A Morphine Prescription Program in Italy (1980-1985): Retrospective Evidence of Protection Against Hiv/Aids

Abstract

The purpose of this study was to determine if morphine programines implemented in the city of Naples between 1980 and 1985 might have contributed to the low HIV prevalence rate detected among injecting drug users (IDU's). A case-control study was condusted, comparing 69 HIV-positive and 266 HIV-negative IDU's attending a large drug treatment centre in Naples in the period 1980-84. Cases were less likely than HIV-negative controls to have been prescribed morphine, though the difference was only marginally significant (odds ratio = 0.57; 0.20-1.35). The results suggest that HIV infection tended to be less common among those prescribed morphine. These findings are somewhat unexpected considering that the alternative treatment was represented by methadone provided orally. However, methadone was often given at low, insufficient doses, and was associated with persistent unsafe drug infection. Persons prescribed morphine were able to visit pharmacies every day where they were also able to purchase sterile injection equipment. The suspension of the morphine programmes should be re-evaluated on the basis of these new results.