Association between trends in county-level opioid prescribing and reported rates of gonorrhea cases in the United States

Purpose: We investigated the association between county-level trends in opioid prescribing rates, a proxy for opioid misuse, and rates of reported gonorrhea (GC) among males in the United States. Methods: We used linear mixed-model regression analyses to evaluate the association between county level trends in opioid prescribing rates and rates of reported GC among males during 2010-2015. Results: There was a positive association between trends in county-level opioid prescribing rates and rates of GC among males (beta = -0.068, 95% confidence interval [Cl] = -0.030, -0.105) during 2010-2015. However, the magnitude of this association decreased significantly over time in counties where opioid prescribing rates decreased (beta = -0.018, 95% Cl = -0.030, -0.006) and remained stable (beta = -0.020, 95% Cl = -0.038, -0.002) but was unchanged in counties where opioid prescribing rates increased (beta = -0.029, 95% Cl = -0.058, -0.001). Conclusions: During 2010-2015, we found a positive association between increases in county-level opioid prescribing rates, a proxy for opioid misuse, and rates of reported GC among males especially in counties most affected by the opioid crisis. Integrating sexual health with opioid misuse interventions might be beneficial in addressing the GC burden in the United States. Published by Elsevier Inc.