Substance use in adolescence is a serious societal problem that results in a variety of severe negative consequences for youth. There is a growing body of research that examines substance use, consequences, and psychological dysregulation, but little that examines all three variables together. In order to understand reasons for why adolescent substance users continue to use despite negative consequences, the current study examined the relationship between substance use, consequences, and psychological dysregulation, with psychological dysregulation as a potential mediator between substance use and consequences. The participants were 123 adolescent substance users. Participants completed assessments to measure criteria such as substance-use quantity, substance-use related consequences, and psychological dysregulation, which was further broken down into affective dysregulation, behavioral dysregulation, and cognitive dysregulation. Alcohol-quantity at intake was found to be a significant predictor of consequences, with psychological dysregulation as a significant mediator in the relationship. Marijuana-quantity at intake was not found to be a significant predictor of consequences, but when psychological dysregulation was added as a second predictor variable, it was found to significantly predict consequences. Additionally, alcohol-quantity at intake was significantly correlated with behavioral dysregulation through the aspects of impulsivity, inattention, hyperactivity, and aggression; affective dysregulation through the aspects of emotional reactivity and irritability; and cognitive dyregulation through the aspect of cognitive flexibility. These findings suggest that psychological dysregulation influences how substance users perceive their consequences, and that substance users are more likely to experience psychological dysregulation as a result of use. The results of this study indicate that psychological dysregulation plays an important role in why substance users continue to use despite consequences, and reveals one potential mechanism through which substance users interpret their consequences. Through further investigation, these findings have important societal implications and provide a basis to alter the methodology and theory behind the treatment of substance use disorders.