Key Takeaways
- Impulse control disorders (ICDs) and substance use disorders (SUDs) are two distinct types of mental health conditions. However, they share some similar features and frequently co-occur.
- Both ICDs and SUDs involve problems with behavior regulation and impulse control. The main difference between these conditions is that ICDs don’t necessarily involve the uncontrolled use of substances like drugs or alcohol.
- To effectively treat co-occurring ICDs and SUDs, symptoms of both conditions must be addressed at the same time. This typically involves a combination of therapy, medication, and medical support during detoxification and recovery (as needed).
Impulse control disorders (ICDs) are mental health conditions that make it hard for a person to regulate their behavior. They include conditions like kleptomania, pyromania, conduct disorder, oppositional defiant disorder (ODD), and intermittent explosive disorder (IED). Left untreated, these conditions may lead to harmful behaviors affecting themselves, others, animals, or property. For some, ICDs may contribute to legal trouble and/or incarceration.
Substance use disorders (SUDs) are a different category of mental health conditions. People with SUDs experience strong cravings for substances like drugs and alcohol. They continue to use these substances despite negative consequences to their health, relationships, and overall well-being.
Although ICDs and SUDs are different conditions, they frequently co-occur. For example, research shows that SUDs are present in up to 48% of people with IED, 33% of people with pyromania, and up to 50% of people with kleptomania. Understanding the link between ICDs and SUDs can help you or someone you care about get the help they need to manage their behaviors and improve their mental health.
How are impulse control and substance use disorders linked?
Because ICDs and SUDs co-occur frequently, some have wondered if impulsive behavior can cause harmful substance use (or vice versa). There’s some evidence to suggest that unhealthy substance use may make you more likely to develop an ICD. But substance abuse isn’t considered a stand-alone cause of ICDs.
Researchers are still working to understand the connection between ICDs and SUDs. However, because the conditions share the following risk factors, having one may increase the odds that a person might develop the other.
- Biology: Changes in dopamine levels can impact the reward center in the brain, and these differences have been linked to both ICDs and SUDs.
- Genetics: Having a close relative, like a sibling or parent, who has an ICD or SUD may increase your risk.
- Personality: Being a person who’s naturally more impulsive or comfortable taking risks may make you more susceptible to ICDs and SUDs.
- Environment: Stressful life events — especially during childhood — may lead to ICDs and SUDs in some people.
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What’s the difference between substance use and impulse control disorders?
SUDs and ICDs share some common features, but there are a few important differences between these conditions. While they both involve problems with behavioral regulation, the core feature of SUDs is an uncontrolled craving for substances. People with SUDs continue to use substances like alcohol, opioids, or stimulants despite their negative effects.
However, a person can have an ICD without using substances in unhealthy ways. People with ICDs tend to experience angry outbursts and uncontrolled aggression rather than cravings for substances.
Can you have both impulse control and substance use issues?
Yes, impulse control and substance use issues frequently coexist. For example, a person with an ICD might have a hard time regulating their anger. So they might turn to a substance like alcohol as a way to self-soothe uncomfortable emotions.
Similarly, a person with a SUD might feel less restrained while using a substance. While under the influence, they might be more likely to engage in impulsive behavior because their inhibitions are lowered and they aren’t thinking about the consequences of their actions.
Treatment for impulse control and substance use disorders
If a person has a co-occurring ICD and SUD, they’ll need integrated care that addresses symptoms of both conditions simultaneously. Typically, this will involve a combination of the following supports:
- Therapy: Cognitive behavioral therapy (CBT) can help increase motivation to change, improve interpersonal skills, and help a person develop coping skills to support their recovery. Dialectical behavior therapy (DBT) has been shown to enhance emotional regulation, reduce harmful behaviors, and enhance impulse control. You may choose to attend therapy individually, in a group, or with your family.
- Medication: Several medications have been approved to treat SUDs. In some cases, they may help lessen symptoms of other conditions, like ICDs. If you’re curious about adding medication to your treatment plan, talk to your provider about whether it could be the right option for you.
- Medical care: As you work to strengthen your mental and physical health during your recovery, it will be important for all of your providers (therapists, doctors, psychiatrists, etc.) to collaborate to help you achieve your goals. For example, sometimes a person with an active SUD may require detoxification services to rid their body of harmful substances before engaging with other levels of care, like therapy. This experience is supervised by medical professionals who can communicate with your other providers about your progress.
Impulsivity can make it harder to resist the urge to use substances, but therapy helps by teaching skills like mindfulness, self-reflection, and better decision making.
Find care with Rula
Whether you want to learn to manage your impulsive behavior, use of substances, or both, know that you’re not alone and help is available. While living with ICDs and SUDs can be a challenging experience, a trained therapist can help you navigate the symptoms of both conditions. With the right support, you can improve your self-regulation skills, learn healthy coping strategies, and improve your quality of life as you work toward recovery.
When you need a therapist or psychiatric provider who understands what it’s like to live with a co-occurring ICD and SUD, look no further than Rula. With a network of over 15,000 qualified mental health professionals, we can connect you with the right provider for your needs in just a few clicks. Check out our therapist-matching program today to select a therapist who takes your insurance and schedule your first live video session for as soon as tomorrow.
About the author
Liz Talago
Liz Talago, M.ed. is a mental health professional turned content writer and strategist based in the Detroit metro area. As an independent consultant for mental health organizations, Liz creates meaningful connections between brands and their audiences through strategic storytelling. Liz is known for championing diverse perspectives within the mental health industry and translating bold ideas into inspiring, affirming digital experiences.
In her free time, you can find her hiking with her two German Shepherds, puttering around her dahlia garden, or spending time with her family.
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