The Impact of Attention-Deficit/Hyperactivity Disorder on the Severity of Opioid Addiction: The Role of Impulsivity and Aggression

This study aimed to determine the prevalence of adult attention-deficit/hyperactivity disorder (ADHD) symptoms among individuals with opioid use disorder (OUD) and to examine whether impulsivity and aggression mediate the relationship between ADHD symptoms and addiction severity. A total of 100 individuals diagnosed with OUD and 50 healthy controls completed validated self-report measures assessing ADHD symptoms, impulsivity, aggression, and addiction severity. Compared with healthy controls, individuals with OUD exhibited significantly higher levels of ADHD symptoms, impulsivity, and aggression. Mediation analyses demonstrated that impulsivity partially mediated the association between ADHD symptoms and addiction severity, whereas aggression did not show a significant mediating effect. These findings suggest that the clinical impact of ADHD in OUD may be driven less by diagnostic status alone and more by specific impulsivity-related mechanisms. Identifying and targeting impulsivity may therefore represent an important strategy for improving clinical outcomes in individuals with OUD and comorbid ADHD symptoms.