Tony is HIV positive and takes opioid medication, like fentanyl, for chronic pain relief.

Opioid usage in Australia Fentanyl is 100 times stronger than morphine

Fentanyl is 100 times stronger than morphine It is prescribed for cancer and acute pain

It is prescribed for cancer and acute pain Just 0.25 milligrams of fentanyl can kill

Just 0.25 milligrams of fentanyl can kill Opioid prescriptions have increased by 4 million since 2009

Opioid prescriptions have increased by 4 million since 2009 Opioids account for 26 per cent of all drug-related deaths

The prescriptions stopped when his doctor found out about his illicit drug use, and so he now shops for the drug on the black market.

"I was really sick and I have depression, so opioids like Fentanyl patches really killed two birds with one stone — giving me pain relief but it also makes me feel better," said the 52-year-old, who preferred not to give his surname.

"I pay around $20 for a piece of Fentanyl, but the street value is around $50-$100 a piece.

"Sometimes it will be an exchange of a few packets of cigarettes or a hug."

Fentanyl made headlines in 2016 when popstar Prince was one of 64,000 people in the United States who died from a drug overdose, with opioids largely to blame.

Pain specialist Jennifer Stevens is among some doctors who fear Australia is on the verge of an epidemic of its own.

"We are not quite there yet but we are about four or five years behind the situation in the United States," she said.

Regional areas worst affected

Opioid prescriptions here increased from 10 million per year in 2009 to 14 million per year at the end of 2017 — that is an increase of 40 per cent over the past eight years.

"We know more people are taking prescription opioids like Fentanyl in rural and regional areas, where patients don't have the same access to chronic pain clinics and there's also less support for the GPs," Dr Stevens said.

More than a quarter of all drug-related deaths are now due to opioids, with almost a third of that figure blamed specifically on Fentanyl, according to NSW Police data.

"Fentanyl is really dangerous. It's 100 times stronger than morphine and where patients are wearing patches, they can often sometimes forget about it and that can prove fatal," Dr Stevens said.

Pharmaceutical opioid deaths are now around 2.5 times more common than heroin deaths — the reverse of what was seen in the 1990s.

Patients attacked for drug

Fentanyl is about 100 times more potent than morphine. ( Lucy Barbour )

NSW Users and Aids Association chief executive Mary Harrod said more drug users were turning to Fentanyl, particularly in country towns where heroin was in short supply.

"Fentanyl comes from a chemist, so users know what they are getting and they know that it's clean and pure. Most of the time they are getting it off friends or relatives," she said.

One elderly woman, who lives in Walgett, told the ABC she had been approached by a stranger on the street wanting to purchase Fentanyl patches.

Other patients reported being attacked or threatened, mostly in regional cities in central western New South Wales.

"I have heard that some people have been physically harassed because they were seen picking up some prescription Fentanyl patches," Dubbo pharmacist Greg Shearing said.

"Some patients are even approached by family members of friends wanting to get their hands on the medication, which has become a highly sought after commodity," he said.

A NSW coronial inquest this week heard that three of the six people who fatally overdosed on opioids in the state in May 2016 had fentanyl in their system.

Doctors, medical professionals and drug advocates raised the need to make the drug Naloxone more readily available to police officers and the relatives of opioid users.

"Naloxone reverses the effects of an overdose, it restores breathing and consciousness on the spot and it really could save so many lives," Ms Harrod said.

"But it's not always easy to get at a chemist."

The inquest will resume in August before recommendations are handed down before the end of the year.