Most people taking opioid medication who do not need it for health reasons are sourcing it legally from pharmacists and doctors.

More than half the people who abuse painkillers buy them at a pharmacy over the counter, while another 18 per cent usually obtain them with a medical prescription.

The report by the Australian Institute of Health and Welfare found there was a 24 per cent jump in prescriptions for opioid medication in three years to mid-2015, while the rates of the prescription of oxycodone jumped 60 per cent during the same period.

Australia could face an opioid epidemic like the one in the United States, which is experiencing the worst drug crisis in its history, unless prescription safeguards were strengthened, the institute's report warned.

Last year there were 60,000 drug deaths in the US, including more than 20,000 from synthetic opioids such as synthetic painkiller fentanyl.

"The level of addiction to pharmaceuticals in the USA, and subsequent rise in overdoses, provides insight into the potential harms Australia could experience if safeguards preventing their non-medical use are not strengthened," the report said.

Safeguards on the way in Australia include the controversial ban on over-the-counter codeine, such as Nurofen Plus and Panadeine, which begins in February.

The federal government has recently committed $16 million for a real-time prescription monitoring scheme for addictive medicine, but a national model is yet to be implemented, and is at least a year away.

Pharmaceutical Society of Australia president Shane Jackson said that without real-time prescription monitoring, GPs and pharmacists would continue to struggle to identify when people were shopping around for medication, although he noted Victoria and Tasmania had already pushed ahead with their own initiatives.

He said there also needed to be better management of chronic pain.

"We need to do pain better, because that's where a large proportion of these issues are coming from," Dr Jackson said.

Pharmacy Guild of Australia president George Tambassis??? said pharmacists were concerned about people leaving hospitals with huge bags of medication - and more work should be done to make sure people were not doubling up on drugs, or taking addictive drugs for long periods.

The number of Australians dying drug-related deaths has now far outstripped the road toll. More than 1290 people died on Australian roads in 2016, compared with at least 1800 linked to drugs.

About 550 of those deaths were related to prescription painkillers such as oxycodone, morphine and codeine (a 168 per cent rise in a decade) and 663 to tranquillisers and sleeping pills called benzodiazepines.

Although the prescription of benzodiazepines has been falling since 2010, about 1.81 million prescriptions of diazepam and 1.57 million prescriptions of temazepam were dispensed in 2014-2015.