Opiate-dependent patients (N= 231), classified by sedative disorder status, were characterized according to DSM-IIIR on substance use and psychiatric disorders. Twenty-one percent currently (CUR+) had sedative use disorder, 39% had a history (HX+) of sedative use disorder, and 40% had no history (HX-) of this disorder. Several group differences were found. The HX+ and CUR+ groups had more lifetime drug use disorders (means = 4.5 and 4.3vs.3.2 in the HX- group), including alcohol, cannabis, stimulants, cocaine, and hallucinogens. In contrast, other psychiatric disorders (e.g.,anxiety and depression) were low in prevalence and did not differ across groups, with the exception of a higher prevalence of antisocial personality disorder in the HX+ and CUR+ groups (39.6% and 38.5%vs.17.9% in HX- group). The results suggest that sedative use disorder is related more to a severe spectrum of multiple substance abuse than it is to self-medication of underlying mood or anxiety disorders.