Stochastic differential equations (SDE) often exhibit large random transitions. This property, which we denote as pathwise stiffness, causes transient bursts of stiffness which limit the allowed step size for common fixed time step explicit and drift-implicit integrators. We present four separate methods to efficiently handle this stiffness. First, we utilize a computational technique to derive stability-optimized adaptive methods of strong order 1.5 for SDEs. The resulting explicit methods are shown to exhibit substantially enlarged stability regions which allows for them to solve pathwise stiff biological models orders of magnitude more efficiently than previous methods like SRIW1 and Euler-Maruyama. Secondly, these integrators include a stiffness estimator which allows for automatically switching between implicit and explicit schemes based on the current stiffness. In addition, adaptive L-stable strong order 1.5 implicit integrators for SDEs and stochastic differential algebraic equations (SDAEs) in mass-matrix form with additive noise are derived and are demonstrated as more efficient than the explicit methods on stiff chemical reaction networks by nearly 8x. Lastly, we developed an adaptive implicit-explicit (IMEX) integration method based off of a common method for diffusion-reaction-convection PDEs and show numerically that it can achieve strong order 1.5. These methods are benchmarked on a range of problems varying from non-stiff to extreme pathwise stiff and demonstrate speedups between 5x-6000x while showing computationally infeasibility of fixed time step integrators on many of these test equations.