Non-medical use of prescription drugs, polysubstance use, and mental health in transgender adults.

BACKGROUND: In recent years, the non-medical use of prescription drugs (NMUPD) has increased dramatically and has been associated with adverse health outcomes. Prior work has not examined this behavior in large samples of transgender adults.

METHODS: Transgender adults (N=155) recruited from community venues in the Mid-Atlantic region completed anonymous, self-administered surveys assessing demographic information, NMUPD and other substance use, the non-medical use of hormones, psychosocial factors, and psychiatric symptoms.

RESULTS: Overall, 26.5% of participants reported lifetime NMUPD with the most commonly reported medications used non-medically being prescription analgesics (23.9%), anxiolytics (17.4%), stimulants (13.5%), and sedatives (8.4%). Non-medical use of hormones was also frequently reported (30.3%). Participants reporting NMUPD were also more likely to report the use of illicit drugs. NMUPD, but not the non-medical use of hormones, was associated with lower self-esteem, more gender identity-based discrimination, and more self-reported symptoms of anxiety, depression, and somatic distress. Psychiatric symptoms remained statistically associated with NMUPD after controlling for demographic factors and other substance use.

CONCLUSIONS: Prescription drug misuse was relatively common in this sample and was robustly associated with emotional distress. Substance use and mental health interventions for this population may benefit from incorporating the assessment and treatment of NMUPD.