In Victoria, 632 people died from drug overdoses in 2025, the highest level in a decade, according to a Victorian Coroners Court report on Wednesday.
This more than doubles the 291 road deaths in 2025, according to Transport Accident Commission figures, for the second year running.
"That is an absolutely tragic figure," Scott Drummond, interim chief executive at the Victorian Alcohol and Drug Association told AAP of the annual overdose deaths in 2025.
"That is the human cost of Victoria's overdose crisis."
The increase in overdose fatalities continues a decade long trend, but the latest figures point to some changes in drug type, reasons for consumption and demographies.
Relative to alcohol and pharmaceuticals, illicit substances are playing an increasingly large role in contributing to fatal overdoses in Victoria.
Illegal drugs, notably heroin, methamphetamine and GHB, contributed to 66.9 per cent of overdose deaths in 2025.
The share of overdose deaths linked to illicit drugs has increased substantially over three years, nudging pharmaceuticals as the top contributor, at 67.1 per cent in 2025.
Meanwhile, Greater Geelong emerged as the local government area with the highest number of fatal overdoses in 2025.
It recorded 45 deaths over the year, overtaking Melbourne, which recorded 41 fatal overdoses, for the first time on record.
That finding suggests regional support services, including harm reduction initiatives, are in dire need of greater funding, Mr Drummond said.
It follows calls from Victorian Coroner Simon McGregor for a safe injecting room in the area following the overdose death of a woman in 2025.
The 33-year-old, referred to as BP in the coroner's report in August, was found unresponsive in her St Albans Park bedroom with a cocktail of drugs in her system.
Coroner McGregor said the woman had a long history of drug use, including heroin, and that local harm reduction services were needed to combat rising heroin overdoses.
"I am not the first Victorian Coroner to have raised these concerns," he wrote in his findings.
Mr Drummond argued Wednesday's findings should be a "wake-up" call to policymakers, adding treatment providers had been calling out for support.
Without an increase in harm-reduction services, including medically supervised injection rooms, and treatment places, overdose deaths will continue to climb, he said.
"I don't want to be back having conversations on this topic next year when (annual overdose deaths are) approaching or over 700," he said.
"I offer my heartfelt condolences to all touched by this preventable public health crisis."
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