Australian medical experts are meeting in Melbourne on Friday in a bid to tackle increasing problems surrounding prescription painkillers.
The meeting involving pain and addiction medicine specialists and Victorian government health officials will discuss ways to tighten guidelines around prescribing painkillers.
It comes after revelations in recent weeks that vials of the powerful painkiller fentanyl belonging to Ambulance Victoria had been emptied and replaced with water, with several paramedics stood down.
Concerns over a black market for the same drug in regional Victoria, with reports pensioners were selling their medication to supplement welfare payments, have also prompted the meeting.
Meanwhile, the latest figures from the National Drug and Alcohol Research Centre showed a spike in the number of overdoses from opioids including heroin and prescription painkillers such as oxycodone, also known as oxycontin.
The report found there were 500 accidental opioid drug overdoses in 2008 with preliminary figures suggesting there were 612 in 2009 and 705 in 2010.
The biggest increase in these deaths was in Victoria, with a 133 per cent increase from 73 in 2001 to 170 in 2008.
The state had the highest proportion of deaths at 34 per cent in 2008 as well as the highest rates of death (56.5 per million).
Former dean of the Australian and New Zealand College of Anaesthetists' Faculty of Pain Medicine (FPM), Dr David Jones said opioids should not be the first option to treat aches and pains.
"They should be considered only for severe pain with a fair attempt made to define an identified cause, when other reasonable measures have failed, and only after careful assessment of the patient," Dr Jones said in a statement.
"Most importantly, any pain management plan involving opioids must include an exit strategy for withdrawal."
Under FPM principles, doctors and patients must discuss a treatment plan to first trial opioids with an agreement to discontinue the trial if certain goals are not met.
Only one doctor should prescribe the opioids, with one pharmacy dispensing the drugs and no early repeats or loss replacements, according to the faculty's principles.
Any agreed actions from the meeting will be presented to the Victorian health department for consideration and distributed to medical professionals nationwide.
The meeting includes members of the Victorian Department of Health, the Victorian Medical Board, the Australian Medical Association, the Royal Australian College of General Practitioners and the Royal Australian and New Zealand College of Psychiatrists.