedatives or hypnotics
- Difficulty controlling use in terms of onset, termination, or amount
- Physiological withdrawal state when use is reduced or stopped
- Evidence of tolerance — increased doses required for the same effect
- Progressive neglect of alternative pleasures or interests
- Persistent use despite clear evidence of harmful consequences
Duration Dependence syndrome (F13.2): three or more features present simultaneously for at least one month, or repeatedly within a 12-month period
Exclusion Criteria
- Short-term prescribed use of benzodiazepines without features of dependence or misuse
ICD-10-AM Subcodes
| Code | Name | Description |
|---|---|---|
| F13.0 | Acute intoxication | Transient condition following sedative/hypnotic ingestion, characterised by slurred speech, incoordination, impaired attention, and reduced consciousness. |
| F13.1 | Harmful use | Pattern of sedative or hypnotic use causing damage to physical or mental health. |
| F13.2 | Dependence syndrome | A cluster of physiological, behavioural, and cognitive phenomena with strong desire to use sedatives, tolerance, and withdrawal on cessation. |
| F13.3 | Withdrawal state | Symptoms occurring on cessation or dose reduction, including anxiety, tremor, sweating, insomnia, and risk of seizures. |
| F13.4 | Withdrawal state with delirium | Sedative-hypnotic withdrawal complicated by delirium, potentially life-threatening and requiring urgent medical management. |
| F13.5 | Psychotic disorder | Psychotic phenomena occurring during or after sedative/hypnotic use. |
Classification Boundaries
Includes
- Benzodiazepine dependence
- Barbiturate dependence
- Sedative harmful use
- Hypnotic withdrawal
Australian Clinical Context
Benzodiazepine prescribing is closely monitored via real-time prescription monitoring (SafeScript in Victoria, DORA in NSW, similar programs in other states). Guidelines recommend short-term use only (typically ≤2–4 weeks). PBS-subsidised sedatives are subject to quantity limits.
Medicare (MBS) Pathways
Better Access to Mental Health Care
The primary Medicare pathway for mental health treatment in Australia. Requires a GP Mental Health Treatment Plan (MHTP) referral. Available for any clinically diagnosed mental disorder.
10 individual + 10 group sessions per calendar year
| Provider Type | MBS Items | Session Type |
|---|---|---|
| Clinical Psychologist | 80000–80025 | Psychological therapy (higher rebate) |
| Registered Psychologist | 80100–80123 | Focused psychological strategies |
| Occupational Therapist | 80125–80145 | Focused psychological strategies |
| Social Worker | 80150–80175 | Focused psychological strategies |
| Psychiatrist | 291, 296–299, 300–308 | Psychiatric consultation |
GP referral items: 2700, 2701, 2715, 2717
Eligibility: Any clinically diagnosed mental disorder as defined by WHO ICD-10 Chapter V. Requires a GP or psychiatrist referral.
Exclusions:
- Intellectual disability (use Complex Neurodevelopmental Disorder pathway or specialist referral)
- Dementia and organic mental disorders (use specialist referral pathway)
- Tobacco use disorder
State and territory drug and alcohol services may also apply alongside MBS.
Grounded Scribe suggests the right MBS item codes from your recording so you can claim accurately without re-keying.
Reference information sourced from MBS Online (mbsonline.gov.au). Item availability, rebates, and eligibility criteria may change. This is not billing advice — always verify current items before claiming. Last verified: April 2026.
Clinical Documentation Notes
Sedative-hypnotic withdrawal (including benzodiazepine withdrawal) can be life-threatening — similar to alcohol withdrawal. Never recommend abrupt cessation; a slow taper is standard. Withdrawal severity assessment should consider dose, duration of use, and half-life of the specific agent.
Related Diagnostic Codes
ICD-10-AM diagnostic codes commonly associated with the Mental and Behavioural Disorders Due to Sedatives or Hypnotics (F13).
Frequently Asked Questions
Why is sedative withdrawal potentially more dangerous than opioid withdrawal?
Unlike opioid withdrawal (which is rarely life-threatening), sedative-hypnotic and alcohol withdrawal can cause seizures and death. Both alcohol and benzodiazepines act on GABA receptors; abrupt cessation causes CNS hyperexcitability. Medical supervision is essential for moderate-to-severe dependence.
References
- World Health Organization. ICD-10-AM.
- American Psychiatric Association. DSM-5-TR. 2022.
- AIHW. National Drug Strategy Household Survey.
This tool calculates scores based on published guidelines for professional reference. It does not provide clinical diagnoses. Scores are provided as reference information only and should be interpreted by a qualified practitioner in the context of a comprehensive assessment.
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