This study assessed the impact on benzodiazepine injection among IDU in Sydney of removing temazepam gel capsule preparations from the Australian market.

Several data sources were used: (1) data from the NSW Illicit Drug Reporting System (IDRS) (an annual, cross-sectional survey of regular IDU in Sydney) for the period 1996 - 2005; (2) data from inner Sydney outreach services and the Sydney Medically Supervised Injecting Centre (MSIC) on last drug injected; and (3) national benzodiazepine prescription data, by formulation, from the Drug Utilisation Sub-Committee for the period 2001 - 06.

Removal of temazepam gel capsule formulations from the Australian market in 2004 resulted in increased prescribing of tablet formulations but overall benzodiazepine prescription numbers remained stable. Injection of benzodiazepines ceased as a mode of administration of benzodiazepines among IDU in inner Sydney, but very frequent oral use of benzodiazepines remained highly prevalent.

Removal of an easily injectable form of benzodiazepines appeared to halt injection of benzodiazepines among disadvantaged IDU. However, IDU continue to use the drug heavily and interventions to assist IDU with reducing dependent benzodiazepine use are warranted. There is a need for continued vigilance to emergent injecting drug use risks to implement timely harm reduction strategies.