Fatalities from accidental overdose in rural and regional NSW have doubled since 2008, statistics reveal. 

For the first time, the rest of NSW has surpassed the rate of accidental overdose in Sydney, bucking the perception that overdose is a “big smoke” problem. 

But rather than a rise in illicit drug use, the heightened death rates point to a misuse of prescription pain relief medication, Tamworth regional ambulance inspector Ray Tait said. 

“Instances of heroin overdose have diminished over the past five years,” he said. 

Instead, pharmaceuticals like oxycodone, fentanyl, codeine and benzodiazepines (or Valium) were common culprits for accidental overdose. 

Mr Tait said “the tyranny of distance” impacts rural people, as ambulances can take longer to reach people in the country than in the city. 

Many don’t realise they have overdosed and call 000 too late, he said. 

He urged people to follow doctors’ instructions and not to offer their prescription medication to others. 

“We need to appreciate that prescription drugs are specifically that – prescribed for the individual, not for the population at large. 

Local pharmacist Greg Anderson suggested accidental overdose could be a reflection of poorer literacy and numeracy levels in the country, with people misreading labels and miscalculating dosages. 

He said although “it certainly can happen”, overdosing by accident was “not quite as easy as people would think”.

“With most pain relievers, you’re probably going to fall asleep before you overdose, unless you make a very big error,” Mr Anderson said. 

He said quality heroin is difficult to source in Tamworth, so people “toy with alternatives” and often abuse prescriptions for powerful painkillers. 

The accidental overdose death rate in NSW, excluding Sydney, rose from 2.25 in 2008 to 4.72 per 100,000 people in 2012. The rate was 4.09 in Sydney. 

In 2012, there were 604 accidental overdose deaths in Australian capital cities compared with 327 in regional and rural areas. 

The figures come from the Penington Institute, which analysed data from the 

Australian Bureau of Statistics into separated instances of accidental overdose mortality rates in capital cities compared to the rest of the state.