A retired judge has backed calls for more drug rehabilitation centres in the bush, warning addicts in regional areas are too often thrown behind bars.

John Nicholson SC served as a New South Wales District Court judge for more than a decade and regularly presided over sittings in Dubbo, where drug-related crime is high.

When sentencing offenders, Mr Nicholson told Background Briefing there were times he had no choice but to impose a jail term.

''I had to take an option that was much less pleasant, but still within the appropriate boundaries of sentencing, and that might be custody,'' he said.

There are no local rehabilitation centres for drug addicts who face court in Dubbo ( ABC News: Nick Lowther )

In these cases, Mr Nicholson said he would have preferred to send offenders to rehab to address the underlying causes of their criminal behaviour.

But unlike Sydney, this is not an option in Dubbo.

''You would think all people should be equal before the law,'' Mr Nicholson said.

''If a range of options in regional New South Wales was denied to a judge when sentencing somebody, it could hardly be said, at least in my view, that that person was equal before the law with those in the city.''

Addicts steal to fuel drug habit

According to first responders, Dubbo is experiencing a drug-related crime epidemic.

In the past eight years, the number of people hospitalised for methamphetamine in the region has risen by over 2,000 per cent.

Rates of theft, a crime often committed to support addiction, are nearly double the state average.

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Politicians and police have previously responded with an expensive law and order crackdown, resulting in over-crowded jails.

That is despite research showing taxpayers save $110,000 each time an offender is sent to rehab instead of prison.

Mr Nicholson said locking people up often exacerbates drug addiction.

"Nobody should think that drugs are not being used in New South Wales prisons,'' he said.

''Very often people would come out with a heightened addiction to drugs.''

Mayor's change of heart

Even committed conservatives are beginning to acknowledge the need for a new approach.

Speaking to Background Briefing, Dubbo Mayor Ben Shields, who has been in local politics for nearly two decades, made an unusual concession for a politician, telling the program his long-standing views have evolved.

Dubbo Mayor Ben Shields no longer thinks a tough-on-crime approach to drugs is the best solution ( ABC News: Bronwyn Adcock )

''To a certain degree it's maturity from me,'' Mr Shields said.

''What did Einstein say about the definition of madness is doing the same thing over and over again and hoping to get a different outcome?

''Well we can't do that all the time, it's simply not working.''

Mr Shields now supports the establishment of a rehab facility in Dubbo.

He has also called for a Drug Court, which would take a public health approach to sentencing offenders.

''I do believe there has been a genuine shift in what a lot of the mainstay conservatives in places like Dubbo are starting to think,'' Mr Shields said.

''Once upon a time there was the 'hang them' attitude. Now it's starting to change and I think society in general are getting a little bit more sophisticated and understanding the root causes of problems.

''We need to have a good serious look at it from an entirely different point of view and realise that yes, there are criminal aspects to this, but it's largely driven by a medical problem that needs to be sorted out.''

Troy Parmount holds a photo of his girlfriend Darlene Smith who died of a drug overdose. ( ABC News: Nick Lowther )

Punishment had 'little or no effect'

Troy Parmount knows what it is like to lose someone to addiction.

He carries a photo around in his wallet of him and his partner, Darlene Smith. He keeps another, larger, laminated photo at home. Both photos were taken during his visits to Darlene when she was in prison.

Mr Parmount and Ms Smith got together when they were in their early thirties. A couple of years into their relationship, he discovered she was using drugs, mainly the powerful prescription painkiller oxycodone.

"She kept it from me for a couple of years … she didn't want to tell me, she thought I was going to leave her, but I didn't. I stuck by her … tried to help her out," he said.

Troy Parmount believes his girlfriend may still be alive if she had been able to go to rehab in Dubbo. ( ABC News: Nick Lowther )

Ms Smith supported her habit by shoplifting. Soon, she started cycling in and out of prison.

A magistrate said she needed to go into residential rehabilitation, but there was no facility in Dubbo.

Ms Smith's uncle, local Aboriginal Elder Frank Doolan, said Darlene's stints in prison did nothing to halt her addiction, and her need to shoplift.

''When she came to the attention of the judicial system, they lined her up and duly punished her and punished her some more, and all of that had a little or no effect,'' he said.

''It was a case of the mouse on the revolving wheel.''

Indigenous elder Frank Doolan says Darlene Smith's death was a tragedy ( ABC News: Bronwyn Adcock )

On a Monday morning in July, 2015, Ms Smith, who had just turned 40, was released from another stint in prison.

On Wednesday morning, Mr Parmount woke up to get ready for work, and found Ms Smith overdosed on the kitchen floor.

"It was already too late,'' he said.

Ms Smith was already dead.

''Every person we lose in circumstances such as Darlene's is a tragedy,'' Mr Doolan said.

''As long as there are Darlene Smiths in this world and as long as society refuses to acknowledge they exist … we're going to have a lot more incidents where women who are mothers … wind up dead on the kitchen floor.''

'No excuse' for government not to act

At one stage, it appeared the NSW Government was poised to act on the Dubbo community's wishes to have a drug court and rehab centre.

When the member for Dubbo and then deputy premier Troy Grant was on the state election campaign trail back in March 2015, he suggested plans were afoot.

''That work is well down the train. It is is close to being finalised," he said.

"I absolutely believe that a rehabilitation centre working with a Drug Court can make a difference."

Mr Grant declined to speak to Background Briefing, but subsequently launched an online survey to gauge community sentiment in Dubbo.

Police say Dubbo is in the midst of a drug-related crime epidemic ( ABC News: Nick Lowther )

Critics were concerned this survey was a delaying tactic and would be deliberately worded to stir up fear.

Nicholas Cowdery, former NSW director of Public Prosecutions, questioned what the questions would be.

"'Do you want a drug court set up in the building next to your house', or something like that?'' he said.

Mr Cowdery said he was concerned Mr Grant was ''framing his questions and pitching his survey to produce a result that would reinforce his own views''.

''We have huge amounts of data now that shows the Drug Court has been an enormously successful initiative and there is no excuse now for not expanding the operation of the Drug Court,'' he said.