Cannabis and substance use crisis in vulnerable TNBP communities

This Spanish study reveals a concerning reality: 18.6% of trans and non-binary people (TNBP) reported problematic substance use in the past year, with cannabis being the most common substance involved at 11.8%. Researchers surveyed over 1,500 TNBP aged 15+ between October 2023 and March 2024, using online and community-based recruitment. The findings show that problematic use patterns were significantly linked to social vulnerability factors, including experiences of physical violence, untreated anxiety or depression, engagement in sex work, and lack of university education—highlighting how systemic discrimination creates conditions that drive substance misuse in this population.

The research identified multiple interconnected risk factors that increase vulnerability to problematic substance use. Age (particularly 25-34 years old), combined with mental health struggles and experiences of violence, created compounding risks. Notably, cannabis use was identified as both a substance of concern and a factor associated with broader problematic substance patterns, suggesting that cannabis may serve as a gateway to or coincide with other problematic use behaviors in this vulnerable group. Other substances of concern included non-prescribed tranquilizers (5.2%) and cocaine (2.4%).

These findings underscore a critical public health gap: trans and non-binary individuals face unique barriers to healthcare, social support, and mental health services, which directly correlates with elevated substance use rates. The researchers emphasize that effective interventions must address the root causes of vulnerability—discrimination, social isolation, and untreated mental illness—rather than focusing solely on substance use itself. Targeted harm reduction services, mental health support, and anti-discrimination efforts are urgently needed to address health inequities in this marginalized community.