Victoria's heroin death toll is at its highest level in 17 years and overdose hot spots are spreading beyond the notorious inner-city suburb of Richmond, a coroner has said.

Coroner Audrey Jamieson found heroin was the main contributor in 220 overdose deaths in Victoria in 2017, more than double the number in 2012.

This is the highest toll since the "heroin drought" of late 2000, when the supply of the drug on Melbourne's streets plummeted.

The new figures also show heroin accounted for the vast majority of the state's total illegal drug overdose fatalities in 2017.

It comes after Ms Jamieson investigated the heroin overdose death of 24-year-old Samuel Morrison at his suburban Melbourne home in June 2016.

Heroin was a main contributor in the 220 overdose deaths recorded in Victoria last year. Picture: iStock (iStock)

The case prompted her to order a broader report on the state's drug overdoses, focusing particularly on heroin-related fatalities.

As well looking at the number of heroin overdoses, the report examined the locations, finding the City of Yarra had 16 deaths in 2017.

But heroin deaths in Yarra, which encompasses the hot spot of North Richmond where a safe injecting room was opened in June, actually fell slightly in recent years.

The City of Brimbank, which is in Melbourne's northwest and includes the suburbs of Sunshine and St Albans, recorded the most heroin overdoses in 2017 with 19 deaths.

Ms Jamieson has said the data suggests the rise in heroin-related deaths is manifesting in a number of areas across metropolitan Melbourne.

She threw her support behind the Medically Supervised Injecting Centre in North Richmond and hoped it marked the start of a renewed and broadly co-ordinated push to prevent harm to people who inject drugs.

"So that lessons learned from interventions in one area are shared and applied in a timely manner to other areas where they could have a positive impact on the lives of people who inject drugs," she wrote.

The figures also showed the City of Yarra was the only local government area where the majority of overdoses were of people who didn't live in that area.

"The City of Yarra attracts people from other areas to use heroin to an extent that does not occur anywhere else," Ms Jamieson wrote in her report.

Meanwhile, overdoses from methamphetamine dropped from 119 deaths in 2016 to 91 in 2017, although that figure is still nearly triple what it was in 2012.

Total drug overdoses in Victoria are also on the rise with 523 recorded in 2017, including both legal and illegal drugs, the figures show.

The sedative Diazepam, also known as Valium, was responsible for the highest number of fatal overdoses with 242 in 2017, up from 133 in 2012.