Drug Problems Research Articles

Piloting the integration of SMART Recovery into outpatient alcohol and other drug treatment programs

BackgroundResearch suggests peer support groups can amplify and extend treatment effects and enhance long-term recovery from Alcohol and Other Drug (AOD) problems. However, they are rarely integrated into outpatient treatment programs, resulting in a missed opportunity for peer-to-peer learning, and increased connection to others social networks where people want to reduce or cease substance use.MethodIn this mixed-methods study, we examined the uptake, participant experiences and impacts of Self-Management and Recovery Training (SMART) when embedded in three public AOD treatment programs in a pilot program in Australia. Groups were delivered initially in-person but transitioned online during the COVID-19 pandemic.ResultsA total of 75 SMART Recovery groups were run by the pilot sites, with an average attendance of 6.5 people per meeting. Among Participants (N = 31) who completed the survey, 94% reported benefits relating to substance use (i.e., reduction/ successful maintenance of abstinence), 71% reported improvements in their mental health and wellbeing, 74% reported improvements in their physical health, and 81% reported feeling better connected with others. In-depth qualitative interviews were conducted with 10 participants to explore their experiences. Thematic analysis revealed four themes: motivation to attend, active ingredients, views on the integration of SMART into formal AOD, and the advantages and disadvantages of online groups.ConclusionTaken together, these findings suggest embedding SMART Recovery in AOD treatment is a worthwhile endeavour. This was indicated by a good uptake and evidence of multiple and unique benefits to participants over and above their usual care, notably, better management of their AOD use, health, wellbeing, and sense of connection with others.

The Scylla State. A gendered understanding of the experiences of marginalised women in the United Kingdom.

Since the formation of the 2012 Coalition government, the UK has been subject to 12 years of neoliberal policy enacted with ferocity and vigour. This has comprised austerity measures including the retrenchment of welfare via the reshaping of the welfare state and public services according to business practices, ideals of individual responsibilisation and overwhelmingly, the notion of reducing the state's ideological and fiscal responsibility for equity and social welfare. The neoliberal state has been conceptualised by Loic Wacquant as a Centaur, boasting a liberal head, yet one atop an authoritarian body whose focus isthe designated 'underclasses', the socially and economically non-compliant. The Centaur takes away with one hand while ruling punitively with the other, specifically via 'prisonfare' and 'workfare' to compel submission to precarious and sub-par employment. Although compelling, the Centaur State is justifiably critiqued for its blindness to gender and focus upon the manifestation of neoliberalism in the States. By exploring the stories of 23 women in the UK with histories of survival sex working and problematic drug use, a distinct gendered alternative reality emerges of the operation and machinations of the neoliberal state. Rather than a Centaur, marginalised women experience the Scylla State, a covert, hydra-headed beast motivated by neo-Victorian ideals of 'womanfare'. The operations of the Scylla State are unpredictable, replicate traumatising interpersonal experiences and variously involve surveillance, coercion, conditionality and the responsibilisation of victimhood to justify increasingly punitive responses to women's survival strategies in the face of increasing trauma and deprivation.

Not just teens, big drug problems in young adults

The Monitoring the Future (MTF) panel study released this month shows that adults ages 35–50 have a big problem with binge drinking and marijuana. This panel study focuses on post‐high school participants; the basic MTF survey is of high school students only. So, epidemiologists can now find out about trends as these young people get older. And it is a good thing to know too, because the most recent survey has found that among adults ages 35–50, there are historic highs for.

Behavioral Health Service Use Among Licensed Social Workers: A Qualitative Inquiry

ABSTRACT This paper presents qualitative data collected from 996 licensed social workers in the United States who reported mental health and/or alcohol and other drug problems and indicated the types of services they used to address these issues. Outpatient therapy was the most commonly accessed modality to treat mental health issues. Regarding problems with alcohol and other drugs, self-help groups were the most frequently utilized intervention. Qualitative findings suggest that behavioral health service use has influenced respondents’ work with clients, personal and professional development, and career trajectories. Barriers to service use, such as stigma and limited access to care, were also identified. Implications for social work education and professional practice are discussed.

Mental health as determining factor of urban district’s character: Case study Bratislava – the Pentagon

Abstract Drug use and drug addiction have a high prevalence in the population, which has been widely documented since the 1980s. According to the United Nations, the physical environment in which we live is one of the strongest determinants of our health. In the case of drug abuse concentration in a particular urban space, one of the points to consider is the architectural and urban form of the location. In the Slovak context, a significant representative of concentrated drug activity is a part of the Medzi Jarkami housing estate, nicknamed the “Pentagon”. In an effort to eradicate drug activity, local residents fortified the Pentagon, changing its urban landscape and furthering its ghettoisation. Although drug abuse is a criminal act, it is imperative to acknowledge that drug addiction is a mental illness. Therefore, it is not sufficient to look at spaces such as the Pentagon from a criminal perspective but also from that of mental health. Our study aims to explore the connection between the residents’ mental health and the quality of the urban structure they live in. We performed a urban design analysis, utilizing on-site participant observation and structural interviews supplemented by desktop research. The case study analysis proved that the mental status of the local residents has an essential impact on the development of urban neighbourhoods. A number of environmental stressors were detected as present in the built structure. Furthermore, there is the stigmatization of whole urban districts caused by a high incidence of drug addiction as a mental disorder that, in the bigger terms, influences the “image” of the area. The drug problem in the Pentagon left its marks on the whole urban district of Vrakuňa, reducing the residents’ quality of life significantly over the years.

Highly stressful events and posttraumatic stress disorder symptoms among veterinary professionals: Prevalence and associations with mental health and job-related outcomes.

Explore the relationship between highly stressful events in veterinary medicine and mental health outcomes such as posttraumatic stress disorder (PTSD). Using narratives of highly stressful work events from 359 veterinary professionals, we calculated the prevalence of PTSD using both the standard Criterion A from DSM-5-TR and an expanded definition of a traumatic event that included animals as victims. Bivariate correlations were performed to probe for relationships between exposure to highly stressful events and other negative mental health outcomes. Seventy-six (21.1%) veterinary professionals reported exposure to a Criterion A work-related event, and 141 (39.3%) reported exposure under the expanded definition. Further, 13 (3.6%) to 50 (13.9%) veterinary professionals screened positive for PTSD, depending on how the traumatic stressor was defined and whether PTSD symptoms were linked to the same event or multiple events. Screening positive for PTSD was positively associated with suicidal ideation, psychological distress, and burnout. Defining traumatic stressors broadly and linking PTSD symptoms to multiple events resulted in more robust correlations and revealed positive associations with depression, suicide attempt, and problematic alcohol and drug abuse. The number of exposures to highly stressful work events was also positively associated with depression, suicidal ideation, psychological distress, and burnout and negatively associated with job satisfaction. Future research should consider strategies to mitigate the negative consequences that result from unavoidable exposure to highly stressful events in the veterinary workplace. Moreover, the types of events specific to veterinary medicine should be considered when assessing for traumatic events and post-exposure symptoms in veterinary professionals. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A Comparative Study on Cyclodextrin Derivatives in Improving Oral Bioavailability of Etoricoxib as a Model Drug: Formulation and Evaluation of Solid Dispersion-Based Fast-Dissolving Tablets.

Etoricoxib, as a model drug, has a poor solubility and dissolution rate. Cyclodextrin derivatives can be used to solve such a problem. A comparative study was run on three cyclodextrin derivatives, namely β-CD, HP β-CD, and SBE β-CD, to solve the drug problem through the formulation of solid dispersions and their preparation into fast-dissolving tablets. Preparations utilized different (1:1, 1:2, and 1:4) drug:carrier ratios. Nine fast-dissolving tablets (containing 1:4 drug: carrier) were formulated using Prosolv ODT® and/or F-melt® type C as super-disintegrants. Optimized formulation was chosen based on a 32 factorial design. The responses chosen were the outcomes of the in vitro evaluation tests. The optimized formulation that had the highest desirability (0.86) was found to be SD-HP3, which was prepared from etoricoxib: HP β-CD at a 1:4 ratio using equal amounts of Prosolv ODT® and F-melt® type C. An in vivo evaluation of SD-HP3 on a rabbit model revealed its superiority over the marketed product Arcoxia®. SD-HP3 showed a significantly lower Tmax (13.3 min) and a significantly higher Cmax (9122.156 μg/mL), as well as a significantly higher AUC, than Arcoxia®. Thus, the solubility, dissolution, and bioavailability of etoricoxib were significantly enhanced.

Obstacles to treatment retention in opioid use disorder: An international substance use disorder treatment worker survey.

Treatment retention is associated with better outcomes and reduced risk amongst people experiencing opioid use disorder (OUD). Despite this, treatment retention remains low amongst this population. We carried out an international cross-sectional survey of substance use disorder (SUD) treatment service workers. We aimed to understand the barriers to treatment retention in the context of OUD from the provider perspective, identify differences in response preference between professional groups, and describe regional differences in treatment provision. We report data from 497 respondents based in the USA and the UK. Personality disorders, low motivation to change and social problems were the most often reported obstacles to retention. Comorbid SUD, hepatitis and HIV were not reported as often as expected. We identified associations between professional groups and response preferences related to comorbid SUD, low motivation, living arrangements and communication difficulties. UK respondents used behavioural treatments more than their US counterparts. US respondents more often reported using objective methods of measuring retention such as urine analysis, compared to their UK counterparts. The findings from this survey suggest that regional differences exist between US and UK based SUD treatment service workers. Personality disorders represented the most often experienced obstacles to treatment retention amongst patients with OUD, with mental health and social problems more often reported than comorbid drug problems or physical health problems. Statistically significant relationships exist between professional group and obstacles reported. These data may be used to identify additional training needs amongst SUD treatment service staff.

Youth Empowerment in Prevention of Drug Abuse in Muara Badak Ulu Village, Muara Badak District, Kutai Kartanegara Regency, East Kalimantan Province

This drug problem is very troubling among teenagers. Where more and more teenagers are involved in drug abuse. Adolescence is a very appropriate target to be used as a strong foundation in preventing the increasingly widespread drug abuse. The aim of this service is to empower teenagers in preventing drug abuse in Muara Badak Ulu Village, Muara Badak District, Kutai Kartanegara Regency. The method used is through lectures and discussions. The results of community service activities for 10 teenagers in Muara Badak Ulu Village, Muara Badak District, are that it is hoped that teenagers can fortify themselves with faith and positive activities so that they can avoid drug abuse and become a successful and happy generation in the future.

Development of Co-Crystallization Technique to Improve Solubility of Anti-Diabetic Drug

Co-crystallization is a useful crystal engineering approach for changing the physiochemical and structural characteristics of drug crystals. Pharmaceutical co-crystals are nonionic supramolecular complexes that can be utilized in pharmaceutical development to change physiochemical qualities including solubility, stability, and bioavailability without changing the chemical makeup of API. Canagliflozin Hemihydrate is a anti-diabetic drug. Canagliflozin belongs to class IV drug in BCS classification. i.e. low solubility and low permeability. The major problem of this class drug is it slow solubility in biological fluids,which results into poor bioavailability after oral administration. The purpose of this study was to prepare pharmaceutical co-crystals ofCanagliflozin to enhance solubility and dissolution rate by using co-crystallization technique. The co-former used inthis study is Thiourea. The Optimized co-crystal was characterized by FTIR, XRPD, SEM and other pharmaceutical properties like solubility and melting point were alsoevaluated.

Peranan Sekolah dalam Upaya Pencegahan Penyalahgunaan Narkoba di Kalangan Pelajar

The drugs problem in Indonesia is still complex and urgent. This is important because, in the last 10 years, this drug problem has been rife and has become news in various media so it has become widespread. Evidence that can be seen together is the continued increase in the number of drug abusers or addicts significantly, accompanied by an increase in the number of disclosures of drug crime cases, which have increasingly varied patterns and the larger and more complex the networks or syndicates. Drug trafficking has spread to many groups, ranging from adults, teenagers, students, and even children. The purpose of carrying out Community Service Activities is to build an introduction and understanding of the types and dangers of drugs and what role schools can play in preventing drug abuse among students. PkM activities are carried out for 1 day, namely on Wednesday 12 July 2023, and are carried out using the method of raising awareness or increasing understanding of a problem in the form of activities in the form of counseling or material lectures aimed at students and the school with the title "The Role of Schools in Efforts Prevention of Drug Abuse among Students". The counseling or lecture method interspersed with discussions was chosen by the team as the most effective method for introducing and strengthening understanding of the dangers of drugs to school officials and students. Narkoba is an abbreviation of Narcotics, Psychotropics, and Addictive Materials. In various kinds of literature, it is explained that the notion of narcotics is a substance/substance that can affect a person's psychological/psychological condition (thoughts, feelings, and behavior) and can cause physical and psychological dependence. Regarding the role of the school in efforts to prevent drug abuse among students, it is divided into two forms, namely the role of the school (the school) and the role of students who can collaborate with the school.

Schools and Juvenile Treatment Drug Courts: A Case Study on Treatment Access through Collaboration and Advocacy

Abstract Adolescent substance use is typically addressed from the perspectives of school personnel (e.g., teachers, school counselors, social workers, and resource officers) who interact daily with students in school settings. Consequences of adolescent substance use in the schools may include suspension or expulsion and possible legal involvement. However, many adolescents do not have access to evidence-based treatment to address drug and alcohol use. Services are often not available or fragmented, resulting in poor compliance with treatment and inadequate treatment outcomes for youth. Cross-sector collaboration among schools, community behavioral health agencies, and juvenile court service units offers an opportunity to improve access to care and efficiency in delivering care to adolescents with drug and alcohol problems. Illuminated through a single case study, embedded substance use treatment in schools through partnerships with the court service unit and community behavioral health providers can increase access to care. Counselors and social workers play a key role in advocating for joint efforts to increase service access and improve treatment outcomes. Advocacy efforts may include participation and leadership in community coalitions, training and consultation in evidence-based practices, and seamless communication across all organizations that serve youth with substance use disorders.

Delineation of the distinct inflammatory signaling roles of TAK1 and JAK1/3 in the CIA model of rheumatoid arthritis.

Rheumatoid arthritis (RA) is a complex autoimmune disease characterized by hyperactive immune cells within the joints, which leads to inflammation, bone degeneration, and chronic pain. For several decades, frontline immunomodulators such as the anti-tumor necrosis factor (TNF) biologics adalimumab (Humira), etanercept (Enbrel), and infliximab (Remicade) have successfully managed disease progression for many patients. However, over time, patients become refractory to these treatments requiring chronic disease to be managed with conventional and more problematic disease modifying antirheumatic drugs such as methotrexate and hydroxychloroquine, and corticosteroids. Due to the large proportion of patients who continue to fail on frontline biologic therapies, there remains an unmet need to derive novel alternative targets with improved efficacy and safety profiles to treat RA. Recent advances in the field have defined novel targets that play important roles in RA pathology, including the Janus activated kinase (JAK) and transforming growth factor beta activated kinase-1 (TAK1). Although three inhibitors of the JAK signaling pathway have been approved for the treatment of moderately to severely active RA in patients who failed on one or more anti-TNFs, at present, no FDA approved TAK1 treatments exist. Our recent discovery of a highly potent and selective, orally bioavailable TAK1 inhibitor has provided insight into the therapeutic potential of this protein kinase as a novel target for RA. Here, we show the distinct cytokine signaling of tofacitnib (Xeljanz; JAK1/3 inhibitor) compared to HS-276 (TAK1 inhibitor) in lipopolysaccharide (LPS) challenged THP-1 cells. Furthermore, in the collagen induced arthritis pre-clinical mouse model of RA, both tofacintib and HS-276 attenuated disease activity score and inflammatory cytokines in the serum. Overall, our results delineate the distinct cytokine signaling of JAK1/3 and TAK1 targeted therapies in vitro and in vivo and suggest that selective TAK1 inhibitors may provide superior therapeutic relief in RA with fewer adverse events.

Training on Procedures for Using Good and Correct Medicine for Health Cadres at the Surobayan Sedayu Mosque

During the pandemic and post-pandemic times, public awareness of health has increased. This condition, of course, must be accompanied by increased health knowledge, including knowledge about medicine. The Al-Hikmah Surobayan Mosque Foundation and LAZISMU Sedayu are starting a health center for residents, so this community service is aimed at training health cadres regarding drug problems. The community service, which took place at the Al-Hikmah Mosque Health Center on March 5, 2023, was attended by 22 health cadres aged 50.78 years. In this activity, the speakers were pharmacists from the pharmacist profession study program FKIK UMY and pharmacists from the UAD pharmacy faculty, assisted by students who were members of PIO activities.The training was carried out in stages, starting with a brief introduction to the types of drugs, then how to use drugs, store drugs, and recognize signs of drug side effects. This service collaborated with the Faculty of Pharmacy Ahmad Dahlan University collaborators. The results of the community service that has been carried out show increased knowledge of cadres and the community regarding drugs, as indicated by an increase in the average post-test score (from 69.1 to 81). This activity was continued by sending students who are members of the Drug Information Center (PIO) during the opening hours of the health center on Saturday and Sunday. The pharmacist must assist cadres on an ongoing basis to escort the health center to the Pratama clinic

Living with siblings’ drug use. Bereaved siblings’ family stories

ABSTRACT Family members’ problematic drug use is challenging for siblings affecting their well-being and their relationships within the family. Research about siblings living with brothers or sisters’ problematic drug use and research on bereaved siblings’ experiences indicates that life situations and support needs for both minor siblings and adult siblings can easily be overlooked, both in practice and in research. This article contributes to this knowledge gap by examining how siblings provide meaning to their sibling’s drug use problem and how they position themselves and other family members accordingly. Qualitative semi-structured interviews were used for data collection, and fourteen bereaved siblings were interviewed. A narrative thematic analysis was chosen, and four themes were generated. These four themes, (1) Surviving difficult family life, (2) The relationships in continuous change, (3) It’s worse for the parents, and (4) “We”, as a synonym for the family, are presented in this article. Our findings demonstrated how complex and multifaceted siblings’ stories about living with their brothers or sisters’ ongoing drug use are. This study calls for more attention to siblings’ situations. Siblings’ lives are affected by their brothers or sisters’ problems, and siblings should also be involved in routine support and treatment practices.

Condom Use at Last Sex and Sexual Negotiation Among Young African American Women in North Carolina: Context or Personal Agency

African American women are 10.8 times more likely to be diagnosed with HIV compared with White women. This descriptive study fills a gap by examining associations among social and contextual factors and sexual communication, condom use, and safer sex negotiation among African American women. Study participants between 18 and 25 years of age and who reported recent substance use were recruited from three North Carolina counties. A risk behavior survey was administered via audio computer-assisted self-interview, and logistic regression analyses were conducted to assess associations between social and contextual variables and condom use at last sex with a main partner. Education (AOR: 2.078; 95% CI: 1.214, 3.556), sexual communication with a main partner (AOR: 1.079; 95% CI: 1.050, 1.109), and condom use relationship scale (AOR: 1.059; 95% CI: 1.023, 1.098) were positively associated with condom use at last sex, whereas living with a main partner (AOR: 0.447; 95% CI: 0.210, 0.950) and the alcohol and drug problem scale (AOR: 0.971; 95% CI: 0.944, 0.998) were negatively associated with condom use (p < 0.05). The study findings show that among young African American women at risk for HIV, contextual and personal factors may influence condom use. A socio-ecological approach combining personal empowerment, interpersonal, structural, and biobehavioral strategies is necessary in implementing holistic gender-focused HIV prevention programs.

Deep learning-assisted multicolor fluorescent probes for image and spectral dual-modal identification of illicit drugs

llicit drug detection is an important part of drug problem management, and existing detection strategies suffer from inefficiency and narrow scope of application, which cannot fully meet the needs of practical work. Here, a multi-color fluorescent carbon dots was synthesized in one step and used as probes for the fluorescence sensing detection of three habitual illicit drugs, heroin, ketamine and methamphetamine. The fluorescence response results were recorded in the form of image fixation and spectral detection, which contained the subtle fingerprint information of these illicit drugs. Further, a multi-modal detector based on multi-task deep learning was constructed to achieve qualitative and semi-quantitative illicit drug detection, with accuracies of 98.4 % and 84.4 % for image and 99.9 % and 99.6 % for spectral, respectively, and a broad detection range from 1 ng/mL to 1 mg/mL. The process showed that deep learning significantly enhanced the detection sensitivity and range of fluorescent probes, and the dual-modal image-spectrum recognition met the practical needs of illicit drug on-site fast detection and accurate analysis, providing a new technical solution for illicit drug detection.

Associations between DSM-5 posttraumatic stress disorder Criterion E2 endorsement and selected self-destructive behaviors in recent-era veterans: A focus on disordered eating.

Revisions to the posttraumatic stress disorder (PTSD) criteria in the DSM-5 included a new criterion in the alterations in arousal and reactivity cluster (i.e., engagement in reckless and self-destructive behaviors; Criterion E2). Despite its clinical significance, little is known about how this symptom corresponds to engagement in specific direct and indirect self-harm behaviors. We examined associations between E2 and self-reported recent engagement in direct and indirect self-harm behaviors, including disordered eating, which is not included in the prototypical E2 symptom scope, in a trauma-exposed sample of 1,010 recent-era veterans (61.5% self-identified women, 38.5% self-identified men). We also tested whether gender moderated these associations. We repeated analyses in a subsample of participants with clinically elevated PTSD symptoms. Participants self-reported past-month PTSD symptoms (PCL-5) as well as past-month nonsuicidal self-injury, suicidal ideation, suicide planning, fasting, purging, binge eating, compulsive exercise, and problematic alcohol and drug use. We found no evidence for moderation by gender for any of the behaviors examined in the main sample. However, after controlling for gender and demographic covariates, weighted logistic regressions showed small, significant associations between E2 score and direct self-harm behaviors, substance use, purging, and binge eating, aORs = 1.30-1.91. Criterion E2 was linked to behaviors included in the typical symptom scope (self-directed violence, substance use) and those that are not (disordered eating behaviors). Comprehensive screening for self-destructive behaviors, including disordered eating, among veteran men and women who endorse Criterion E2 is indicated.

PERAN BADAN NARKOTIKA NASIONAL DALAM INTERVENSI BERBASIS MASYARAKAT UNTUK MENGURANGI PENYALAHGUNAAN NARKOBA (Studi Deskriptif Pada Remaja di Desa Pesanggrahan Kota Batu)

The problem of drugs has become a global issue and is a problem in many countries. This shows that drug crime has become a transnational and dangerous activity. The condition of drug abuse and illicit trafficking has now penetrated to the rural level, and has even spread to remote villages. With a government program that focuses on the welfare of rural communities and has an impact on improving the village economy, it turns out that the village is a potential market for drug dealers. This study aims to determine the role of the National Narcotics Agency in reducing Drug Abuse through Community-Based Interventions. This research uses descriptive research type and qualitative research approach. Determination of the research location using a purposive area technique. The technique of determining the informants used purposive sampling. Data collection techniques were carried out using observation, interviews, and documentation. Techniques for systematic data analysis are data collection, data reduction, data display, conclusion drawing, and verification. In this study, researchers used the technique of data validity triangulation of sources The results showed that the role of the National Narcotics Agency in Reducing Drug Abusers through Community-Based Interventions included: 1. The National Narcotics Agency played a role in the initial formation of the Community-Based Intervention Program, 2. The National Narcotics Agency played a role in providing assistance to face various obstacles, 3 The National Narcotics Agency plays a role in facilitation, namely providing motivation and support, 4. The National Narcotics Agency plays a role in initial monitoring and final monitoring to record weaknesses and problems encountered, 5. The National Narcotics Agency plays a role in evaluation to find out whether the program or activity is achieving results desired or not as a consideration in making decisions regarding program planning and program implementation.

Prevalence of substance use and mental health problems among transgender and cisgender U.S. adults: Results from a national probability sample

Transgender individuals experience numerous health disparities relative to cisgender individuals. However, most transgender-health studies have focused on convenience samples with limited generalizability. This study utilized data from the 2016–2018 TransPop Study, the first national probability sample of transgender adults (n=274) with a cisgender comparison sample (n=1162). Using multivariable logistic regression, adjusted for demographics, we compared the prevalence of hazardous drinking, problematic drug use, serious psychological distress, suicidality, and non-suicidal self-injury between transgender and cisgender individuals and among transgender men (n=78), transgender women (n=120), and transgender nonbinary individuals (n=76). Among transgender individuals, 28.2% (95%CI 21.2–35.2) and 31.2% (95%CI 23.8–38.7) reported hazardous drinking and problematic drug use, respectively; 44.4% (95% CI 35.8–53.0) reported recent suicidal ideation, 6.9% (95% CI 2.3–11.5) reported a recent suicide attempt, and 21.4% (95% CI 14.5%-28.4%) reported recent non-suicidal self-injury. In their lifetime, 81.3% (95%CI 75.1–87.5) of transgender respondents had suicidal ideation, 42.0% (95%CI 34.2–49.8) had attempted suicide, and 56.0% (95% CI 48.2–63.8) reported non-suicidal self-injury. Most (81.5%; 95%CI 75.5–87.5) had utilized formal mental health care and 25.5% (95%CI 18.5–32.4) had sought informal mental health support. There were no differences in alcohol or drug-use outcomes between transgender and cisgender adults. Compared to cisgender adults, transgender adults had higher odds of serious psychological distress (aOR=3.1; 95%CI 1.7–5.7), suicidal ideation (recent: aOR=5.1, 95%CI 2.7–9.6); lifetime: aOR=6.7, 95%CI 3.8–11.7), lifetime suicide attempts (aOR=4.4, 95%CI 2.4–8.0), and non-suicidal self-injury (recent: aOR=13.0, 95%CI 4.8–35.1); lifetime: aOR=7.6, 95%CI 4.1–14.3). Transgender nonbinary adults had the highest odds for all outcomes, including substance use outcomes. Findings from these national probability samples support those of earlier convenience-sample studies showing mental health disparities among transgender adults relative to cisgender adults, with nonbinary individuals at highest risk. These findings also highlight variations in risk across sub-groups of transgender individuals.