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With the greater acceptance of adult attention-deficit hyperactivity disorder (ADHD) as a valid clinical diagnosis, this disorder has been increasingly recognized among substance abusers seeking treatment. Because adult ADHD occurs in a substantial minority of substance abusers—from 10 to 30 percent—the question arises of whether individuals identified as having adult ADHD and substance abuse would benefit from targeted treatment interventions. Cocaine abusers with childhood histories of ADHD are more likely to use cocaine at an earlier age and to have more exposure to treatment, but they do less well in treatment (1). Furthermore, Dansereau and associates (2) have found that methadone maintenance patients with “poor attention” do less well in treatment. Thus it seems reasonable to conclude that improving an individual’s difficulties with inattention, hyperactivity, or impulsivity will increase that person’s likelihood of succeeding in substance abuse treatment.