A NSW coroner "deeply troubled" by evidence at an inquest into six opioid-related deaths has recommended the premier host a drug summit to develop evidence and human rights-based policy.
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Deputy State Coroner Harriet Grahame delivered her findings on Friday into the accidental drug overdose deaths of five men and one woman, who cannot be named for legal reasons, as a result of heroin or multi-drug toxicity in 2016.
The inquest, called after a spike in drug-related deaths that year, heard that there is "considerable slippage and overlap" in the use of the terms opiate and opioid however they include morphine, codeine, heroin and fentanyl.
"Lowering the rate of opioid overdose is clearly achievable but it will require a government willing to listen to health experts and to act decisively on their advice," Ms Grahame said.
"As former commissioner of the Australian Federal Police, Mick Palmer, told the inquest, it will require us to rethink our drug policy - 'we can't prohibition our way out of the current problem'."
The coroner made a number of recommendations including that the Department of Premier and Cabinet host a drug summit to consider ways of reducing drug overdose deaths and minimising harm to users, their families and the community.
Decriminalising personal use of drugs and reducing the stigma and shame currently associated with drug use should be fully and genuinely considered at the expert conference, she said.
Ms Grahame further recommended an action plan be developed after the summit with a comprehensive whole of government and community approach to managing illicit drug use.
She also made a number of recommendations to NSW emergency services and the state's health and justice departments regarding naloxone nasal spray - a medicine that can be administered to reverse opiate overdose.
"I remain deeply troubled by the evidence arising from this inquest," the coroner said.
"In my view, it clearly establishes that many opiate and opioid-related deaths are genuinely preventable if we, as a community, are prepared to rethink our approach to drug policy."
NSW Labor has pledged to hold a summit with police, addiction specialists and other stakeholders if elected on March 23.
"The Berejiklian government has refused to acknowledge the seriousness of drugs in our community and ignoring the experts is not the answer," opposition health spokesman Walt Secord said in a statement on Friday.
"As the NSW coroner has said - the time for a drug summit is now."
Ms Grahame will oversee an inquest later this year into the deaths of five people killed by suspected drug overdoses at music festivals in late 2018 and early 2019.
Premier Gladys Berejiklian commissioned an expert panel to investigate the festival deaths but its terms of reference restricted it from considering pill testing.
Australian Associated Press