Impulsivity and Substance Abuse: What Is the Connection?

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Abstract
The role of impulsivity in substance abuse has recently received increased attention from both researchers and clinicians. Although past studies and treatment primarily focused on compulsive aspects of substance use associated with craving, it is becoming apparent that impulsivity is also a factor in the initiation and maintenance of substance use disorders. This article presents data from the authors' group and others showing that individuals with substance abuse have higher impulsivity than non–substance-using populations and that impulsivity has a negative impact on substance abuse treatment. Other data are presented showing that children and adolescents who have the highest rates of later substance abuse also have increased impulsivity. Finally, evidence that drugs of abuse can increase impulsivity as measured in the human behavioral laboratory are presented. These results support impulsivity as being both a risk factor and a consequence of substance abuse. In light of these findings, the authors discuss pharmacologic and behavioral methods of decreasing the effect of impulsivity on substance abuse treatment.